Antimicrobial Stewardship Activities in Public Healthcare Facilities in South Africa: A Baseline for Future Direction

Antimicrobial resistance (AMR) is a growing problem worldwide, including South Africa, where an AMR National Strategy Framework was implemented to instigate antimicrobial stewardship programmes (ASPs) and improve antimicrobial prescribing across sectors. To address the need to assess progress, a seq...

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Bibliographic Details
Published in:Antibiotics (Basel) 2021-08, Vol.10 (8), p.996
Main Authors: Engler, Deirdré, Meyer, Johanna Catharina, Schellack, Natalie, Kurdi, Amanj, Godman, Brian
Format: Article
Language:English
Subjects:
Ambulatory care
Antibiotics
Antimicrobial agents
Antimicrobial resistance
antimicrobial stewardship programmes
Developing countries
Drug resistance
Drug stores
Health care
Health care facilities
Health care policy
Health facilities
Hospitals
LDCs
Nosocomial infections
Pharmacists
primary healthcare
Public health
Public sector
Research design
South Africa
Viral infections
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Summary:Antimicrobial resistance (AMR) is a growing problem worldwide, including South Africa, where an AMR National Strategy Framework was implemented to instigate antimicrobial stewardship programmes (ASPs) and improve antimicrobial prescribing across sectors. To address the need to assess progress, a sequential mixed methodology with an explanatory research design was employed. In Phase 1, a self-administered questionnaire was completed by healthcare professionals (HCPs) from 26 public sector healthcare facilities across South Africa to assess compliance with the Framework. The results were explored in Phase 2 through 10 focus group discussions and two in-depth interviews, including 83 participants. Emerging themes indicated that public healthcare facilities across South Africa are facing many challenges, especially at entry level primary healthcare (PHC) facilities, where antimicrobial stewardship activities and ASPs are not yet fully implemented. Improved diagnostics and surveillance data are a major shortcoming at these facilities. Continuous education for HCPs is deficient, especially for the majority of prescribers at PHC level and health campaigns are nearly non-existent. Involvement and visibility of management at certain facilities is a serious shortfall. Consequently, it is important to call attention to the challenges faced with improving antimicrobial prescribing across countries and address these to reduce AMR, especially in PHC facilities, being the first point of access to healthcare for the vast majority of patients in developing countries.
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics10080996