Practices and Perspectives of Lead Implementers on Implementation of Antimicrobial Resistance Strategic Plan: A...

Addressing the escalating threats of antimicrobial resistance (AMR) through developing and implementing context-specific strategy remains a worldwide priority response. However, its adoption and implementation have often been fragmented in low-resource settings and are currently under-researched. This study evaluates the multi-stakeholder perspectives, practices and operational challenges encountered across Ethiopian national lead implementers of the AMR strategic plan in combating AMR.

This cross-sectional, descriptive study recruited seven AMR stakeholders, recognised as lead implementers of the national AMR strategic plan across human, animal and environmental health sectors in Ethiopia. Data were gathered via face-to-face, semi-structured interviews and document review. Then the collected data were transcribed verbatim and thematically analysed.

The findings reveal the adoption and commencement of implementing the Ethiopian national AMR strategic plan at varying levels across One Health sectors in Ethiopia. While all key informants had positive perspectives towards implementation and were familiar with the strategic objectives, the practices were inconsistent. Among the five strategic objectives, sub-indicators associated with raising awareness, strengthening infection and prevention control practices and optimising antimicrobial use were better implemented with moderate to full engagement of lead implementers (≥ 75%). Meanwhile, no stakeholder initiated new vaccines and drug substances development and environmental risk assessment for antimicrobials yet. The cross-cutting barriers such as weak and fragmented inter-sectoral collaboration, inconsistent follow-up and scarcity of human and financial resources remained hampering effective implementation.

Findings demonstrated that despite the existence of an AMR tackling strategy and initiatives, implementation and enforcement remain below the level required by the urgency of the AMR situation. It underscores the importance of bridging implementation gaps by prioritising AMR, strengthening equivalent engagement and collaborations, and capacity building.