The impact of CwPAMS in Ghana
Sarah Cavanagh, our AMS Senior Technical Advisor, reflects on her recent visit to Ghana as part of our Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme.
“My trip has reinforced my belief in the power of international healthcare partnerships, which are increasingly vital as we face global challenges like AMR. The enthusiasm, innovation, and dedication I witnessed in Ghana give me hope for our continued progress in this crucial fight.”
In October, I visited Ghana in support of the country’s contribution to addressing the major global health challenge of reducing antimicrobial resistance (AMR). The trip was funded by the Department of Health and Social Care’s Fleming Fund and was part of the UK Aid programme which supports 25 countries across Africa and Asia in tackling AMR.
The Commonwealth Pharmacists Association (CPA) is committed to empowering pharmacists to improve health and well-being throughout the Commonwealth through, in large part, strengthening international healthcare collaborations and disseminating knowledge to advance global public health. Antimicrobial stewardship (AMS) is an area in which the CPA has been heavily involved through its CwPAMS and SPARC programmes, which each empower pharmacy professionals to become local leaders in AMS, recognising the pivotal role they can play in the fight against AMR.
As part of CwPAMS, a novel application of the hub-and-spoke model operates across health partnerships to build AMS capacity and capability in several African nations, including Ghana. A large focus of this model involves encouraging collaborations, multi-professional working and the use of the CwPAMs ‘hub’ to streamline national action plans by centralising specific resources and expertise.
Throughout my visit, I was involved in numerous meetings in aid of strengthening these hub-and-spoke partnerships in which representatives from different healthcare systems showcased work and shared best practices.
Accra
Starting in the capital, Accra, my trip began with several high-level meetings, including discussions with the UK’s Health Advisor in Ghana, in which we explored ways to strengthen the country’s national action plan and develop more robust strategies to combat AMR through the responsible use of antibiotics. I also participated in a workshop which saw five Ghana-based health partnerships present their ongoing work in AMR. These partnerships, linking UK hospitals with healthcare providers in Ghana, demonstrate the power of the international healthcare collaborations the CPA champions.
I had brought with me eight boxes of our AMS board game, which I helped develop with the CPA. The game encourages players to explore the practicalities of AMS and the different ways we can all help reduce AMR. The game was used at many of the workshops I attended, so was well worth the eight kilograms of luggage they added to my trip! The enthusiasm and commitment from our Ghanaian colleagues were immediately apparent to me, and I was especially impressed by the multidisciplinary participation in the workshops – doctors, nurses, pharmacists, microbiologists and surgeons alike were all engaged in working together to tackle the threat of AMR.
Ho
After Accra, I travelled to Ho, the regional capital of the Volta region. There, working alongside colleagues from University College London Hospital who are involved in one of the local health partnerships, we ran workshops and presentations to develop local solutions to tackling AMR. What struck me most was the innovative approaches being taken to raise awareness about AMR; unlike in the UK, Ghana has successfully integrated this education into non-healthcare settings such as schools (where students show remarkable engagement with the material) and religious settings, such as mosques, churches and places of worship for traditional faiths.
The results have been remarkable. Through focused training and development programmes in collaboration with their healthcare partnerships, local facilities have significantly reduced their antibiotic consumption and introduced appropriate antimicrobial prescribing guidelines and protocols. This includes diagnostic testing, wherein a patient’s blood, urine or sputum sample will first be taken to identify the specific cause of an infection before antibiotics are prescribed.
It was clear to me that Ghana’s healthcare system, although facing its challenges, demonstrates a remarkable agility in implementing change. With fewer bureaucratic barriers than we sometimes face in higher-income countries, new initiatives can be implemented at a faster rate.
As with many healthcare systems, resource, financial and time constraints are a constant struggle for teams in Ghana in terms of implementing sustainable change. Furthermore, Ghana also faces particular and complex challenges: antibiotics are often available over the counter without prescription, leading to widespread misuse, and the quality and availability of these medications can be highly variable, sometimes forcing healthcare providers to use inappropriate alternatives. These factors make our work even more crucial, and it was especially helpful to meet with the Health Advisor for the UK in Ghana as well as the Fleming Fund in-country team who shared support for collaborative healthcare partnerships.
The country itself left an indelible impression on me. Ghana’s people are remarkably friendly and cheerful, making it an inspiring place to work – helped in no small part by the profound appreciation for healthcare services I found among Ghanaians.
This current phase of support from the Fleming Fund concludes in April, and future extensions will depend on available government resources. However, the project has demonstrated significant value, not least through its bidirectional learning – while we’ve contributed to Ghana’s healthcare systems, we’ve also gained valuable insights that benefit ours, particularly in leadership development among junior staff.
My trip has reinforced my belief in the power of international healthcare partnerships, which are increasingly vital as we face global challenges like AMR. The enthusiasm, innovation, and dedication I witnessed in Ghana give me hope for our continued progress in this crucial fight.
About CwPAMS and the Fleming Fund
Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) is an initiative to tackle AMR and promote AMS. They are backed by funding from The Department of Health and Social Care’s Fleming Fund, a UK aid programme supporting up to 25 countries across Africa and Asia to tackle antimicrobial resistance (AMR). The Fleming Fund invests in strengthening data surveillance systems through a portfolio of country grants, regional grants and fellowships managed by Mott MacDonald, and global projects managed by partners.