Introduction: Tuberculosis (TB) is a significant public health problem in Papua New Guinea (PNG). Poor infection prevention and control (IPC) measures in healthcare settings may partly contribute to the high burden of TB in PNG. This study examines the implementation of the TB infection prevention and control (TBIPC) policy introduced by the national health department in 2011 in rural hospitals in the Highlands and Momase region of PNG.

Methods: A self-administered structured questionnaire adapted from the WHO TBIPC framework and site observations were undertaken to assess the TBIPC activities. Questionnaires and observation data were analysed using SPSS. Fishers' exact test was performed to determine the similarities and differences in TBIC practices between the health facilities. Significance was assessed at p<=.05. Ethics approval was given by Griffith University Human Research Ethics Committee (GU Ref No: 2021/921).

Results: Ten of thirteen rural hospitals in the Highlands and Momase region (78%) were surveyed. The majority (N=8,80%) of rural hospitals have inadequate TBIPC programs. Two (20%) facilities have intermediate or advanced TBIPC programs. The facility with advanced TBIPC employed a doctor with public health training. COVID-19 pandemic has provided the impetus to strengthen IPC programs in rural health facilities. Significant differences in TBIPC practices were identified across the two regions (p=0.03).

Conclusion: Overall, TBIPC guidelines were inadequate in rural hospitals in PNG. The significant differences in TBIPC practices in rural hospitals remain a severe challenge to the TB control efforts. Public health training for health workers could play an important role in IPC programs.