Healthcare professionals save lives

Project title: Antimicrobial Stewardship and Conservancy in Africa.

The project aims to create a critical mass of Masters and PhD credentialed faculty in Universities and for healthcare professionals in the public health sector, particularly women, with the requisite biomedical, clinical and social sciences and /or policy related knowledge and skills to optimally manage infection, prevent its spread and employ strategies to prevent the emergence and dissemination of antimicrobial resistance. Further it will aim to improve the capacity of health systems to manage infections and contain antimicrobial resistance.

Background

The common causes of morbidity and death in Malawi and Mozambique are malaria, tuberculosis, HIV/AIDS, acute respiratory tract infections and diarrheal diseases. In Malawi the adult HIV prevalence is estimated at 12 % with an estimated 85 000 new infections occurring annually. Of the 28 000 tuberculosis cases reported annually, 70 % of the patients also test positive for HIV. Malaria is the major cause of hospital visits in under-five children and adult deaths. In Mozambique approximately six million cases of malaria are reported each year, around 24 % of deaths among children under-five are due to malaria and many of the high numbers of maternal deaths are directly or indirectly caused by malaria infection. Mozambique has an incidence rate of 431 cases of tuberculosis per 100 000 people and ranks 19th among the 22 high-burden countries in the world. In 2008, an estimated 1 800 000 were living with HIV and more than 370 000 were in need of antiretroviral treatment. However, the true national burden of AMR infections remains unknown in these countries, largely due to the absence of bacterial surveillance systems and diagnostic facilities both in the communities and in hospitals.

Increasingly, AMR is recognized as a key obstacle in the successful management of infectious diseases. Traditional empirical treatment is the sole recourse in countries that lack a reference laboratory, clearly constituting a considerable risk of treatment failure as well as waste of resources by health services through procurement of ineffective medicines.

There is a lack of qualified faculty as well as health professionals, both to develop more knowledge through education and research, and to establish infrastructure and surveillance systems in order to deal with the challenge of antimicrobial resistance and conservancy both in Malawi and in Mozambique.

Building capacity within higher education and research to meet the challenges of antimicrobial resistance and effective treatment of communicable diseases.

The project is a cooperation between the University of Kwa Zulu Natal in South Africa, University of Malawi in Malawi, Institutio Superior de Ciencias de Saude in Mozambique and the University of Tromsø in Norway.

Six major “focus streams” will serve as the conceptual framework for the project; antimicrobial use and resistance, curriculum and pedagogy, policy and health systems, socio-behavioural factors, and the cross-cutting themes of gender equality and monitoring and evaluation. These focus streams will guide the research and pedagogy related to antimicrobial stewardship.

The project is designed to improve key-infection related health statistics in Malawi and Mozambique by conducting research and generate evidence of the nature and extent of antimicrobial resistance (AMR) with a view to designing context-specific interventions for its containment. In order to achieve this, the project will provide postgraduate opportunity for academic staff at UNIMA and ISCISA as well as developing existing laboratories, IT and administrative capacities.

The qualifications of university staff will be strengthened as well as health professionals/students in i.e. teaching and developing curriculum on-line, writing for publications, grant writing and inclusion of social sciences in research. At the end of the project a GRIPP (getting research into policy and planning) conference will be held with stakeholders and policy makers. Establishment of proper sentinel surveillance systems in collaboration with Ministry of Health will also be an important component.

There is a strong focus on gender mainstreaming in all components of the project. It aims to have 50 % women involved in all project activities, and one of the main objectives is to provide opportunities for female academic staff to pursue professional development and qualifications.

Key goals and achievements

Overall goal
Facilitate progress towards the achievement of millennium development goals 3, 4, 6 & 8 in Malawi and Mozambique.

The objectives of the project are

1. Strengthened higher education institutions in Malawi and Mozambique.
2. Strengthened health systems in Malawi and Mozambique.
3. Enhanced research capacity/competency.
4. Human capital development.
5. Context-specific knowledge generation informing policy & practice.
6. Increased participation and stature of women in education, research and policymaking.