Background

Antimicrobial stewardship (AMS) is an important strategy to control antimicrobial resistance. Resources are available to provide guidance for design and implementation of AMS programmes, however, these may have limited applicability in resource-limited settings including those in Asia.

Context-specific matters for Health Care Facility (HCF)-level AMS implementation are not yet captured in the current HCF tools. Understanding implementation needs and practices within the Asian context and being able to monitor progress over time are key to assisting local healthcare facilities with improving antimicrobial use.

A context-specific assessment tool that is practical and responsive to the local conditions is needed to support institutions to start and maintain AMS programmes in Asia. This assessment tool will be complementary to the WHO tools on the national and HCF level to provide support for hospitals in assessing their AMS status and improving the programme implementation.

Objectives

1. To develop, test and validate a context-specific assessment tool of AMS programs in conjunction with the US CDC team and global partners, building from the available guidance documents and experience
2. To explore the current state of AMS implementation (the core elements, policy and practices, interventions, evaluation metrics) using an established WHO tool (national level) and the new assessment tool (hospital level) in four countries of different income status in Asia
3. To understand the existing AMS resources at the national and hospital level, support from the government (including health ministry and departments), level of training, processes and factors influencing AMS activities and interventions and perceived needs for implementation at the study hospitals in four countries
4. To determine perceived successes/ failures of AMS interventions across the hospital networks in the four countries