Antimicrobial stewardship capacity and infection prevention and control assessment of three health facilities in the Ashanti Region of Ghana

Abstract

Background Addressing antimicrobial resistance (AMR) requires the rational use and optimization of available resources for prevention and management of infections. Structures in health facilities to support optimal antimicrobial therapy and AMR containment therefore need assessment and strengthening. Objectives To assess antimicrobial stewardship (AMS) capacity and conformance to National and WHO Infection Prevention and Control (IPC) guidelines in three hospitals in Ashanti region of Ghana. Methods A cross-sectional study using WHO’s hospital questionnaire for AMS capacity assessment, and Infection Prevention and Control Framework (IPCAF) to assess IPC practices in the three hospitals. Results All the facilities had Drug and Therapeutics and IPC Committees with microbiology laboratory services. H3 and H1 did not have a formal AMS programme or an organizational structure for AMS. However, both institutions had a formal procedure to review antibiotics on prescriptions for quality assessment and relevance. H2 and H1 did not participate in any surveillance of antibiotic resistance patterns or consumption. H1 had basic, while H2 and H3 had intermediate-level IPC systems scoring 385, 487.5 and 435.8 out of 800 respectively. Conclusions All the facilities assessed had AMS capacity and IPC conformity gaps that require strengthening to optimize antimicrobial use (AMU) and successful implementation of IPC protocols. Regular surveillance of antimicrobial consumption and microbial resistance patterns should be an integral part of activities in health institutions to generate evidence for impactful actions to contain AMR and improve AMU.

Evaluation of the implementation of hospital hygiene components in 30 health-care facilities in the Autonomous District of Abidjan (Cote d'Ivoire) with the WHO Infection Prevention and Control Assessment Framework (IPCAF)

“…Overall, 8 facilities had an advanced level of IPC readiness, 18 an intermediate level, 23 a basic level, and 7 an inadequate level t [16]. Another study conducted in three Ghanaian hospitals found that they had basic and intermediate IPC systems with scores of 385, 487.5 and 435.8 out of 800 [9].…”

“…Nosocomial infections contracted during a stay or a passage in an hospital environment constitute a public health problem in the world [1][2][3] and in particular in Africa [4][5][6][7]. They are characterized by an heavy nancial impact and mortality due to the virulence of the pathogene agents and their resistance to the effects of anti-infectious medicine [8][9][10][11]. These infections are mainly due to the failure of hygiene mechanisms in health-care facilities [12,13].…”

“…Although studies have proven the feasibility and effectiveness of these guidelines using the evaluation frameworks proposed by the WHO in several countries around the world [15][16][17][18], much remains to be done, especially in developing countries [9,11,13,19].…”

Evaluation of the implementation of hospital hygiene components in 30 health-care facilities in the Autonomous District of Abidjan (Cote d'Ivoire) with the WHO Infection Prevention and Control Assessment Framework (IPCAF)

“…Overall, 8 facilities had an advanced level of IPC readiness, 18 an intermediate level, 23 a basic level, and 7 an inadequate level [16]. Another study conducted in three Ghanaian hospitals found that they had basic and intermediate IPC systems with scores of 385, 487.5 and 435.8 out of 800 [9].…”

“…However, not all countries are at the same level of implementation of these tools. Although studies have proven the feasibility and effectiveness of these guidelines using the evaluation frameworks proposed by the WHO in several countries around the world [15][16][17][18], much remains to be done, especially in developing countries [9,11,13,19].…”