Antibiotics | Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals' Practice of Antimicrobial Stewardship (AMS) Programmes in Ghana's Volta Region

This article examines the implementation of a hub-and-spoke antimicrobial stewardship (AMS) model in Ghana's Volta Region, demonstrating its significant role in improving healthcare professionals' awareness of antimicrobial resistance (AMR), enhancing clinical practices, and strengthening leadership capabilities. Despite challenges such as resource limitations and community behavioral changes, the model offers a feasible solution for low- and middle-income countries (LMICs) to combat AMR.

 

Literature Overview
This article titled 'Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals’ Practice of Antimicrobial Stewardship (AMS) Programmes in the Volta Region of Ghana', published in the journal Antibiotics, reviews and summarizes the effectiveness of implementing a hub-and-spoke AMS model in Ghana's Volta Region. Through qualitative interviews, the study analyzes the model's impact on AMS knowledge, clinical practices, and leadership development, providing practical reference for antimicrobial resistance (AMR) management in low- and middle-income countries (LMICs).

Background Knowledge
Antimicrobial resistance (AMR) represents a critical global public health challenge, particularly in resource-limited countries where antimicrobial misuse is prevalent, exacerbating drug resistance. The hub-and-spoke model, a networked collaboration strategy, enables centralized hubs to support peripheral spokes (healthcare facilities) through resource sharing and knowledge dissemination. Recently applied in AMS programs across multiple countries, this model effectively monitors and educates on antimicrobial use. Ghana's Volta Region, characterized by uneven urban-rural healthcare distribution and widespread community pharmacies, serves as an ideal setting for this model. The study further validates its effectiveness in enhancing healthcare professionals' AMR competence, optimizing antimicrobial prescribing, and promoting multidisciplinary collaboration, while identifying implementation barriers at the community level, such as public self-medication practices.

 

 

Research Methods and Experiments
The study employed a qualitative descriptive design, collecting insights from 11 healthcare professionals in Ghana's Volta Region through in-depth interviews. Interview topics focused on knowledge acquisition, clinical practice changes, leadership development, collaboration mechanisms, and implementation challenges related to AMS programs. Thematic analysis identified 8 core themes: knowledge and skill enhancement, clinical and leadership practice changes, knowledge sharing and interfacility collaboration, implementation barriers, patient education, data-driven management practices, sustainability, and future visions.

Key Conclusions and Perspectives

• Participants demonstrated significant improvements in understanding AMR and its clinical implications, particularly regarding antimicrobial misuse and infection control measures.
• In clinical practices, physicians adopted more cautious prescribing habits, increasingly relying on culture and sensitivity testing while adhering to AMS guidelines.
• Leadership development was evident through participants' roles in AMS committees, driving multidisciplinary collaboration and institutional policy formulation.
• Interfacility knowledge sharing and collaboration strengthened through workshops, infection control meetings, and point prevalence survey (PPS) data exchange.
• Major challenges included funding shortages, inadequate laboratory infrastructure, staffing difficulties, and community self-medication practices.
• Patient education and community engagement emerged as critical components for AMR mitigation, utilizing media campaigns, religious institutions, and interpersonal networks.
• Data tools like PPS surveys were recognized as effective for assessing antimicrobial use trends and guiding interventions.
• For sustainability, participants emphasized institutional integration of AMS through ward-level AMS representatives, continuous staff training, and administrative support.

Research Significance and Prospects
The study provides empirical validation of the hub-and-spoke AMS model's applicability in LMICs, demonstrating its effectiveness in enhancing AMR awareness and clinical practices. Future research should focus on long-term sustainability and strategies for deeper integration of AMS practices within healthcare systems and community behaviors to achieve systemic AMR interventions.

 

 

Conclusion
This research demonstrates the hub-and-spoke AMS model effectively enhanced healthcare professionals' AMR awareness and practice capabilities in Ghana's Volta Region. Training, multidisciplinary collaboration, and data-driven approaches led to positive advancements in antimicrobial prescribing, infection control, and leadership development. However, resource constraints and public self-medication practices remain key challenges. The study recommends institutionalizing AMS through ward-level representatives, ongoing staff training, and administrative support to ensure long-term effectiveness. Future studies should evaluate model sustainability and explore deeper integration of AMS practices within healthcare systems and community behaviors to advance comprehensive AMR strategies.

 

Mairead McErlean, Eneyi Kpokiri, Preet Panesar, Cornelius C Dodoo, and Yogini H Jani. Evaluation of a Hub-and-Spoke Model to Enhance Healthcare Professionals’ Practice of Antimicrobial Stewardship (AMS) Programmes in the Volta Region of Ghana. Antibiotics.