Antimicrobial resistance (AMR) is a growing global concern that affects not only human health but also the well-being of animals and the environment. According to the Uganda National Action Plan on Antimicrobial Resistance, health education is one of the priority areas to combat this issue and promote responsible antibiotic use. The partnership between Nottingham Trent University and Makerere University in collaboration with Buckinghamshire Healthcare NHS Trust and the Ministry of Health organised two-day training workshops from 19th to 23rd September 2023 in the districts of Butambala and Nakaseke in Uganda. These workshops brought together various stakeholders from the fields of human, animal, and environmental health, with the goal of enhancing their understanding of AMR, antimicrobial stewardship (AMS), infection prevention and control (IPC) and Substandard and Falsified Medicines (SFMs). In addition, the workshops aimed to instil an appreciation on the pivotal role of the One Health approach in addressing AMR and promoting effective AMS.
A total of over 140 participants, consisting of community pharmacists, pharmacy technicians, nurses, veterinary officers, health assistants, environmental health officers, health educators, doctors, clinical officers, and other health practitioners from Nakaseke and Gombe hospitals and respective lower-level health facilities in Nakaseke and Butambala districts attended the trainings.
The workshop was facilitated by professionals from Buckinghamshire Healthcare NHS Trust, Nottingham Trent University, and Makerere University. To make the participants understand the gravity of AMR, Aarash Ahmadi a pharmacist from Buckinghamshire Healthcare NHS Trust emphasized the global consequences of AMR and its significant impact on Uganda, using practical demonstrations such as the glow germ experiment to drive home the point.
Natasha Hamilton, a Buckinghamshire Healthcare NHS Trust pharmacist led the discussions on AMS, the actions required to prevent AMR, and the barriers to prudent antibiotic use. Participants in both districts were engaged in case studies that required problem-solving skills based on the Uganda Clinical Guidelines and the prescribing companion app. These case studies were representative of human health, animal health, and environment sectors to cater to the entire audience. These interactive sessions allowed participants to actively engage in the learning process.
To emphasize the importance of different health professionals working together in the fight against AMR, Prof. Lawrence Mugisha introduced the concept of One Health in both districts. He explained its significance in the context of AMR, emphasizing the need for collaboration among different disciplines to combat AMR effectively. He also cautioned against the use of antibiotics for humans in animals and vice versa.
Dr. Herbert Bush Aguma from the Department of Pharmacy at Makerere University spearheaded the session on Substandard and Falsified Medicines and provided practical guidance on identifying them. Using examples and pictures, he explained the differences between these concepts and the critical role health workers play in ensuring safe access to medicines.
Some of the cross-cutting challenges in promoting AMS that were raised by participants from both districts included non-compliance to treatment guidelines by private facilities that are money minded, financial constraints by patients which forces them to take incomplete doses, and influence from pharmaceutical companies that are marketing their products.
The closing ceremonies at the end of the workshops captured remarks from District health District Officers (including Dr. Aliga Simon in Nakaseke district), District Veterinary Officers, Hospital Medical Superintendents, the Uganda Project Lead Dr. David Musoke from Makerere University School of Public Health, Dr. Winnie Nambatya, Commonwealth Pharmacist Association (CPA) in-country consultant, and participants who all expressed gratitude for the impactful workshops. At the end of the training each participants received a certificate in recognition of their attendance. “There is need to come up with a sustainability plan for antimicrobial stewardship interventions and practices that have been picked from the workshop” said Dr. Nambatya, the in-country CPA consultant.
Another unique session was on Gender Equality and Social Inclusion (GESI) in AMR which was headed by Elma Banyan from Nottingham Trent University. She highlighted the role of having men involved in health programmes by virtue of them being heads of families and providers in their homes. “To fight against AMR, there is need to have different gender and social groups on board because they are the final consumers of drugs.” Elma mentioned during one of the workshops.
The workshops were facilitated by a multi-disciplinary team of professionals from Uganda and UK. Two pharmacists from Buckinghamshire Healthcare NHS Trust, 3 Environmental Health specialists from Makerere University School of Public Health, a Pharmacist from Entebbe Regional Referral Hospital, a Pharmacist and Lecturer from Department of Pharmacy at Makerere University, a Professor from the College of Veterinary, Animal Resources and Biosecurity at Makerere University, Biosciences, and a PhD student from Nottingham Trent University who brought unique perspectives to the training.
This project titled: Centre of Excellence on antimicrobial stewardship in Central Uganda is funded by the Commonwealth Partnerships for Antimicrobial Stewardship Scheme (CwPAMS), an initiative of Commonwealth Pharmacists Association (CPA) and Tropical Health and Education Trust (THET) under the Fleming Fund of the UK Department of Health and Social Care (DHSC).
Written by Caral Nabbanja, Suzan Nakalawa and Grace Biyinzika Lubega
