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.

ASPRIPHYN-1 (Antimicrobial Stewardship toolkit for PRIvate-sector PHYsicians in Nigeria) Project 

Antimicrobial resistance (AMR) poses a major threat to global health, with low‑ and middle‑income countries experiencing the greatest burden. In Nigeria, where the private sector delivers a substantial proportion of healthcare, limited stewardship support and inconsistent prescribing oversight contribute to inappropriate antibiotic use. Yet few antimicrobial stewardship interventions have been specifically developed for private‑sector physicians or adapted to the realities of Nigeria’s health system. In this study, we will develop and assess key components of a future cluster randomized trial aimed at testing a context‑specific antibiotic stewardship intervention tailored to Nigeria’s private healthcare sector. The intervention will focus on fostering sustainable behavior change, promoting evidence‑based prescribing through the integration of the WHO AWaRe Antibiotic Handbook, and ensuring strategies align with local constraints. Once developed, the intervention will be tested over six months in 24 private clinics across the Federal Capital Territory and Lagos State. Because prescription records are often unavailable, the study will also test practical methods for measuring antibiotic use. This study will refine the program to ensure it meets local needs and lays the groundwork for future expansion. By improving antibiotic use, the project aims to help reduce drug-resistant infections and strengthen public health in Nigeria and beyond.

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.