Providing an evidence base for antibiotic stewardship for midwives in the Kabarole District of Uganda : a modified action research study.

Welsh, J 2019, Providing an evidence base for antibiotic stewardship for midwives in the Kabarole District of Uganda : a modified action research study. , PhD thesis, University of Salford.

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Abstract

This study has taken a modified action research approach to explore the understanding held by midwives working across four healthcare facilities in the Kabarole district of Uganda about antibiotic resistance and antibiotic stewardship. Antibiotic resistance is fast becoming a threat to the health of the global population. Antibiotic resistance arises when an antibiotic becomes ineffective at treating a bacterial infection which it once could. Antibiotic resistance is a natural phenomenon, but the ineffective use of antibiotics, such as inappropriate prescribing by healthcare professionals and poor adherence to prescribed regimens by patients, is increasing the speed at which resistance is developing. Antibiotic stewardship is the name for a collective group of activities that aim to prolong the effectiveness of antibiotics.
In using a modified action research methodology the study has gone through five cycles of action using a mixed methods approach to data collection. Data collected from observational work that was informed by ethnographic approaches, and secondary data analysis were used throughout the five cycles. Interviews with midwives were used in three of the five cycles. Findings from the first two cycles of action found that knowledge held by midwives about antibiotic resistance and antibiotic stewardship was lacking. The remaining three cycles of this study sought to bridge these knowledge gaps. An evidence base for antibiotic stewardship was presented to the midwives in the form of a training session. This session was followed up with monthly feedback for the midwives reporting on their responses to the evidence base in terms of their adherence to antibiotic stewardship practices. Findings have demonstrated that a simple intervention in the shape of a training session combined with monthly feedback and a longitudinal approach to mentorship, have supported the midwives in this study to progressively bring their antibiotic stewardship activities into line with evidence-based guidelines. The extent to which the antibiotic stewardship practices of the midwives in this study changed to align with evidence-based guidelines differed between individuals and healthcare facilities. These findings underline the important role that context plays in behaviour change. Future efforts to modify the practice of midwives should take this factor into consideration when designing interventions aimed at changing behaviours.

Item Type: Thesis (PhD)
Schools: Schools > School of Health and Society
Funders: Iolanthe Midwifery Trust
Depositing User: Joanne Welsh
Date Deposited: 09 Oct 2019 08:54
Last Modified: 09 Nov 2019 02:31
URI: http://usir.salford.ac.uk/id/eprint/52326

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