A mixed methods study on the status and challenges of implementing antimicrobial stewardship programmes in seventeen hospitals in Kampala, Uganda

Background The present study evaluated the status of implementation and the barriers of AMS in private hospitals in Kampala, Uganda. Methods A cross-sectional survey was conducted in seventeen private hospitals in Kampala, Uganda, between August 2020 and September 2020, using a mixed methods approach. Qualitative data was collected using key informant (KI) interviews while quantitative data was collected using the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) checklist. Transcripts from key informant interviews were analyzed using the content analysis method and data from the CwPAMS checklist was analyzed using descriptive statistics. Results Most hospitals in the study area had no designated AMS team lead, budget for AMS activities, documents outlining the roles and responsibilities of the AMS team, minutes of AMS meetings, and regular reports on AMS. There was also a shortage of staff for AMS activities, low training on AMS, AMS was not prioritized, and there were inadequate resources to train staff on optimizing antimicrobial prescribing. Conclusions There are multiple barriers to the implementation of Antimicrobial Stewardship in private hospitals in Kampala. More resources need to be allocated to the study area to carry out AMS activities.