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

Abstract

In recent years, health partnerships have shared infection prevention and control (IPC) innovations between United Kingdom (UK) hospitals and Low-Middle-Income Countries (LMICs). 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 programme to increase antimicrobial stewardship (AMS) capacity in four African countries: Ghana, Tanzania, Uganda, and Zambia as part of the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme. A systematic approach was applied to assess gaps in AMS interventions and inform development of the CwPAMS programme through desk-based assessments, including of National Action Plans on AMR, online focus group meetings, and expert advisory group reviews. Twelve partnerships were selected for the CwPAMS programme. 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 score assigned to the programme following evaluation using the Organisation for Economic Cooperation and Development Assistance Committee (OECD-DAC) Evaluation Criteria was 82% (very good).