CwPAMS' Stakeholder Visit to Uganda: Lessons Learnt

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In April 2022, the Commonwealth Pharmacists Association (CPA) held the first stakeholder meeting since the start of the pandemic. Representatives from 10 African countries joined for training, networking, sharing and learning activities in Entebbe, Uganda.

The activities were part of two programmes of work supported by the Fleming Fund: The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) and the Surveillance and Prescribing support for Antimicrobial Stewardship Resource Capacity building (SPARC) programme. These programmes aim to address antimicrobial resistance (AMR) in LMICs.

Training and Networking

As part of the SPARC programme, delegates took part in training exercises on Point Prevalence Surveys. Attendees included hospital site champions and in-country consultants (ICCs) from Eswatini, Malawi, Nigeria and Zimbabwe, and the training touched upon the role of behavioural change and working with multi-disciplinary teams to promote antimicrobial stewardship (AMS). There was also a demonstration of the new antimicrobial prescribing app, which delegates shared their thoughts on.

Representatives from the CwPAMS programme, including eight technical ICCs from CwPAMS countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia) and CwPAMS partners in Uganda and the THET country office, joined the SPARC delegates for some parts of their training activities.

A networking dinner was then held, where Dr David Musoke - a CwPAMS Partnership Lead at Makerere University with Nottingham Trent University - shared his experiences in AMS projects over the past two years.

AMR board game and explainer animation videos

Later in the week, the delegates shared their experiences of using the AMS board game - an interactive tool encouraging a teams of health workers (the ‘players’) to discuss AMS - and were introduced to the AMS explainer animation videos.

The AMS explainer animation videos use fictional situations to educate people on AMS. The information is easy to understand, with eight different dialects to enhance their value within countries in the CwPAMS programme.

Site visits

Representatives from CPA visited two CwPAMS sites in Uganda: Jinja Regional Referral Hospital and Kawempe National Referral Hospital.

At Kawempe National Referral Hospital, CPA observed the processes for manufacturing alcohol-based hand sanitiser. The pharmacists also held a focus group to understand the barriers to implementing AMS schemes.

Progress

Participants from the CwPAMS ICCs and implementing partners in Uganda reported that CwPAMS projects were improving AMS in their countries.

Examples shared include:

• The success of interventions, in particular the manufacture of hand sanitiser. This is now being scaled up for further impact at local and national levels.
• CwPAMS’ World Antimicrobial Awareness Week campaign, which raised awareness of the role of pharmacists in preventing AMR.
• Empowering pharmacists in-country, which was particularly emphasised by delegates in Malawi and Ghana.

On the role of CwPAMS in empowering pharmacists in-country, Felix Kaminyoghe, the CPA In-Country Advisor for Malawi, said:

Feedback and improvements

Feedback from attendees on major accomplishments over the CwPAMS programme included:

• Strong stakeholder engagement.
• Bidirectional learning between African and UK colleagues.
• Activities contributing to national action plan priorities.
• Capacity building in-country teams in AMS.
• Networking and sharing lessons locally, regionally and globally.

Colleagues also raised areas of improvement, including:

• More face-to-face engagements to assist project delivery and strengthen collaboration.
• Increasing the application time window for partnerships, and helping African partners identify UK partners to make initial connections.
• Improve ethical approval processes for project activities in African countries.
• Support partners in their understanding and management of cultural differences.

The representatives shared our enthusiasm for the next phase of the CwPAMS programme, which we look forward to starting in the Autumn. CwPAMS 2 aims to further our impact, tackling the same priorities as the current phase whilst expanding the scope into improving the use of clinical microbiology and antimicrobial prescribing data to inform decisions, and enhancing the detection and reporting of substandard and falsified medical products.