Strengthening Institutional And Workforce Capacity To Tackle Antimicrobial Resistance Through The Commonwealth Partnerships For Antimicrobial Stewardship Programme

• By: RUTTER, Victoria (Commonwealth Pharmacists Association)
• Co-author(s): Ms Maxencia Nabiryo (Commonwealth Pharmacists Association, London, United Kingdom)
  Mrs Frances Garraghan (Commonwealth Pharmacists Association, London, United Kingdom)
  Mrs Claire Brandish (Commonwealth Pharmacists Association, London, United Kingdom)
  Ms Jessica Fraser (Tropical Health and Education Trust, London, United Kingdom)
  Mr Richard Skone-James (Tropical Health and Education Trust, London, United Kingdom)
  Ms Ayesha Iqbal (Commonwealth Pharmacists Association, London, United Kingdom)
  Ms Helena Rosado (Commonwealth Pharmacists Association, London, United Kingdom)
  Mrs Victoria Rutter (Commonwealth Pharmacists Association, London, United Kingdom)
  
• Abstract:

  Background
  The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) is a health partnership programme funded by the UK Department for Health and Social Care’s Fleming Fund and managed by the Commonwealth Pharmacists Association (CPA) and the Tropical Health & Education Trust (THET). CwPAMS aims to leverage the expertise of UK health institutions and technical experts to strengthen the capacity of health institutions and workforce across the Commonwealth (CW), in particular low- and middle-income countries (LMICs), by creating bidirectional learning opportunities to address antimicrobial resistance challenges. Since its launch in 2019, the programme has supported the implementation of 26 antimicrobial stewardship (AMS) and infection prevention and control (IPC) projects across eight countries. The first phase of the programme (CwPAMS 1), implemented in 2019/2021, delivered 12 projects across Ghana, Tanzania, Uganda, and Zambia. An extension of the programme (CwPAMS 1.5), in 2021/2022, provided opportunities for further work and expansion to Kenya, Malawi, Nigeria and Sierra Leone.
  
  Purpose
  To evaluate the effectiveness of the CwPAMS programme in building AMS/IPC capacity and capability in health institutions and workforce in CwPAMS countries.
  
  
  Method
  A total of 20 AMS/IPC monitoring and evaluation indicators were developed and established to assess success and impact of each partnership. 'Before and after' indicators were measured, where possible, and compared to further understand change and impact. Indicators included, for example, the number of LMIC healthcare staff trained in AMS/IPC and demonstrating improved knowledge after training compared to before; demographic information was also collected. All data were collected and analysed in Microsoft Excel. As a service evaluation, this study did not require ethical approval.
  
  
  Results
  Since its inception, CwPAMS has facilitated the training of over 6,500 LMIC healthcare staff across the 8 CwPAMS countries. A total of 19 UK-LMIC partnerships have been established to deliver 26 projects. CwPAMS-1 enabled the training of 3,324 LMIC healthcare staff, 407 of which were pharmacists. The extension of the programme, CwPAMS-1.5, enabled the training of further 3,432 LMIC healthcare staff, 342 of which were pharmacists. In both phases of the programme, the majority of LMIC healthcare staff increased their knowledge and awareness of AMS, prescribing, and consumption surveillance (96% and 91% of LMIC healthcare staff, respectively). In CwPAMS-1.5, 76% also increased their knowledge and awareness of IPC principles (not measured in CwPAMS-1). In addition to the programme’s impact on LMICs, CwPAMS also created capacity-building opportunities for 370 UK volunteers, the majority of which (87%) indicated that their NHS institution had benefited through their participation in CwPAMS; of these, 72% also stated having increased capacity for AMS activities in their team.
  
  Conclusion
  The CwPAMS programme contributed to health system strengthening across the CW, in particular LMICs. By improving AMS/IPC knowledge and practice, health institutions and the workforce, including pharmacists, were central in the implementation and success of the programme. The next phase of the CwPAMS programme was rolled out in March 2023, establishing 24 partnerships across the eight CwPAMS countries, and will continue being monitored and evaluated.