Opportunities and challenges for improving antimicrobial stewardship in low and middle income countries ; lessons learnt from the maternal sepsis intervention in Western Uganda

Ackers, HL ORCID: https://orcid.org/0000-0001-7811-636X, Ackers-Johnson, G, Seekles, ML, Odur, J and Opio, S 2020, 'Opportunities and challenges for improving antimicrobial stewardship in low and middle income countries ; lessons learnt from the maternal sepsis intervention in Western Uganda' , Antibiotics, 9 (6) , p. 315.

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Abstract

This paper presents findings from an action-research intervention designed to identify ways of improving antimicrobial stewardship in a Ugandan Regional Referral Hospital. Building on an existing health partnership and extensive action-research on maternal health, it focused on maternal sepsis. Sepsis is one of the main causes of maternal mortality in Uganda and Surgical Site Infection, a major contributing factor. Post-natal wards also consume the largest volume of antibiotics. The findings from the Maternal Sepsis Intervention demonstrate the potential for remarkable changes in health worker behaviour through multi-disciplinary engagement. Nurses and midwives create the connective tissue linking pharmacy, laboratory scientists and junior doctors to support an evidence-based response to prescribing. These multi-disciplinary ‘huddles’ form a necessary, but insufficient, grounding for active clinical pharmacy. The impact on antimicrobial stewardship and maternal mortality and morbidity is ultimately limited by very poor and inconsistent access to antibiotics and supplies. Insufficient and predictable stock-outs undermine behaviour change frustrating health workers’ ability to exercise their knowledge and skill for the benefit of their patients. This escalates healthcare costs and contributes to Anti-Microbial Resistance.

Item Type: Article
Schools: Schools > School of Health and Society > Centre for Applied Research in Health, Welfare and Policy
Journal or Publication Title: Antibiotics
Publisher: MDPI
ISSN: 2079-6382
Related URLs:
Funders: Commonwealth Partnership for Antimicrobial Stewardship (CwPAMS)
Depositing User: USIR Admin
Date Deposited: 04 Jun 2020 11:47
Last Modified: 09 Jun 2020 13:30
URI: http://usir.salford.ac.uk/id/eprint/57172

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