Successful outcome for antimicrobial stewardship capacity building meetings in Uganda
Feedback after a successful CwPAMS and SPARC meeting
Antimicrobial Stewardship (AMS) refers to a coordinated and healthcare system-wide approach to monitoring and advocating the responsible use of antimicrobial medications. Two pressing issues related to the escalation of antimicrobial resistance include prescribing practices and surveillance. In the past few years, the Commonwealth Pharmacists Association (CPA) in partnership with the Tropical Health and Education Trust (THET), have developed several ground-breaking interventions through their CwPAMS (Commonwealth Partnerships for Antimicrobial Stewardship) programme, which was initially established in four African countries (Ghana, Tanzania, Uganda and Zambia). This was expanded to include a further four countries (Kenya, Malawi, Nigeria, and Sierra Leone) upon successfully receiving additional grant funding last year.
Each of these eight countries had clinical sites that partnered with sites in the UK. Examples of some of the interventions and work carried out included the development of an Antimicrobial Prescribing App, Antimicrobial Stewardship Game (AMS Game) and Surveillance Training to monitor and report on antimicrobial use through the Global Point Prevalence Survey (GPPS).
In recent months, the CPA’s vision for tackling AMR in the Commonwealth has further evolved into a new programme of work – SPARC (Surveillance and Prescribing Support for Antimicrobial Stewardship Resource Capacity Building) which received funding in December 2021.
Funded by UK aid through the Department of Health and Social Care’s Fleming Fund, SPARC draws on the successful outcome of the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme and expands the reach of our AMR work to 22 priority Fleming Fund countries.
On the 26th and 27th of April 2022, the first SPARC training workshops were hosted in Uganda to train and empower in-country consultants (ICCs) and site champions from Nigeria, Eswatini, Malawi and Zimbabwe to help change behaviour in antimicrobial use through the collection and reporting of Global Point Prevalence Survey (GPPS) data. ICCs from all eight CwPAMS countries, Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda and Zambia also joined the workshops around the use of a new antimicrobial standard treatment guideline app and had a chance to provide feedback to future programmes. The training was led by experts in Health Psychology, Antimicrobial Stewardship, Public Health, Education, and Health App Development.
Day one focused on Capacity Building Workshops – with a multidisciplinary team of clinicians, pharmacists, pharmacy technicians and nurses contributing – which focused on numerous aspects of antimicrobial stewardship and continuous quality improvement, including how to conduct a Point Prevalence Survey (PPS) at a facility level, develop AMS interventions based on the PPS data and concluded with the role of developing Communities of Practice and taking the pledge to become an Antibiotic Guardian.
Some of the members of the CPA team met with the Ugandan Commissioner of Pharmacy – Pharmacist Okuna Nevile Oteba and some senior pharmacists at the Ministry of Health Pharmacy Division to discuss our new SPARC programme and the successful ongoing CwPAMS programme of work to help tackle AMR. The ministry team pledged their support and willingness to collaborate.
I learnt a lot from the trip to Uganda. Antimicrobial resistance (AMR) is a global war that needs all countries to work together. Point Prevalence Surveys (PPS) will help us measure and improve stewardship and also develop interventions for a paradigm shift towards reducing antimicrobial resistance.
Mr Keith Ndlovu - Senior Pharmacist, Victoria Chitepo Provincial Hospital, Zimbabwe
Day two opened with a competitive session playing the Antimicrobial Stewardship Game (AMS Board Game) which further inspired discussion and interactive learning. SPARC site champions received and will use board games to help prepare teams for data collection events in their respective countries.
Training on day two demonstrated how to use the new SPARC App (under development). Capacity building also included customization and maintenance of local guidelines for country requirements. With access to prescribing guidelines identified as a common barrier to practising good antimicrobial stewardship, the SPARC App – available offline – facilitates access to national and international treatment guidelines for both human and animal health. Various behaviour change and intervention development techniques were taught during the workshops in relation to social science including a CwPAMS surgical prophylaxis explainer video which was shown to delegates.
The time in Uganda was really great in terms engagement and networking. The backgrounds and experiences were so diverse and enriched the discussions and made the whole experience really great.
Yvonne Yirenkyiwaa Esseku, ICC Ghana
Uganda photo gallery
About the CPA
The CPA works to support pharmacists in strengthening healthcare systems; through the safe and effective use of medicines, improving access and quality of medicines and vaccines, and the prevention of disease and promoting healthy lifestyles. Through their government channels, they are vocal advocates for improved access and quality of medicines and vaccines; embedding pharmacists at all levels of medicines management to achieve this goal.
THET has a vision of a world where everyone has access to healthcare. We achieve this by training and educating health workers in Africa and Asia, working in partnership with organisations and volunteers from across the UK. Founded in 1988 by Professor Sir Eldryd Parry, we are the only UK charity with this focus.
About the Fleming Fund
The Fleming Fund is a £265 million UK aid investment managed by the Department of Health and Social Care to tackle antimicrobial resistance by supporting low- and middle-income countries to generate, use and share data on AMR. Mott MacDonald has been appointed as the Fleming Fund Management Agent and is responsible for the management of the Fleming Fund Programme of Country and Regional Grants and the Fleming Fellowship Scheme.