A comprehensive assessment of antimicrobial stewardship; adoption and effectiveness in Kenya

Abstract

Objective: This study aimed to evaluate the implementation of antimicrobial stewardship (AMS) initiatives in selected Kenyan hospitals using a combined approach of Transformative Innovation Policy (TIP) research and Basic Science research.

Methods: The TIP approach, based on transformative innovation criteria, incorporated data collection through interviews and workshops. The Basic Science Approach employed health system assessment tools customized through the TIP lens. These tools included periodic national, county and healthcare facility assessment tools for AMS, laboratory assessment tools, and questionnaires developed using the Open Data Kit (ODK) application. Interviews were conducted with key informants and healthcare professionals from the county department of health and hospital administration.

Results: All nine participating counties had developed antimicrobial resistance action plans. The findings demonstrated significant efforts by hospitals to align with antimicrobial stewardship. However, challenges such as a lack of data, funding, and training opportunities persist. While the laboratories showed capacities for basic bacteriology, investments in modern lab facilities and equipment were necessary to improve diagnostic capabilities.

Conclusion: The study revealed the progress made in implementing antimicrobial stewardship initiatives in Kenyan referral hospitals. It highlighted the need for data-driven policies, adequate funding, and training opportunities to strengthen antimicrobial stewardship programs. Collaboration among hospitals, county health agencies, and healthcare providers is crucial to promote sensible antibiotic use and reduce antibiotic resistance. Effective antimicrobial stewardship programs can enhance treatment outcomes, decrease over-the-counter antibiotic use, and reduce healthcare expenditures.