Antimicrobial stewardship knowledge and perception among physicians and pharmacists at leading tertiary teaching hospitals in Zambia (4)

14 January, 2020

Dear Neil,

I happen to be a member of the project team that is undertaking the CwPAMS partnership initiative at the University Teaching Hospitals (UTH) in Zambia. Am happy to share some of our experiences participating on and collaborating with partners on the CwPAMS. I also trust that other key partners such as the Tropical Health Education Trust (THET) are also able to share comprehensive reports on outcomes of the CwPAMS project at UTH in Zambia.

The partnership is a pharmacist-led initiative by Zambian- and UK-based pharmacists on the Brighton-Lusaka Health Link (BLHL). The BLHL brings together pharmacists at UTH and University of Zambia (UNZA) in Lusaka and those in Brighton NHS hospitals, University of Sussex, and University of Brighton, respectively, working together to improve health and education.

The CwPAMS partnership aims to strengthen AMS at UTH. Key objectives of the CwPAMS project at University Teaching Hospitals (UTH) in Zambia are four-fold: (1) Develop and implement an AMS training and capacity building for health professionals at UTH; (2) Develop and pilot a modified in-patient prescription chart for antibiotics at UTH; (3) Enhance Infection Prevention Control (IPC) using behavioral change methodology in sampled wards. IPC interventions tried include on-the-job IPC trainings, sensitization through poster messages, actively promoting handwashing, 'bare below the elbow' dress code for health professionals on the wards, and so on; (4) Measure point-prevalence of antibiotic utilization in the selected wards at UTH using GPPS methodology before and at specific intervals following AMS interventions.

With technical support from the BLHL, an in-service trainer-of-trainers (ToT) package on AMS principles was developed and conducted in Lusaka. Key stakeholder engagement was also done. Health professionals (medical doctors, pharmacists, and nurses) from various Clinical Departments at UTH were trained as AMS champions. Training materials for roll-out trainings locally were mobilised. In-house trainings using OJT and small group sessions at the hospital have since commenced and ongoing. The AMS training package was co-developed with expert input taking on board local needs and adapting experiences from Brighton NHS hospitals in the UK and Ndola Teaching Hospital in Zambia. Teams also shared best practices in AMS through an exchange visit of a Zambian multidisciplinary team of AMS champions at UTH visiting Brighton NHS to learn best practices, knowledge and skills transfer.

The CwPAMS at UTH has scored on many fronts including team-building and utilizing interventions that are mostly locally-driven and not so resource-intensive. Majority of the interventions tried are quite adaptable. It remains to be evaluated the cost-effectiveness of these interventions, including quality of capacity-built, and overall gains made on reducing AMR at UTH. We expect to monitor this in future.

As a project team in Zambia, we are also interested to learn from others, particularly how other countries and healthcare settings are implementing cost-effective AMS interventions targeting the healthcare workers. Will be good to hear more about this.

With thanks and kind regards,


HIFA-Zambia profile: Aubrey Chichonyi Kalungia started his career as Pharmacist in the Ministry of Health Zambia and served at the University Teaching Hospital in Lusaka for two years before taking up specialization in Pharmacology and Global Health. He holds a Bachelor of Pharmacy degree from University of Zambia, School of Medicine), a Masters degree in Pharmacology (University of Oxford, UK) and reading for a Masters degree in Global Health Science (University of Oxford, UK) as a Rhodes Scholar. His interests are in pharmacological drug research, clinical trials, pharmaceutical policy, global access to healthcare, maternal and child health, and tropical disease research. chichokalungia AT