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Volume 14
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10.3390/antibiotics14080794
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Article

Bridging the Capacity Building Gap for Antimicrobial Stewardship Implementation: Evidence from Virtual Communities of Practice in Kenya, Ghana, and Malawi

by
Ana C. Barbosa de Lima
1,*,
Kwame Ohene Buabeng
2,3,
Mavis Sakyi
4,5,
Hope Michael Chadwala
6,
Nicole Devereaux
1,
Collins Mitambo
6,
Christine Mugo-Sitati
7,
Jennifer Njuhigu
8,
Gunturu Revathi
9,
Emmanuel Tanui
8,
Jutta Lehmer
1,
Jorge Mera
1 and
Amy V. Groom
1,*
1
ECHO Institute, University of New Mexico Health Sciences Center, 1650 University Blvd. NE, Albuquerque, NM 87102, USA
2
Department of Pharmacy Practice, School of Pharmacy, University of Health and Allied Sciences, Ho, PMB 31, Ghana
3
Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi 00233, Ghana
4
Technical Coordination Directorate, Ministry of Health, P.O. Box M-44, Accra, Ghana
5
Doctoral Programme, Interfaculty Initiative in Planetary Health, Nagasaki University, Nagasaki 852-8131, Japan
6
Ministry of Health, P.O. Box 30377, Lilongwe 3, Malawi
7
ECHO Africa, University of New Mexico Health Sciences Center, Nairobi, Nairobi Area, 00200, Kenya
8
Ministry of Health, P.O. Box 30016, Nairobi, Kenya
9
Department of Pathology, Aga Khan University, P.O. Box 30270-00100, Nairobi, Kenya
*
Authors to whom correspondence should be addressed.
Antibiotics 2025, 14(8), 794; https://doi.org/10.3390/antibiotics14080794 (registering DOI)
Submission received: 18 June 2025 / Revised: 12 July 2025 / Accepted: 23 July 2025 / Published: 4 August 2025
(This article belongs to the Special Issue Global Strategies for Antimicrobial Stewardship: Insights from WHO and PAHO)
Review Reports Versions Notes

Abstract

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusion: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity.
Keywords: AMS; AMR; IPC; community of practice; virtual education; e-learning; healthcare facility assessment AMS; AMR; IPC; community of practice; virtual education; e-learning; healthcare facility assessment

Share and Cite

MDPI and ACS Style

Barbosa de Lima, A.C.; Buabeng, K.O.; Sakyi, M.; Chadwala, H.M.; Devereaux, N.; Mitambo, C.; Mugo-Sitati, C.; Njuhigu, J.; Revathi, G.; Tanui, E.; et al. Bridging the Capacity Building Gap for Antimicrobial Stewardship Implementation: Evidence from Virtual Communities of Practice in Kenya, Ghana, and Malawi. Antibiotics 2025, 14, 794. https://doi.org/10.3390/antibiotics14080794

AMA Style

Barbosa de Lima AC, Buabeng KO, Sakyi M, Chadwala HM, Devereaux N, Mitambo C, Mugo-Sitati C, Njuhigu J, Revathi G, Tanui E, et al. Bridging the Capacity Building Gap for Antimicrobial Stewardship Implementation: Evidence from Virtual Communities of Practice in Kenya, Ghana, and Malawi. Antibiotics. 2025; 14(8):794. https://doi.org/10.3390/antibiotics14080794

Chicago/Turabian Style

Barbosa de Lima, Ana C., Kwame Ohene Buabeng, Mavis Sakyi, Hope Michael Chadwala, Nicole Devereaux, Collins Mitambo, Christine Mugo-Sitati, Jennifer Njuhigu, Gunturu Revathi, Emmanuel Tanui, and et al. 2025. "Bridging the Capacity Building Gap for Antimicrobial Stewardship Implementation: Evidence from Virtual Communities of Practice in Kenya, Ghana, and Malawi" Antibiotics 14, no. 8: 794. https://doi.org/10.3390/antibiotics14080794

APA Style

Barbosa de Lima, A. C., Buabeng, K. O., Sakyi, M., Chadwala, H. M., Devereaux, N., Mitambo, C., Mugo-Sitati, C., Njuhigu, J., Revathi, G., Tanui, E., Lehmer, J., Mera, J., & Groom, A. V. (2025). Bridging the Capacity Building Gap for Antimicrobial Stewardship Implementation: Evidence from Virtual Communities of Practice in Kenya, Ghana, and Malawi. Antibiotics, 14(8), 794. https://doi.org/10.3390/antibiotics14080794

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