McErlean Mairead, Kpokiri Eneyi, Panesar Preet, Cooper Emily E, Jato Jonathan, Orman Emmanuel, Odoi Hayford, Hutton-Nyameaye Araba, Somuah Samuel O, Folitse Isaac, Aku Thelma A, Ben Inemesit O, Farragher Melissa, Hail Leila, Dodoo Cornelius C, Jani Yogini H
Centre for Medicines Optimisation Research & Education-CMORE, University College London Hospitals NHS Foundation Trust, 250 Euston Road, London NW1 2PG, UK.
Clinical Research Department, Faculty of Infectious & Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Antibiotics (Basel). 2025 Jul 2;14(7):672. doi: 10.3390/antibiotics14070672.
: Antimicrobial resistance (AMR) poses a critical global health challenge, particularly in resource-limited settings. A hub-and-spoke model, decentralising expertise and distributing resources to peripheral facilities, has been proposed as a strategy to enhance the antimicrobial stewardship (AMS) capacity in low- and middle-income countries. : This study sought to understand healthcare professionals' experiences of a hub-and-spoke AMS model in the Volta Region of Ghana and its influence on clinical practice, leadership, and collaborative endeavours to address AMR. : A qualitative descriptive design was adopted. In-depth interviews were conducted with 11 healthcare professionals who participated in the AMS program. Thematic analysis was used to identify key themes related to the knowledge and skills that were gained, clinical and leadership practice changes, capacity building, and challenges. : Participants reported an increased awareness of AMR, particularly regarding the scale and clinical implications of antimicrobial misuse. The clinical practice improvements included more judicious prescribing and enhanced adherence to infection prevention and control measures. Many respondents highlighted stronger leadership skills and a commitment to capacity building through AMS committees, multidisciplinary collaboration, and cross-organisational knowledge exchange. Despite resource constraints and logistical hurdles, participants expressed optimism, citing data-driven approaches such as point prevalence surveys to track progress and inform policy. Engagement with hospital management and public outreach were viewed as essential to sustaining AMS efforts and curbing over-the-counter antibiotic misuse. : The hub-and-spoke model caused observable improvements in AMS knowledge, clinical practice, and leadership capacity among healthcare professionals in Ghana. While challenges remain, particularly in securing sustainable resources and shifting community behaviours, these findings underscore the potential of network-based programs to catalyse systemic changes in tackling AMR. Future research should explore long-term outcomes and strategies for embedding AMS practices more deeply within healthcare systems and communities.
抗菌药物耐药性（AMR）对全球健康构成了严峻挑战，在资源有限的环境中尤为如此。一种将专业知识分散并将资源分配到周边设施的中心辐射型模式已被提议作为提高低收入和中等收入国家抗菌药物管理（AMS）能力的策略。
本研究旨在了解加纳沃尔特地区医疗保健专业人员对中心辐射型AMS模式的体验及其对临床实践、领导力以及应对AMR的协作努力的影响。
采用了定性描述性设计。对11名参与AMS项目的医疗保健专业人员进行了深入访谈。采用主题分析法来确定与所获得的知识和技能、临床和领导实践变化、能力建设以及挑战相关的关键主题。
参与者报告称，他们对抗菌药物耐药性的认识有所提高，特别是对抗菌药物滥用的规模和临床影响的认识。临床实践的改进包括更明智的处方以及加强对感染预防和控制措施的遵守。许多受访者强调了更强的领导技能以及通过AMS委员会、多学科协作和跨组织知识交流致力于能力建设。尽管存在资源限制和后勤障碍，但参与者表示乐观，列举了如现患率调查等数据驱动方法来跟踪进展并为政策提供信息。与医院管理层的互动和公众宣传被视为维持AMS努力和遏制非处方抗生素滥用的关键。
中心辐射型模式使加纳医疗保健专业人员在AMS知识、临床实践和领导能力方面有了明显改善。虽然挑战依然存在，特别是在确保可持续资源和改变社区行为方面，但这些发现强调了基于网络的项目在推动应对AMR的系统性变革方面的潜力。未来的研究应探索长期结果以及将AMS实践更深入地融入医疗保健系统和社区的策略。
