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Volume 14
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10.3390/antibiotics14070672
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Article

Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals’ Practice of Antimicrobial Stewardship (AMS) Programmes in the Volta Region of Ghana

by
Mairead McErlean
1,
Eneyi Kpokiri
2,
Preet Panesar
1,
Emily E. Cooper
1,
Jonathan Jato
3,
Emmanuel Orman
3,
Hayford Odoi
3,
Araba Hutton-Nyameaye
3,
Samuel O. Somuah
3,
Isaac Folitse
4,
Thelma A. Aku
3,
Inemesit O. Ben
3,
Melissa Farragher
5,
Leila Hail
5,
Cornelius C. Dodoo
3 and
Yogini H. Jani
1,6,*
1
Centre for Medicines Optimisation Research & Education—CMORE, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK
2
Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
3
School of Pharmacy, University of Health and Allied Sciences, Ho PMB 31, Ghana
4
Pharmacy Directorate, Ho Teaching Hospital, Ho P.O. Box MA 374, Ghana
5
Infection Prevention and Control Department, University College London Hospitals NHS Foundation Trust, 5th Floor Central, 250 Euston Road, London NW1 2PG, UK
6
School of Pharmacy, University College London, 29–39 Brunswick Square, London WC1N 1AX, UK
*
Author to whom correspondence should be addressed.
Antibiotics 2025, 14(7), 672; https://doi.org/10.3390/antibiotics14070672
Submission received: 27 May 2025 / Revised: 23 June 2025 / Accepted: 26 June 2025 / Published: 2 July 2025
(This article belongs to the Special Issue Antibiotics Stewardship in Low and Middle-Income Countries)
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Abstract

Background: Antimicrobial resistance (AMR) poses a critical global health challenge, particularly in resource-limited settings. A hub-and-spoke model, decentralising expertise and distributing resources to peripheral facilities, has been proposed as a strategy to enhance the antimicrobial stewardship (AMS) capacity in low- and middle-income countries. Aim: This study sought to understand healthcare professionals’ experiences of a hub-and-spoke AMS model in the Volta Region of Ghana and its influence on clinical practice, leadership, and collaborative endeavours to address AMR. Methods: A qualitative descriptive design was adopted. In-depth interviews were conducted with 11 healthcare professionals who participated in the AMS program. Thematic analysis was used to identify key themes related to the knowledge and skills that were gained, clinical and leadership practice changes, capacity building, and challenges. Results: Participants reported an increased awareness of AMR, particularly regarding the scale and clinical implications of antimicrobial misuse. The clinical practice improvements included more judicious prescribing and enhanced adherence to infection prevention and control measures. Many respondents highlighted stronger leadership skills and a commitment to capacity building through AMS committees, multidisciplinary collaboration, and cross-organisational knowledge exchange. Despite resource constraints and logistical hurdles, participants expressed optimism, citing data-driven approaches such as point prevalence surveys to track progress and inform policy. Engagement with hospital management and public outreach were viewed as essential to sustaining AMS efforts and curbing over-the-counter antibiotic misuse. Conclusions: The hub-and-spoke model caused observable improvements in AMS knowledge, clinical practice, and leadership capacity among healthcare professionals in Ghana. While challenges remain, particularly in securing sustainable resources and shifting community behaviours, these findings underscore the potential of network-based programs to catalyse systemic changes in tackling AMR. Future research should explore long-term outcomes and strategies for embedding AMS practices more deeply within healthcare systems and communities.
Keywords: antimicrobial stewardship; hub-and-spoke model; antimicrobial resistance antimicrobial stewardship; hub-and-spoke model; antimicrobial resistance

Share and Cite

MDPI and ACS Style

McErlean, M.; Kpokiri, E.; Panesar, P.; Cooper, E.E.; Jato, J.; Orman, E.; Odoi, H.; Hutton-Nyameaye, A.; Somuah, S.O.; Folitse, I.; et al. Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals’ Practice of Antimicrobial Stewardship (AMS) Programmes in the Volta Region of Ghana. Antibiotics 2025, 14, 672. https://doi.org/10.3390/antibiotics14070672

AMA Style

McErlean M, Kpokiri E, Panesar P, Cooper EE, Jato J, Orman E, Odoi H, Hutton-Nyameaye A, Somuah SO, Folitse I, et al. Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals’ Practice of Antimicrobial Stewardship (AMS) Programmes in the Volta Region of Ghana. Antibiotics. 2025; 14(7):672. https://doi.org/10.3390/antibiotics14070672

Chicago/Turabian Style

McErlean, Mairead, Eneyi Kpokiri, Preet Panesar, Emily E. Cooper, Jonathan Jato, Emmanuel Orman, Hayford Odoi, Araba Hutton-Nyameaye, Samuel O. Somuah, Isaac Folitse, and et al. 2025. "Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals’ Practice of Antimicrobial Stewardship (AMS) Programmes in the Volta Region of Ghana" Antibiotics 14, no. 7: 672. https://doi.org/10.3390/antibiotics14070672

APA Style

McErlean, M., Kpokiri, E., Panesar, P., Cooper, E. E., Jato, J., Orman, E., Odoi, H., Hutton-Nyameaye, A., Somuah, S. O., Folitse, I., Aku, T. A., Ben, I. O., Farragher, M., Hail, L., Dodoo, C. C., & Jani, Y. H. (2025). Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals’ Practice of Antimicrobial Stewardship (AMS) Programmes in the Volta Region of Ghana. Antibiotics, 14(7), 672. https://doi.org/10.3390/antibiotics14070672

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