Email this article 
Hide
Show all
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
Keywords
Metrics
Total abstract views: 3701Total article views: 1809
Crossref Citations
1. An intervention to improve antibiotic prescription behavior in veterinary students: A protocol based on the multi‐theory model to tackle antimicrobial resistance
Laleh Hassani, Razie Toghroli, Teamur Aghamolaei, Hamid Sharifi, Maziar Jajarmi, Manoj Sharma
Health Science Reports vol: 7 issue: 2 year: 2024
doi: 10.1002/hsr2.1886
2. The impact of socioeconomic disparities climate factors and antimicrobial stewardship on antimicrobial resistance in Africa
Yousra A. El-Maradny, Mark Anum Nortey, Clyde M. Hakayuwa, Ebuka Louis Anyamene, J. Jenifer Florence Mary, Stephen Tetteh Engmann, Christopher Yao Tsikata, Duaa Ashraf Ahmed, Chizaram Onyeaghala, Amira M. Heniedy, Samwel Rema Gesaka, Abdullahi Saminu, Majani Edward
Discover Public Health vol: 22 issue: 1 year: 2025
doi: 10.1186/s12982-025-00631-5
3. Current status and future direction of antimicrobial stewardship programs and antibiotic prescribing in primary care hospitals in Zambia
Faustina Makiko, Aubrey Chichonyi Kalungia, Martin Kampamba, Steward Mudenda, Natalie Schellack, Johanna Catharina Meyer, Flavien Nsoni Bumbangi, Michael Okorie, David Banda, Derick Munkombwe, Ilunga Mutwale, Joseph Yamweka Chizimu, Maisa Anita Kasanga, Freddie Masaninga, Zoran Muhimba, Chileshe Lukwesa, Duncan Chanda, Raphael Chanda, Mirfin Mpundu, Chiluba Mwila, Anja St Claire-Jones, Melanie Newport, Roma Chilengi, Israel Abebrese Sefah, Brian Godman
JAC-Antimicrobial Resistance vol: 7 issue: 3 year: 2025
doi: 10.1093/jacamr/dlaf085
4. Global Burden of Fungal Infections and Antifungal Resistance from 1961 to 2024: Findings and Future Implications
Steward Mudenda
Pharmacology & Pharmacy vol: 15 issue: 04 first page: 81 year: 2024
doi: 10.4236/pp.2024.154007
5. Antimicrobial stewardship situation analysis in selected hospitals in Zambia: findings and implications from a national survey
Joseph Yamweka Chizimu, Steward Mudenda, Kaunda Yamba, Chileshe Lukwesa, Raphael Chanda, Ruth Nakazwe, Bwalya Simunyola, Misheck Shawa, Aubrey Chichonyi Kalungia, Duncan Chanda, Uchizi Chola, Tebuho Mateele, Jeewan Thapa, Kenneth Kapolowe, Mazyanga Lucy Mazaba, Mirfin Mpundu, Freddie Masaninga, Khalid Azam, Chie Nakajima, Yasuhiko Suzuki, Nathan Nsubuga Bakyaita, Evelyn Wesangula, Martin Matu, Roma Chilengi
Frontiers in Public Health vol: 12 year: 2024
doi: 10.3389/fpubh.2024.1367703
6. Status and implications of the knowledge, attitudes and practices towards AWaRe antibiotic use, resistance and stewardship among low- and middle-income countries
Zikria Saleem, Catrin E Moore, Aubrey C Kalungia, Natalie Schellack, Olayinka Ogunleye, Audrey Chigome, Kona Chowdhury, Freddy Eric Kitutu, Amos Massele, Nishana Ramdas, E Sam Orubu, Aislinn Cook, Felix Khuluza, Trust Zaranyika, Elisa Funiciello, Giulia Lorenzetti, Miriam Nantamu, Ayuska Parajuli, Amanj Kurdi, Hellen Nabayiga, Ammar Abdulrahman Jairoun, Mainul Haque, Stephen M Campbell, Dena Van Der Bergh, Brian Godman, Mike Sharland
JAC-Antimicrobial Resistance vol: 7 issue: 2 year: 2025
doi: 10.1093/jacamr/dlaf033
7. Antibiotic use at the Centre Hospitalier Universitaire de Zone d'Abomey Calavi/Sô-Ava (CHUZ/AS) in Benin: a point prevalence survey
Morelle Sèssiwèdé Gnimavo, Bawa Boya, Steward Mudenda, Aurel Constant Allabi
JAC-Antimicrobial Resistance vol: 7 issue: 1 year: 2024
doi: 10.1093/jacamr/dlae220
8. Point Prevalence Survey of Antibiotic Use in Level 1 hospitals in Zambia: Future Prospects for Antimicrobial Stewardship Programs
Steward Mudenda, Adriano Lubanga, Shazia Jamshed, Bibian Biemba, Racheal Sakala, Mervis Chiyabi, Lorraine Kavubya, Linda Milambo, Flavien Bumbangi, Joseph Chizimu, Kaunda Yamba, Evelyn Wesangula, Audrey Chigome, Aubrey Kalungia, Israel Sefah, Zia Mustafa, Amos Massele, Zikria Saleem, Richard Mutemwa, Eustarckio Kazonga, Massimo Sartelli, Johanna Meyer, John Muma, Roma Chilengi, Brian Godman
Infection and Drug Resistance vol: Volume 18 first page: 887 year: 2025
doi: 10.2147/IDR.S509522
9. Increasing the use of the WHO AWaRe system in antibiotic surveillance and stewardship programmes in low- and middle-income countries
Zikria Saleem, Samia Sheikh, Brian Godman, Abdul Haseeb, Shairyar Afzal, Muhammad Usman Qamar, Mohammad Tarique Imam, Safa S Almarzoky Abuhussain, Mike Sharland
JAC-Antimicrobial Resistance vol: 7 issue: 2 year: 2025
doi: 10.1093/jacamr/dlaf031
10. Hospital prescribing patterns of antibiotics in Zambia using the WHO prescribing indicators post-COVID-19 pandemic: findings and implications
Steward Mudenda, Robert Chilimboyi, Scott Kaba Matafwali, Victor Daka, Ruth Lindizyani Mfune, Loriane Arielle Mobou Kemgne, Flavien Nsoni Bumbangi, Jimmy Hangoma, Billy Chabalenge, Larry Mweetwa, Brian Godman
JAC-Antimicrobial Resistance vol: 6 issue: 1 year: 2023
doi: 10.1093/jacamr/dlae023
11. Plasmid conjugation drives within–patient plasmid diversity
Fan Grayson, Leo Loman, Toby Nonnenmacher, Diane Pople, Jack Pollard, Bharat Patel, David Williams, Luke Hounsome, Katie L. Hopkins, Julie V. Robotham, Alice Ledda
Microbial Genomics
vol: 11 issue: 3 year: 2025
doi: 10.1099/mgen.0.001361