Impact of Multidisciplinary-Led Implementation of Antimicrobial Stewardship Programs in Zambia: Findings and Implications

<b>Background/Objectives</b>: Antimicrobial resistance (AMR) is a critical global health threat, with sub-Saharan Africa disproportionately affected. Antimicrobial stewardship (AMS) programs are essential in combating AMR; however, data on their implementation in resource-limited settings like Zambia remain scarce. This study assessed the post-implementation status of World Health Organization (WHO) AMS core elements in selected public hospitals in Zambia. <b>Methods</b>: A cross-sectional pre- and post-intervention survey was conducted in 11 public hospitals across Zambia's 10 provinces. Baseline (pre-implementation) and 12-month follow-up (post-implementation) assessments were carried out using the WHO-adapted Periodic National and Healthcare Facility Assessment Tool. The six AMS core elements evaluated included leadership, accountability, AMS actions, education, monitoring, and feedback. <b>Results</b>: The average AMS program score increased from 59% at pre-implementation to 81% at post-implementation. Significant improvements were observed in education and training (+36%) and accountability (+31%). While leadership and monitoring also showed positive trends, gaps persisted in AMS actions (63%) and feedback/reporting mechanisms (68%). Drug and Therapeutics Committee (DTC) functionality improved by 23%, with 90% of facilities now holding regular DTC meetings. Implementation of AMS actions, such as ward rounds, rose from 0% to 73%. Challenges remained in clinical audit feedback, resource mobilization, and prescribing optimization. Variability across facilities highlighted differences in leadership, resources, and technical capacity. <b>Conclusions</b>: AMS implementation in Zambia improved substantially across key domains. However, sustained leadership, adequate financing, and continuous capacity-building are needed to address persistent gaps and ensure long-term success in mitigating AMR.

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Publication Details

Journal
Antibiotics
Published
2025-11-07
DOI
https://doi.org/10.3390/antibiotics14111125
Primary Topic
Antibiotic Use and Resistance
Type
article
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article

Impact of Multidisciplinary-Led Implementation of Antimicrobial Stewardship Programs in Zambia: Findings and Implications

Kaunda Yamba, Kelvin Mwangilwa, Adrian Muwonge, Steward Mudenda et al.
Antibiotics
Antibiotic Use and Resistance
article

Impact of Multidisciplinary-Led Implementation of Antimicrobial Stewardship Programs in Zambia: Findings and Implications

Kaunda Yamba, Kelvin Mwangilwa, Adrian Muwonge, Steward Mudenda, Chie Nakajima, Victor Daka, Duncan Chanda, Fusya Goma, Nyambe Sinyange, Sombo Fwoloshi, Raphael Chanda, Amon Siame, Webrod Mufwambi, Aubrey Chichonyi Kalungia, Cephas Sialubanje, Kaunda Kaunda, Kenneth Kapolowe, John Bwalya Muma, Joseph Yamweka Chizimu, Zoran Muhimba, Jimmy Mapenzi Hangoma, Maisa Kasanga, Priscilla Nkonde Gardner, Evelyn Wesangula, Andrew Bambala, Roma Chilengi, Freddie Masaninga, Ntombi B. Mudenda, Yasuhiko Suzuki, Misheck Shawa, Chikwanda Chileshe, Taona Sinyawa, Charles Chileshe, Shikanga O-Tipo, Paul Simujayang’ombe, Fred Mulako Simwinji, Samson Mukale, Shempela Doreen, Loveness Sakalimbwe
article en

Abstract

<b>Background/Objectives</b>: Antimicrobial resistance (AMR) is a critical global health threat, with sub-Saharan Africa disproportionately affected. Antimicrobial stewardship (AMS) programs are essential in combating AMR; however, data on their implementation in resource-limited settings like Zambia remain scarce. This study assessed the post-implementation status of World Health Organization (WHO) AMS core elements in selected public hospitals in Zambia. <b>Methods</b>: A cross-sectional pre- and post-intervention survey was conducted in 11 public hospitals across Zambia's 10 provinces. Baseline (pre-implementation) and 12-month follow-up (post-implementation) assessments were carried out using the WHO-adapted Periodic National and Healthcare Facility Assessment Tool. The six AMS core elements evaluated included leadership, accountability, AMS actions, education, monitoring, and feedback. <b>Results</b>: The average AMS program score increased from 59% at pre-implementation to 81% at post-implementation. Significant improvements were observed in education and training (+36%) and accountability (+31%). While leadership and monitoring also showed positive trends, gaps persisted in AMS actions (63%) and feedback/reporting mechanisms (68%). Drug and Therapeutics Committee (DTC) functionality improved by 23%, with 90% of facilities now holding regular DTC meetings. Implementation of AMS actions, such as ward rounds, rose from 0% to 73%. Challenges remained in clinical audit feedback, resource mobilization, and prescribing optimization. Variability across facilities highlighted differences in leadership, resources, and technical capacity. <b>Conclusions</b>: AMS implementation in Zambia improved substantially across key domains. However, sustained leadership, adequate financing, and continuous capacity-building are needed to address persistent gaps and ensure long-term success in mitigating AMR.

AntibioticsVol. 14(11)
Hokkaido University of Science (JP), Centre for Infectious Disease Research in Zambia (ZM), Hokkaido University (JP), University Teaching Hospital (ZM), Edinburgh College (GB), Lusaka Apex Medical University (ZM), Copperbelt University (ZM), Sapporo International University (JP), University of Zambia (ZM), Ministry of Agriculture and Livestock (ZM), World Health Organization - Zambia (ZM), University of Africa (ZM), National Institute of Public Administration (ZM), East, Central and Southern Africa Health Community (TZ)
Openalex Percentile: Top 60%
Antibiotic Use and Resistance
DOIOpen Access PDFOpenAlex
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