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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, Muro EP, Munkombwe D, Fraser J, Skone-James R, Rutter V. Tackling antimicrobial resistance: developing and implementing antimicrobial stewardship interventions in four African commonwealth countries through a health partnership model. J Public Health Afr 2023; 14:2335. [PMID: 37538939 PMCID: PMC10395364 DOI: 10.4081/jphia.2023.2335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/08/2022] [Indexed: 08/05/2023] Open
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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Affiliation(s)
| | - Maxencia Nabiryo
- Commonwealth Pharmacists Association (CPA), London, United Kingdom
| | | | - Nduta Kamere
- Commonwealth Pharmacists Association (CPA), London, United Kingdom
| | | | - Omotayo Olaoye
- Commonwealth Pharmacists Association (CPA), London, 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
| | | | - Eva Prosper Muro
- Commonwealth Pharmacists Association (CPA), London, United Kingdom
- Department of Pharmacology, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - 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
| | | | - Victoria Rutter
- Commonwealth Pharmacists Association (CPA), London, United Kingdom
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