AMR Context

AMR is a leading global health issue with 1.27M deaths globally in 2019 making it the 12th leading cause of death, above HIV and malaria with social and economic costs and several of the UN’s Sustainable Development Goals (SDGs) dependent on antimicrobials continued effectiveness. With such dire predictions of the spread of AMR, and with low resource settings (LRSs) being more vulnerable to its spread and impacts, AMR will further widen global health inequalities. Addressing this major health threat is therefore a global priority. Antimicrobial stewardship (AMS) is a key priority in the World Health Organisation’s Global Action Plan to address AMR. Health professionals have a critical role to play to mitigate AMR threats, and their training and education are an integral component of AMS activities. However, due to AMR-related knowledge, skills and job roles evolving rapidly, these individuals and teams need regular learning opportunities to support them to work collaboratively, developing and applying new AMR-related knowledge and skills and changing their work practice to support improvements in AMS. To advance our responses and plan such opportunities we first need to develop a stronger understanding of existing AMS programmes and health professionals’ needs. This OSC project is set to address this.

Objectives of the research study

This study aims to synthesise knowledge around areas of change needed to improve antimicrobial stewardship and identify which of these areas could be strengthened by professional learning programmes and training. The study focuses on human health settings in Uganda and Nepal and will identify the challenges and opportunities associated with engaging with AMS, as well as related work practices that health professionals in those settings develop as part of their AMS-related roles.

In doing so, the project will map knowledge gaps and work practices to develop an understanding of health professionals’ needs in relation to AMS. In doing so we aim to identify how AMS programmes could be supported through appropriate, contextually relevant, technology-supported professional learning.=

The study will leverage existing partnerships with the Nepal Public Health Research and Development Centre (PHRD) to design and implement the project.

In the short term, the study aims to:

(1) Develop an understanding of health professionals’ perceptions, understandings and conceptualisations of AMS and AMR

(2) To understand health professionals existing behaviour in relation to AMS and to identify the AMS-related behaviour(s) in need of change that could be supported in a future intervention

In the long term, the study aims to:

(1) Generate evidence to strengthen the development of large-scale grant bids – a key aspect will be the co-design and development of professional learning programmes on AMS

(2) To support development of strong networks in Uganda and Nepal to be involved in the co-creation, implementation and evaluation of professional learning programmes

(3) To further advance and help shape future research agenda in the area of technology-supported AMS-related professional learning

Sites and participants

To deliver this research study, in Nepal we are looking to engage with:

• Up to two wards or units in a public health facility (human health) that has a discernible AMS policy/strategy and associated activities in place

The study activities will take place between October 2023 and July 2024. Planned activities in each country include:

• Recruitment of a focal person in each site to assist with planning research activities
• Interviews conducted with up to 10 health professionals
• One health professional workshop (comprised of the 10 participants) to be conducted towards the end of the research period to share findings and plan next steps.
• One policy workshop to be conducted towards the end of the research period to share findings and plan next steps.

On-going support by the PHRD, MCRI and the OU teams will be provided to the focal person/s through regular communication. Health professionals will be expected to participate in one interview over the six-month data collection period and one workshop.

The Duration: July 2023 to July 2024.

The Researcher: Koula Charitonos and Saraswati Dawadi, Prof.Dr.Abhinav Vaidya, Ms. Santoshi Giri and Dr. Janak Thapa