Antibiotic ‘entanglements’: health, labour and everyday life in an urban informal settlement in Kampala, Uganda

Nabirye, Christine; Willis, Laurie; Nayiga, Susan; Kayendeke, Miriam; Staedke, Sarah G.; Chandler, Clare I R

doi:10.1080/09581596.2021.1994526

Cited by 13 publications

(8 citation statements)

References 26 publications

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“…The recognition of antibiotics as a “quick fix” for poor hygiene and other structural issues in systems that find the latter hard(er) to implement has been acknowledged in medical literature for the human health field [ 47 , 48 ] but on the results of our search is not yet as well represented within veterinary and animal management journals.…”

Section: Resultsmentioning

confidence: 99%

Transdisciplinary approaches to addressing factors that influence antimicrobial use in dairy cattle: A scoping review

Cole,

Mughal,

Eltholth

et al. 2024

Heliyon

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Section: Resultsmentioning

confidence: 99%

Transdisciplinary approaches to addressing factors that influence antimicrobial use in dairy cattle: A scoping review

Cole,

Mughal,

Eltholth

et al. 2024

Heliyon

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“…Beyond the framing of the problem of irrational use of medicines among health workers as rooted in the lack of knowledge about optimal use of antimicrobials ( Kamuhabwa & Silumbe, 2013 ), what we observed was health workers tailoring their use of the clinical guidelines (or not) to accommodate their limited training and the lack of resources in their setting as has been observed elsewhere in the use of medicines and technologies ( Boonen et al, 2017 ; Tarrant et al, 2021 , 2020 ). Optimising antibiotic use calls for recognition that clinical guidelines are not received in a vacuum and as such clinical practice is shaped by patterns of resources, health worker training and patient expectations ( Broom et al, 2020 ; Nabirye et al, 2021 ; Yantzi et al, 2019 ) as much as the guidelines. In addition, understanding the logic behind health worker prescription decisions would be key in designing locally relevant stewardship intervention packages.…”

Section: Discussionmentioning

confidence: 99%

“…Some elements of global AMR policies such as following a guideline and relying on laboratory diagnoses to guide antibiotic prescription have been shown to be ‘non-scalable’ in low resource-contexts where laboratories are very few ( Cañada, 2021 ). In a context of scarcity, clinical practice is tailored to accommodate deficiencies in the health care system ( MacPherson et al, 2021 ; Nabirye et al, 2021 ; Prince & Otieno, 2014 ), and so health worker practices need to be understood beyond a rubric of ‘noncompliance’. Disseminating clinical guidelines alone is not enough to see a reduction in antibiotic use in healthcare settings.…”

Section: Discussionmentioning

confidence: 99%

Reconciling imperatives: Clinical guidelines, antibiotic prescribing and the enactment of good care in lower-level health facilities in Tororo, Uganda

Nayiga

Willis

Staedke

et al. 2022

Global Public Health

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Faced with the threat of antimicrobial resistance, health workers are urged to reduce unnecessary prescription of antimicrobials. Clinical guidelines are expected to form the basis of prescribing decisions in practice. Emerging through evaluations of best practice – bundling clinical, technological and economic dimensions – guidelines also create benchmarks through which practice can be assessed with metrics. To understand the relationships between guidelines and practice in the prescribing and dispensing of antibiotics, ethnographic fieldwork was undertaken in lower-level health care facilities in rural Eastern Uganda for 10 months between January and October 2020, involving direct observations during and outside of clinics and interviews with staff. In a context of scarcity, where ‘care’ is characterised by delivery of medicines, and is constituted beyond algorithmic outputs, we observed that clinical practice was shaped by availability of resources, and professional and patient expectations, as much as by the clinical guidelines. For stewardship to care for patients as well as for medicines, a better understanding of clinical practice and expectations of care is required in relation to and beyond clinical guidelines.

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“…Furthermore, BBS had the potential to galvanize local action to improve infrastructure, and illuminated the value of informal options in service delivery. Faced by inequitable access to formal services, residents of these two SSA cities often have to fill the gap left by government and nongovernmental organizations (NGOs) by developing "informal" options and practices to access water and sanitation (Maryati et al, 2018;Nabirye et al, 2023). "Formal" and "informal" infrastructure can be distinguished by defining formal as infrastructure linked to governmental and NGO initiatives, and "informal" as alternative infrastructure initiatives that emerge in the communities alongside the formal (Maryati et al, 2018;Nabirye et al, 2023).…”

Section: Methods: Inmentioning

confidence: 99%

Urban Health and Planning in the 21st Century: Bridging Across the Formal and Informal Using an Eco-Social Lens

2024

Frontiers Research Topics

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Frontiers is more than just an open access publisher of scholarly articles: it is a pioneering approach to the world of academia, radically improving the way scholarly research is managed. The grand vision of Frontiers is a world where all people have an equal opportunity to seek, share and generate knowledge. Frontiers provides immediate and permanent online open access to all its publications, but this alone is not enough to realize our grand goals. Frontiers journal seriesThe Frontiers journal series is a multi-tier and interdisciplinary set of openaccess, online journals, promising a paradigm shift from the current review, selection and dissemination processes in academic publishing. All Frontiers journals are driven by researchers for researchers; therefore, they constitute a service to the scholarly community. At the same time, the Frontiers journal series operates on a revolutionary invention, the tiered publishing system, initially addressing specific communities of scholars, and gradually climbing up to broader public understanding, thus serving the interests of the lay society, too. Dedication to qualityEach Frontiers article is a landmark of the highest quality, thanks to genuinely collaborative interactions between authors and review editors, who include some of the world's best academicians. Research must be certified by peers before entering a stream of knowledge that may eventually reach the public -and shape society; therefore, Frontiers only applies the most rigorous and unbiased reviews. Frontiers revolutionizes research publishing by freely delivering the most outstanding research, evaluated with no bias from both the academic and social point of view. By applying the most advanced information technologies, Frontiers is catapulting scholarly publishing into a new generation. What are Frontiers Research Topics?Frontiers Research Topics are very popular trademarks of the Frontiers journals series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area.

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Antibiotic ‘entanglements’: health, labour and everyday life in an urban informal settlement in Kampala, Uganda

Cited by 13 publications

References 26 publications

Transdisciplinary approaches to addressing factors that influence antimicrobial use in dairy cattle: A scoping review

Transdisciplinary approaches to addressing factors that influence antimicrobial use in dairy cattle: A scoping review

Reconciling imperatives: Clinical guidelines, antibiotic prescribing and the enactment of good care in lower-level health facilities in Tororo, Uganda

Urban Health and Planning in the 21st Century: Bridging Across the Formal and Informal Using an Eco-Social Lens

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