The Fleming Fund is working with Uganda’s health care system to break down the barriers to disease surveillance by strengthening laboratory and diagnostic capacity in antimicrobial resistance (AMR) - leveraging in-country infrastructure and sustainability - for global health security.
CwPAMS' Stakeholder Visit to Uganda: Lessons Learnt
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.
CPA team facilitating a feedback session on reflections of CwPAMS 1.5. Attendees include CwPAMS technical in-country advisors and Uganda partnerships representatives.
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.
Jinja Regional Referral Hospital site visit.
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.
Kawempe National Referral Hospital visit.
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:
We participated in CwPAMS 1.5 where the Pharmaceutical Society of Malawi partnered with a team of pharmacists in Wales, pharmacists were engaged in a number of trainings in AMS, awareness campaigns and engaged in conducting PPS.
Felix Kaminyoghe, CPA In-Country Advisor for Malawi.
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.
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The Commonwealth Pharmacists Association (CPA), in partnership with the Tropical Health Education Trust (THET) and funded by the Fleming Fund, developed the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme. The CPA also has a longstanding history of running campaigns on World Antimicrobial Awareness Week (WAAW), which takes place annually between the 18th and 24th of November. WAAW aims to improve the understanding of what antimicrobial medicines are and how their misuse and overuse in humans, animals and the environment are accelerating the speed at which microbes are adapting to resist their effect.