CFID Quality Improvement Pediatrics Antimicrobial Stewardship 2021 PROGRESS REPORT

Project Title: Implementing a Multicenter Antibiotic Stewardship program in Pediatrics across 6 hospitals in Nigeria

Goal of the project: The Overall goal of the project is to contribute towards limiting the spread of antimicrobial resistance, eliminating unnecessary antimicrobial use and improving health outcomes for pediatric patients in Nigeria.

Project Overview

Antimicrobial Resistance (AMR) occurs when bacteria, parasites, viruses or fungi are exposed to antimicrobials but not killed by them; it is a natural phenomenon which gives organisms the opportunity to adapt and change, rendering medicines ineffective. Inappropriate antimicrobial use drives the development of antimicrobial resistance (AMR). Optimizing the use of existing antimicrobial medicines is therefore crucial to the preservation of their efficacy and preventing resistance development.

Nigeria out of 12 countries has one of the highest average number of prescriptions and highest percentage of antibiotic prescription.

In 2017, the percentage of antibiotics prescribed per patient encounter ranged from 26.8% to 71.1%, with the highest proportion reported in children less than five years of age, underscoring the need for AMS in pediatrics in Nigeria.

In view of this, Centre for Initiative and Development (CFID) Taraba being a patient driven; research focused non-profit making  organization in Nigeria is collaborating with Nigeria Centre for Disease Control (NCDC) in  implement this project across 6 semi-urban and rural states in Nigeria, with very poor access to quality health care but high population density of over 25 million people with plans to reach Doctors/Dentists/Nurses/Pharmacists working in pediatrics/children wards or units in each target hospital.

Anticipated Project Timeline

Project Design/Methods: This quality improvement AMS in pediatrics intervention will be implemented in 3 phases:

  • Phase 1; Assessment of Knowledge Attitude and Practices of Health Care Workers on AMS in Pediatrics. • Phase 2; CME trainings for HCPs using the validated AMS modules
  • Phase 3; evaluations, feedback and experience exchange meetings to improve sustainability of project outcomes

Intervention Hospitals

  1. Abuja FCT – Limi Children’s Hospital, Wuse FCT
  2. Benue State – Federal Medical Center (FMC), Makurdi
  3. Nasarawa State – Dalhatu Araf Specialist Hospital (DASH), Lafiya
  4. Plateau – Plateau State Specialist Hospital (PSSH), Jos
  5. Taraba – Federal Medical Center (FMC) Jalingo, Taraba State
  6. Sokoto – Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto

ACTIVITIES CONDUCTED:

ACTIVITIES CONDUCTED WITHIN REPORTING PERIOD

  • Conducted Planning meeting(s) with key stakeholders on AMS in various states
  • Sent out Official engagement letters to all target hospitals
  • Conducted Advocacy to Target hospitals managements and host communities to engage diverse stakeholders and build community support
  • Conducted facility specific AMS Needs assessment and SWOT analysis to guide each hospital management on scope and scale of implementing AMS interventions.
  • Conducted Feedback meeting to target hospitals managements based on gaps identified
  • Set up Pediatrics AMS teams in each hospital (including representative from patient groups)

The survey was based on interviews with facility personnel.  A cross sectional quantitative study was conducted, and data collection was done using structured questionnaires (find attached).

Areas covered within health facilities

  • Hospital management
  • Clinical Microbiologists/Medical Laboratory
  • Infectious disease physicians
  • Pediatricians
  • Pharmacy
  • infectious diseases nurses
  • Infection Prevention and Control
  • Pharmacy department
  • Infection Prevention and Control
  • ICT/Record officer

Pictures of Advocacy/Needs Assessment at FMC Jalingo

Pictures of Activities from FMC Makurdi

Pictures of activities from Playeau State Specialist Hospital, Jos

Pictures of Activities from DASH Lafiya

Pictures of Activities from UDUTH, Sokoto

Pictures of Activities from Limi Children’s’ Hospital Abuja

    

OUTCOMES:

  • Identified facility specific Pediatrics AMS gaps/needs for all target hospitals
  • Feedback/advocacy meetings conducted to share report of need assessment, including identified gaps. This will guide each of the hospital on the scope and scale of PAMS intervention in each of the facilities

PAMS teams established in each of the seven implementing hospitals. In line with best practice, patient representatives were included as part of the AMS teams

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