Background The declaration of COVID-19 a pandemic by the World Health Organization on 11 March 2020 marked the beginning of a global health crisis of an unprecedented nature and scale. The approach taken by countries across the world varied widely, however, the delivery of frontline healthcare was consistently recognised as being central to the pandemic response. This study aimed to identify and explore the issues currently facing pharmacy teams across Commonwealth countries during the COVID-19 pandemic. The study also evaluates pharmacy professionals’ understanding of key knowledge areas from the COVID-19 webinar hosted by the Commonwealth Pharmacists’ Association (CPA). Method A quantitative survey-based approach was adopted, using a 32-item questionnaire developed from the literature on pharmacy and pandemic response. The survey was hosted on Survey Monkey and pilot tested. The final survey was disseminated by CPA member organisations. A 6-item online questionnaire was sent via email to all attendees of CPA's COVID-19 webinar. Descriptive statistics on frequency distributions and percentages were used to analyse the responses. Data were analysed using Microsoft® Excel (2010). Results There were 545 responses from pharmacy professionals across 31/54 Commonwealth countries in Africa, Asia, the Americas, Europe and the Pacific. Majority of the respondents reported being at least somewhat worried (90%) and more than 65% were very worried or extremely about the impact of COVID-19 on them personally and professionally. Nearly two-thirds of respondents stated finding it somewhat difficult or very difficult to work effectively during the pandemic. Challenges mostly faced by pharmacy professionals working remotely included; general anxiety about the impact of COVID-19 on their lives (12%), and difficulties in communicating with their co-workers (12%). Most pharmacy professionals had not previously been actively involved in a global health emergency (82%) nor obtained training on global/public health emergency preparedness (62%). Between 45 and 97% of the COVID-19 webinar attendees provided the correct answers to post-webinar questions, suggesting some improvement in knowledge. Conclusion Our study confirms pharmacy professionals’ concerns about practice during a pandemic and provides preliminary data on the challenges and learning needs of the profession. The CPA has since acted on these findings, providing ongoing opportunities to develop and refine resources for the profession as the pandemic evolves. Pharmacy professionals have also demonstrated improved knowledge on the management of COVID-19 and resources available for professionals.

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Antimicrobial stewardship (AMS) initiatives promote the responsible use of antimicrobials in healthcare settings as a key measure to curb the global threat of antimicrobial resistance (AMR). Defining the core elements of AMS is essential for developing and evaluating comprehensive AMS programmes. This project used co-creation and Delphi consensus procedures to adapt and extend the existing published international AMS checklist. The overall objective was to arrive at a contextualised checklist of core AMS elements and key behaviours for use within healthcare settings in Sub-Saharan Africa, as well as to implement the checklist in health institutions in four African countries. The AMS checklist tool was developed using a modified Delphi approach to achieve local expert consensus on the items to be included on the checklist. Fourteen healthcare/public health professionals from Tanzania, Zambia, Uganda, Ghana and the UK were invited to review, score and comment on items from a published global AMS checklist. Following their feedback, 8 items were rephrased, and 25 new items were added to the checklist. The final AMS checklist tool was deployed across 19 healthcare sites and used to assess AMS programmes before and after an AMS intervention in 14 of the 19 sites. The final tool comprised 54 items. Across the 14 sites, the completed checklists consistently showed improvements for all the AMS components following the intervention. The greatest improvements observed were the presence of formal multidisciplinary AMS structures (79%) and the execution of a point-prevalence survey (72%). The elements with the least improvement were access to laboratory/imaging services (7%) and the presence of adequate financial support for AMS (14%). In addition to capturing the quantitative and qualitative changes associated with the AMS intervention, project evaluation suggested that administering the AMS checklist made unique contributions to ongoing AMS activities. Furthermore, 29 additional AMS activities were reported as a direct result of the prompting checklist questions. Contextualised, co-created AMS tools are necessary for managing antimicrobial use across healthcare settings and increasing local AMS ownership and commitment. This study led to the development of a new AMS checklist, which proved successful in capturing AMS improvements in Tanzania, Zambia, Uganda, and Ghana. The tool also made unique contributions to furthering local AMS efforts. This study extends the existing AMS materials for low- and middle-income countries and provides empirical evidence for successful use in practice.

BackgroundThe declaration of COVID-19 a pandemic by the World Health Organisation on the 11March 2020 marked the beginning of a global health crisis of an unprecedented natureand scale. The approach taken by countries across the world varied widely, however,the delivery of frontline healthcare was consistently recognised as being central to thepandemic response. This study aimed to identify and explore the issues currentlyfacing pharmacy teams across Commonwealth countries during the COVID-19pandemic. The study also evaluates pharmacy professionals’ understanding of keyknowledge areas from the COVID-19 webinar hosted by the CommonwealthPharmacists’ Association ( CPA) on 5 th June 2020.MethodA quantitative survey-based approach was adopted, using a 32-item questionnairedeveloped from the literature on pharmacy and pandemic response. The survey washosted on Survey Monkey and pilot tested. The final survey was disseminated by CPAmember organisations. A 6-item online questionnaire was sent via email to allattendees of CPA's COVID-19 webinar. Descriptive statistics on frequency distributionsand percentages were used to analyse the responses. Data were analysed usingMicrosoft® Excel (2010).ResultsThere were 545 responses from pharmacy professionals across 31/54 commonwealthcountries in Africa, Asia, the Americas, Europe and the Pacific. Majority of therespondents reported being at least somewhat worried (90%) and more than 65% werevery worried or extremely about the impact of COVID-19 on them personally andprofessionally. Nearly two-thirds of respondents stated finding it somewhat difficult orvery difficult to work effectively during the pandemic. Challenges mostly faced bypharmacy professionals working remotely included; general anxiety about the impact ofCOVID-19 on their lives (12%), and difficulties in communicating with their co-workers(12%). Most pharmacy professionals had not previously been actively involved in aglobal health emergency (82%) nor obtained training on global/public healthemergency preparedness (62%). Between 45% to 97% of the COVID-19 webinarattendees provided the correct answers to post-webinar questions, suggesting someimprovement in knowledge.ConclusionOur study confirms pharmacy professional’s concerns about practice during apandemic and provides preliminary data on the challenges and learning needs of theprofession. The CPA has since acted on these findings, providing on-goingopportunities to develop and refine resources for the profession as the pandemicevolves. Pharmacy professionals have also demonstrated improved knowledge on themanagement of COVID-19 and resources available for professionals.