Tackling antimicrobial resistance: developing and implementing antimicrobial stewardship interventions in four African commonwealth countries through a health partnership model

Authors

  • Diane Ashiru-Oredope Commonwealth Pharmacists Association (CPA), London
  • Maxencia Nabiryo Commonwealth Pharmacists Association (CPA), London
  • Lisa Zengeni Ingentium Limited
  • Nduta Kamere Commonwealth Pharmacists Association (CPA), London
  • Alexia Makotose Ingentium Limited
  • Omotayo Olaoye Commonwealth Pharmacists Association (CPA), London
  • William Townsend Tropical Health and Education Trust (THET)
  • Beatrice Waddingham Tropical Health and Education Trust (THET)
  • Ayodeji Matuluko Commonwealth Pharmacists Association (CPA), London https://orcid.org/0000-0002-9778-8695
  • Winnie Nambatya Pharmacy Department, Makerere University, Kampala
  • Yvonne Esseku Ghana College of Pharmacists, Accra
  • Ama Bartimeus Tropical Health and Education Trust (THET)
  • Sara Mahjoub Tropical Health and Education Trust (THET)
  • Nikki D’Arcy Commonwealth Pharmacists Association (CPA), London
  • Chloe Tuck Commonwealth Pharmacists Association (CPA), London
  • Sarah Cavanagh Commonwealth Pharmacists Association (CPA), London
  • Josef Geoola Ingentium Limited https://orcid.org/0000-0001-7057-6660
  • Eva Prosper Muro Department of Pharmacology, Kilimanjaro Christian Medical University College, Kilimanjaro
  • Derick Munkombwe Pharmacy Department, University of Zambia, Lusaka
  • Jessica Fraser Tropical Health and Education Trust (THET) https://orcid.org/0000-0002-4745-6780
  • Richard Skone-James Tropical Health and Education Trust (THET)
  • Victoria Rutter Commonwealth Pharmacists Association (CPA), London

DOI:

https://doi.org/10.4081/jphia.2023.2335

Keywords:

CwPAMS, one health, pharmacy, multi-disciplinary working, AMS, health partnership

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.

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Author Biographies

Winnie Nambatya, Pharmacy Department, Makerere University, Kampala

Commonwealth Pharmacists Association (CP A), London, United Kingdom.

Yvonne Esseku, Ghana College of Pharmacists, Accra

Commonwealth Pharmacists Association (CP A), London, United Kingdom.

Eva Prosper Muro, Department of Pharmacology, Kilimanjaro Christian Medical University College, Kilimanjaro

Commonwealth Pharmacists Association (CP A), London, United Kingdom.

Derick Munkombwe, Pharmacy Department, University of Zambia, Lusaka

Commonwealth Pharmacists Association (CP A), London, United Kingdom.

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Published

21-04-2023

How to Cite

Ashiru-Oredope, D., Nabiryo, M., Zengeni, L., Kamere, N., Makotose, A., Olaoye, O., Townsend, W., Waddingham, B., Matuluko, A., Nambatya, W., Esseku, Y., Bartimeus, A., Mahjoub, S., D’Arcy, N., Tuck, C., Cavanagh, S., Geoola, J., Prosper Muro, E., Munkombwe, D., Fraser, J., Skone-James, R., & Rutter, V. (2023). Tackling antimicrobial resistance: developing and implementing antimicrobial stewardship interventions in four African commonwealth countries through a health partnership model. Journal of Public Health in Africa, 14(6). https://doi.org/10.4081/jphia.2023.2335

Issue

Section

Original Articles