Antimicrobial resistance (AMR) is increasingly making common medicines ineffective, turning once-treatable diseases into serious health risks. This troubling trend is partly fueled by healthcare workers prescribing antibiotics inappropriately and patients opting for self-medication. The rise of AMR is not just a local issue for Uganda; it poses a significant threat worldwide.
In response to this growing crisis, Makerere University School of Public Health (MakSPH) has joined forces with the Royal Free London Hospital NHS Foundation Trust in the UK. With funding from Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) and THET/Global Health Partnerships for Health, they launched a vital project titled “Strengthening Antimicrobial Stewardship through a Nurse-led Approach.” This initiative is focused on combating antimicrobial resistance at Mukono General Hospital in Mukono District, aiming to safeguard the health of the community and beyond.
During World Antimicrobial Resistance Awareness Week (WAAW) from November 18 to 22, 2024, our partnership launched a series of impactful campaigns to raise awareness about AMR. We organized community drive-throughs where health workers utilized a public address system to distribute informational leaflets at various locations, directly engaging with residents. These efforts aimed to educate the community, including roadside pharmacies, about the urgent issue of antimicrobial resistance and its serious implications for public health.
The following day, we invited key stakeholders to Mukono General Hospital to showcase the project’s achievements. This event served as an important opportunity to spread awareness among district stakeholders, patients, village health teams, and local health workers, reinforcing the message about the critical need to address antimicrobial resistance together.
The global threat of AMR is escalating, underscoring the urgent need for local health stakeholders to unite for meaningful discussions and action. To mark World Antimicrobial Resistance Awareness Week, we hosted an event at Mukono General Hospital.
The Makerere University team, comprised of dedicated public health experts and researchers, aimed to empower Village Health Teams (VHTs), local council leaders, and medical officers. They provided these community leaders with the knowledge and tools necessary to tackle AMR effectively, fostering a collaborative effort to combat this pressing issue.
Irene Wobusobozi, the project coordinator, shed light on a sobering reality: Uganda experiences around 30,700 deaths each year linked to antimicrobial resistance. To address this critical issue, the project placed a strong emphasis on infection prevention control (IPC) at the hospital, concentrating on essential practices like hand hygiene and effective waste management. By focusing on these areas, the team aims to make a meaningful impact on patient safety and overall public health.
Why hand hygiene and waste management?
Wobusobozi emphasized that germs, particularly bacteria, are often transmitted in hospitals during interactions between patients and medical officers. This transmission can occur when healthcare professionals, intentionally or not, neglect to wash or sanitize their hands or wear gloves while treating different patients. In response to this issue, the project initiated a program to help health workers produce hand sanitizers, aiming to promote hand hygiene and reduce the spread of infections.
In 2023, the school developed and launched an Antimicrobial Stewardship (AMS) strategy, focusing on implementing both a global action plan and a national action plan as key objectives. A significant aspect of this initiative is the introduction of a prescribing chart, designed to help in-charges and medical officers track and analyze the types of prescriptions given to patients. This tool aims to enhance the careful use of antibiotics and improve patient care.
"Every time we prescribe antibiotics unnecessarily, we contribute to the problem," Wobusobozi explained. "It’s crucial to educate patients about proper usage and the risks associated with self-medication.”
Dr. Geoffrey Kasirye, the Medical Superintendent at Mukono General Hospital, cautioned that antibiotics should not be used without first consulting a medical professional. He also raised concerns about the proliferation of unregistered drug shops, which often prioritize profit over proper patient care and prescriptions. This trend, he noted, poses significant risks to public health, as it undermines the careful use of antibiotics and can lead to harmful consequences for patients.
"Patients often expect a quick fix, but we need to educate them about the differences between viral and bacterial infections," remarked Kasirye. The group agreed that improving communication with patients was essential in curbing the misuse of antibiotics.
Al-haji Asuman Muhumuza, the District Vice Chairperson, stressed the importance of incorporating AMR awareness into current health programs and community initiatives. He suggested creating educational materials that reflect local contexts, such as posters and pamphlets, which could be distributed in health facilities and community centers to spread the message effectively.
"We need to ensure our messages are clear and relatable to our people," highlighted Muhumuza. "Using local languages and culturally relevant examples will enhance understanding and retention to curb AMR."
The District Health Officer, District Veterinary Officer, Chief Administrative Officer, and a microbiologist from Makerere University School of Public Health all reiterated the importance of a united effort to combat AMR. They emphasized that collaboration across sectors is crucial for effectively addressing this growing threat.
The partnership between MakSPH and the Royal Free London NHS Foundation Trust highlights the strength of international collaboration in tackling global health challenges. They established a platform for knowledge sharing and community-driven solutions to foster a collaborative approach to improving health outcomes by uniting local stakeholders.
Several items featuring AMR information were distributed, including T-shirts, leaflets, pens, wristbands, and bags. Nurses who actively participated in the project were recognized with gifts and encouraged to become AMR champions. In closing, the IPC chairperson and AMS committee member expressed gratitude, stating, “We are so grateful for considering us. Before, most of us were in the dark; now we have seen the light. We feel more empowered and confident. Thank you, MakSPH, Royal Free, and all our funders.”
As participants left, they took with them not only newfound knowledge but also a strong sense of community and shared responsibility. The fight against antimicrobial resistance demands ongoing commitment, and the collaborative efforts sparked during this event will undoubtedly contribute to a healthier future for the people of Mukono and beyond.
A handwashing facility was opened by Alhaji Asuman Muhumuza at the facility as he closed the event.
By Eriah Lule
