Barriers to Implementation of Antimicrobial Stewardship in Western Kenya

Brief description: Antimicrobial Resistance (AMR), one of the main global crises in the 21 st Century,poses a big threat to the security of global health, (World Bank 2019; UN General Assembly 2016). AMR was estimated to have caused over 1. 2 Million deaths in 2019 (Murray, 2022). This study further observed that deaths attributable to AMR at
all ages was the highest in sub-Sahara Africa. This therefore, calls for urgent efforts to be directed to better understand and mitigate the AMR situation in the region.
Antimicrobial stewardship (AMS) is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients ( use/core-elements/index.html). This definition applies to both human and animal
health and has been advocated and promoted as a means of reducing development and spread of AMR within the community. Appropriate use of antimicrobials thus
reduces its presence in the environment. In high income countries where AMS is well established AMR related deaths accounted for 13.0 per 100,000 compared to 23. 7 per 100,000 for sub-Saharan Africa (Murray 2022), demonstrating the importance of
AMS programs in mitigating AMR. The World Health Organization has recommended a toolkit that provides guideline for low- resourced settings on how to
implement AMS programmes (WHO, 2019). Nevertheless, studies to understand barriers to implementation of AMS and AMR strategies in human and animal health
in sub-Saharan Africa have been very limited, given the diversity in culture and levels of development in this region. Hence, the implementation of AMS has remained a
challenge in many LMICs. In this study, I propose to understand how social–economic, behaviour and political factors interplay in determining the development
and implementation of AMS programmes in human and animal health spheres in Western Kenya. This region is ladened with a high burden of infectious diseases and
therefore, prone to the use of antimicrobials and the region also exhibits high levels of poverty characteristic of sub-Sahara Africa.

Funding Organization: National Institute for Healthcare Research(NIHR)- Department of Health and Social Care (DHSC) & UKaid
Amount: GBP £5,000

Dr. Lucy K.L. Mandillah - PI