Abstract:
Background: Antimicrobial stewardship programs (ASP), the integrated interventions to improve
proper use of antimicrobials and contain antimicrobial resistance, are facing multifaceted
challenges. For the effective implementation of ASP, improving the knowledge, attitudes and
practices (KAP) of health care professionals (HCPs) and identifying the potential opportunities
and challenges should be priorities in the health facilities. However, the opportunities and
challenges are not well studied in resource limited settings like Ethiopia. The current study was
aimed to assess the level of KAP of HCPs and identify the opportunities and challenges in Jimma
University Medical Center (JUMC).
Method: Hospital-based cross-sectional study design was conducted using both quantitative and
qualitative methods among HCPs in JUMC who are involved in patient care and hospital
leadership. Accordingly, 105 physicians, 140 nurses, 18 pharmacists, 17 midwives and 10
anesthetists were recruited to the study by using systematic random sampling. The participants for
the qualitative/interview part of the study were recruited by using purposive sampling. Interview
guide was developed based on previous similar studies and relevant antimicrobial stewardship
programs checklists. Then statistical and thematic analyses were conducted for the quantitative
and qualitative parts, respectively.
Results: Among the sample population of 290 participants, 276 responded, making the response
rate of 95%. Only 19.6%, 19.6% and 17.0% of the study participants have good knowledge,
positive attitude and good practice towards antimicrobial stewardship programs. The good
understanding of the hospital leadership on the problem, accredited microbiology laboratory and
qualified staffs, the presence of separated ASP unit, devoted and experienced experts, presence of
supportive projects, and the effort of Ethiopian Public Health Institute (EPHI) in encouraging the
programs are the identified opportunities. Lack of fully committed hospital leadership, lack of
dedicated budget for the programs and shortage of microbiology laboratory supplies are the major
challenges identified.
Conclusion: Even though there are good pioneering antimicrobial stewardship strategies in
JUMC, the programs are challenged by lack of full leadership commitment, lack of supplies and
technologies and factors related to private health sectors and the community. The newly started
stewardship activities like awareness creation sessions, regular trainings and antimicrobial
stewardship-oriented ward rounds should be strengthened.
