Date of Award
2023
Document Type
Dissertation
Degree Name
Master of Medicine (MMed)
First Supervisor/Advisor
Dr. Wahu Gitaka
Second Supervisor/Advisor
Dr. Aliza Monroe-Wise
Third Supervisor/Advisor
Prof. Rodney Adam
Department
AKU-East Africa
Abstract
Introduction: Antimicrobial resistance is an important global health threat and it is estimated that by 2050 it will account for 10 million deaths globally. Low and middle income countries are disproportionately affected by the burden of antimicrobial resistance. One of the major causes of antimicrobial resistance is irrational and overuse of antibiotics. Understanding the knowledge, attitudes and priorities of healthcare workers and healthcare administrators on antimicrobial resistance and antimicrobial stewardship is pivotal in implementation of strategies to curb the spread of antimicrobial resistance.
Methods: A qualitative study using in-depth semi-structured interviews was conducted among clinicians and clinic administrators in 12 private outpatient clinics in Kenya. The interviews were audiotaped and field notes were taken. Audiotapes were then transcribed and a thematic analysis was conducted using Nvivo 12 software. The (Capability, Opportunity and Motivation for Behavior) COM-B model was used to understand the knowledge, attitudes and priorities surrounding antimicrobial resistance and antimicrobial stewardship.
Results: Twenty-four participants were interviewed. The following main themes emerged: knowledge, agency, experience, barriers to and needs for implementation, opportunities and ideas, importance and prioritization and attitudes. There was generally a lack of knowledge on antimicrobial stewardship and its components, and participants didn’t perceive antimicrobial resistance to be a problem in their clinics although they reported that it was a problem in the country and globally. There was lack of prioritization of AMS in the clinics. Patient attitudes and practices were reported as one of the main drivers for antimicrobial resistance with patient and provider education emerging as one of the ways to curb AMR.
Conclusion: The lack of knowledge on antimicrobial stewardship and its components coupled with participants stating that antimicrobial resistance was not a problem in their facilities points to a persistent need to educate both healthcare workers and healthcare administrators on antimicrobial resistance and antimicrobial stewardship to allow them to own the problem and hence be pro-active in implementing measures to curb it.
Recommended Citation
Kaniu, M. W. (2023). Knowledge attitudes and priorities regarding antimicrobial resistance and antimicrobial stewardship among clinic administrators and clinicians in outpatient medical centres in Kenya: A qualitative study (Unpublished master's dissertation). Aga Khan University, East Africa.