AMR-related research

Antibiotic STewardship Education for Pharmacists (A-STEP): a pre-post study in Nigeria

The worldwide health crisis of antimicrobial resistance (AMR) affects countries such as Nigeria significantly because antibiotics are frequently sold without prescriptions. The A-STEP project examines the success of a structured educational intervention through a pre-post study which seeks to lower the amount of over-the-counter antibiotic distribution by pharmacists and medical vendors in Nigeria. We will implement the WHO AWaRe guidelines along with standardized patients (SPs) to evaluate provider practices before and after training sessions which include non-monetary incentives. The research approach combines various methods with stakeholder and policymaker interviews to evaluate both acceptability and feasibility. We aim to enhance proper antibiotic utilization by educating healthcare providers and cutting down on surplus antibiotic sales. Research results will help create a national antimicrobial stewardship strategy and implement context-specific interventions to improve responsible antibiotic use throughout Nigeria's private healthcare sector.

Funding: CIHR.

Physician perspectives on antimicrobial resistance and stewardship in Nigeria’s private healthcare sector: a cross-sectional study

Antimicrobial resistance (AMR) is considered a global health threat, particularly in low- and middle-income countries (LMICs), such as Nigeria. The misuse and overuse of antibiotics, limited diagnostic tools and infrastructure, and weak regulatory and enforcement mechanisms are contributing factors to AMR threat. Most of the research and policy initiatives have been directed towards the public sector while the private sectors have received limited attention, despite providing over 60% of health care in the country. Our research aims at addressing this critical knowledge gap by exploring private sector physicians’ perspectives on AMR and stewardship (AMS) in Nigeria. We conducted a cross-sectional study where we surveyed private physicians in Lagos and Abuja state, Nigeria to assess their knowledge and attitudes toward AMR and antibiotic prescribing, and examine their experiences, constraints, and preferences regarding the design and implementation of stewardship initiatives. We used the Consolidated Framework for Implementation Research (CFIR) to understand antibiotic prescribing and the structural barriers to implementing stewardship practices. We aim to use the results for the development of a feasibility and acceptability trial of an AMS intervention in the Nigerian private sector and the development of an AMS program to support the rational use of antibiotics in the private healthcare sector.

Funding: uOttawa.

Barriers and facilitators to antibiotic stewardship in Nigeria’s private healthcare sector: a qualitative interview study with key interest holders

Antimicrobial resistance (AMR) is a pressing global health threat, particularly in low- and middle-income countries such as Nigeria, where the private sector delivers the majority of healthcare but remains underrepresented in national stewardship efforts. This qualitative study will explore the perspectives of key interest holders from regulatory bodies, professional associations, and public health organizations in Nigeria to identify barriers and opportunities for implementing antibiotic stewardship in the private sector through semi-structured virtual interviews. The results will be thematically analyzed via Braun and Clarke’s framework within the Social-Ecological Model. The findings of the study will inform context-specific, sustainable stewardship programs tailored to Nigeria’s private healthcare sector to advance AMR control.

Funding: University of Ottawa