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Original Research
Tackling antimicrobial resistance: developing and implementing antimicrobial stewardship interventions in four African commonwealth countries through a health partnership model
Submitted: 03 April 2024 | Published: 21 June 2023
About the author(s)
Diane Ashiru-Oredope, Commonwealth Pharmacists Association (CPA), London, United KingdomMaxencia Nabiryo, Commonwealth Pharmacists Association (CPA), London, United Kingdom
Lisa Zengeni, Ingentium Limited, United Kingdom
Nduta Kamere, Commonwealth Pharmacists Association (CPA), London, United Kingdom
Alexia Makotose, Ingentium Limited, United Kingdom
Omotayo Olaoye, Commonwealth Pharmacists Association (CPA), London, United Kingdom
William Townsend, Tropical Health and Education Trust (THET), United Kingdom
Beatrice Waddingham, Tropical Health and Education Trust (THET), United Kingdom
Ayodeji Matuluko, Commonwealth Pharmacists Association (CPA), London, United Kingdom
Winnie Nambatya, Commonwealth Pharmacists Association (CPA), London, United Kingdom; Pharmacy Department, Makerere University, Kampala, Uganda
Yvonne Esseku, Commonwealth Pharmacists Association (CPA), London, United Kingdom; Ghana College of Pharmacists, Accra, Ghana
Ama Bartimeus, Tropical Health and Education Trust (THET), United Kingdom
Sara Mahjoub, Tropical Health and Education Trust (THET), United Kingdom
Nikki D’Arcy, Commonwealth Pharmacists Association (CPA), London, United Kingdom
Chloe Tuck, Commonwealth Pharmacists Association (CPA), London, United Kingdom
Sarah Cavanagh, Commonwealth Pharmacists Association (CPA), London, United Kingdom
Josef Geoola, Ingentium Limited, United Kingdom
Eva Prosper Muro, Commonwealth Pharmacists Association (CPA), London, United Kingdom; Department of Pharmacology, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania, United Republic of
Derick Munkombwe, Commonwealth Pharmacists Association (CPA), London, United Kingdom; Pharmacy Department, University of Zambia, Lusaka, Zambia
Jessica Fraser, Tropical Health and Education Trust (THET), United Kingdom
Richard Skone-James, Tropical Health and Education Trust (THET), United Kingdom
Victoria Rutter, Commonwealth Pharmacists Association (CPA), London, United Kingdom
Abstract
In recent years, health partnerships have shared infection prevention and control innovations between United Kingdom hospitals and Low-Middle-Income Countries. However, none had focused on antimicrobial stewardship (AMS), a core component of tackling antimicrobial resistance (AMR). This paper documents an effective approach to developing a program to increase AMS capacity in four African countries: Ghana, Tanzania, Uganda, and Zambia as part of the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) program. A systematic approach was applied to assess gaps in AMS interventions and inform the development of the CwPAMS program through deskbased assessments, including National Action Plans on AMR, online focus group meetings, and expert advisory group reviews. Twelve partnerships were selected for the CwPAMS program. AMS support tools were developed based on recommendations from the scoping, including an AMS checklist tool, a healthcare worker knowledge and attitudes questionnaire, and an antimicrobial prescribing app to support clinical decision-making. Training workshops on AMS were developed and delivered to volunteers in Africa and the UK using a train-the-trainer model. The tools and workshops facilitated capacity building for AMS through the generation and strengthening of knowledge, skills, commitment, structures, systems, and leadership among stakeholders in the UK and Africa. The overall average rating assigned to the program following independent evaluation using the Organisation for Economic Cooperation and Development Assistance Committee Evaluation Criteria was very good. The evaluation also highlighted that the majority of the HPs (75%) focused on AMS and/or improved prescribing practice; all HPs have developed and implemented AMS strategies, guidelines, and tools within their hospitals; and NHS staff were able to translate the knowledge and skills they had received early on in the program into clinical practice in response to COVID-19 challenges.</p
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