The project titled “Centre of Excellence for Antimicrobial Stewardship in Central Uganda”, a collaborative effort between Makerere University, Nottingham Trent University, and Buckinghamshire Healthcare NHS Trust successfully conducted one-day trainings on antimicrobial stewardship (AMS) for Community Health Workers (CHWs) in Kyengera town council, as well as on Bussi and Zzinga islands in Wakiso district. This training was in line with objective 1 of the Uganda National Action Plan on Antimicrobial Resistance (AMR) which highlights the urgent need for raising community awareness as a key strategy to curb AMR.
Using a One Health lens, 265 CHWs were trained on AMR, AMS, Infection Prevention Control (IPC), Gender and Social inclusion (GESI), and substandard and falsified medicines (SFM). The trainings in Kengera Town Council took place from 28th November to 31st December 2024 at Mpiringisa Church of Uganda - Maya, Nakitokolo Presbyterian Primary School - Namagoma, St. Aloysius Primary School- Kyengera and St. Bruno Primary School - Kasenge respectively. The training on Zzinga island took place on 30th January 2024 at Bishop Kawuma Primary School, while the one on Bussi island happened on 31st January 2024 at the subcounty offices.
These trainings were facilitated by Doreen Nabwire - the in-charge of Kasanje Health Centre III, Aidah Nakate - a health worker from Kajjansi HCIV, incharges of the respective health facilities, and Carol Esther Nabbanja, Grace Biyinzika Lubega and Filimin Niyongabo - project team members from Makerere University School of Public Health.
Upon arrival, each CHW was pre-assessed prior to the training to ascertain their knowledge on AMR and AMS and a post-assessment was given to CHWs after the training to assess the knowledge gained.
Filimin gave introductory remarks and clarified on the objective of the trainings which aimed at raising awareness on AMR, AMS, IPC with an overall target of promoting the right use of antimicrobials. He encouraged them to learn as much possible and share knowledge gained with their community members since they are in contact with their communities. Furthermore, he explained the One Health concept during trainings where he called on CHWs to desist from using antibiotics for humans to treat animals and their improper disposal in the environments.
Doreen and Aidah led the training sessions where she defined AMR, its causes, effects and used the balloon experiment to explain these concepts. CHWs were also taken through substandard and falsified medicines and different ways to identify them. They urged CHWs to use the multiplier effect for dissemination of information to the communities that they are in touch with. “You have been trained on AMS so that you spread this information to others. Tell ten people who will also tell other people and information will spread to everyone,” said Doreen.
The in-charges of the respective health facilities explained the concept of antimicrobial stewardship and called on CHWs to become role models, health educate their communities on proper stewardship practices such as completing doses, practicing proper hand hygiene. They also encouraged them to take good care of the medicines so that they remain effective in treating infections. “As a steward, you have to begin with yourself before influencing others. Do your role as a steward and we will jointly fight AMR,” said Naiga Nulu, the incharge of Zzinga HCII.
Experiments such as the glow germ handwashing experiment were used to demonstrate the right handwashing technique to CHWs. Additionally, group work was given to CHWs who later presented on the AMS key messages to deliver to their communities.
Dr. David Musoke, the Ugandan project lead and Professor Linda Gibson, the UK project lead gave closing remarks at each of these trainings where they appreciated CHWs for attending the training and their continued community service. CHWs were reminded that AMR is a global threat that requires immediate action to save lives and encouraged to be AMS champions in their communities.
The Project Leads thanked facilitators from health facilities, coordinators of CHWs and the team from Makerere University for delivering the training.
Conclusion
The one-day trainings were a success, leaving a lasting impact on the participants and empowering the CHWs to actively promote awareness about Antimicrobial Resistance (AMR) within their communities. Post-assessments held after each training session revealed that the participants had significantly increased their knowledge about AMR and AMS. This project is funded by the Commonwealth Partnerships for Antimicrobial Stewardship scheme, an initiative of The Tropical Health and Education Trust and Commonwealth Pharmacists Association under the Fleming Fund of the UK Department of Health and Social Care.
By Carol Nabbanja.
