# Attitudes of healthcare workers at a District in KwaZulu-Natal regarding institutionalisation of antimicrobial stewardship

## TL;DR

This study explores healthcare workers' attitudes and knowledge about antimicrobial stewardship in a South African district, highlighting the importance of experience and training in combating antibiotic resistance.

## Contribution

The study provides new insights into healthcare workers' perceptions and knowledge of antimicrobial stewardship in a sub-Saharan African context.

## Key findings

- Most participants felt they had a key role in reducing antibiotic resistance and had good knowledge of antimicrobials.
- Participants with less than 12 months of employment had limited knowledge of antimicrobials and AMS programs.
- Experience and adequate staffing are critical for institutionalizing AMS programs in public health facilities.

## Abstract

The Antimicrobial Stewardship (AMS) programme is one of the strategic initiatives of the World Health Organization’s global action plan to reduce antimicrobial resistance (AMR). In sub-Saharan countries, there is insufficient scientific evidence regarding healthcare providers’ perception of institutionalisation of ASPs as a strategy to reduce AMR.

This study investigated the knowledge, attitudes and practices of healthcare workers in the uMgungundlovu District regarding the enablers and barriers to institutionalisation of AMS programmes in public health settings.

This was a prospective, cross-sectional and a 5-point-Likert-scale (1 = minimal; 2 = limited; 3 = average; 4 = good and 5 = comprehensive) questionnaire-based arm of a larger mixed-methods study. Voluntary participants were purposively recruited from hospitals and community health centres in the uMgungundlovu District, South Africa.

Forty-nine (N = 49) participants were recruited. That is, 33% (n = 16), 28% (n = 14), 25% (n = 12) and 14% (n = 7) were nurses, pharmacists as well as pharmacist interns, medical practitioners and healthcare managers, respectively. Eighty percent (n = 40; median score 5, interquartile range [IQR] 4–5) and 67% (n = 33; median score 4, IQR 3–4) of participants felt that they had a key role in reducing antibiotic resistance; and good knowledge of antimicrobials as well as AMS programmes, respectively. However, participants who had been employed for less than 12 months across all the facilities had ‘limited’ knowledge (median score of 2; IQR 1–3.5) of antimicrobials and AMS programmes.

Healthcare workers in public healthcare settings in the uMgungundlovu District knew how crucial their roles were in reducing AMR.

This study highlights the need for employment experience and adequate healthcare service providers as critical factors for the successful institutionalisation of AMS programmes in public health facilities.