ArticleAntimicrobial stewardship & healthcare epidemiology : ASHE2023
Facilitators and barriers to implementing antimicrobial stewardship programs in public South African hospitals.
Article in Antimicrobial stewardship & healthcare epidemiology : ASHE, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- Antibiotic Prescribing in Hospitalized Pediatric Patients Before Implementation of a Syndromic Antibiogram at Maputo Central Hospital, Mozambique.Pediatric reports · 2026Article
- Barriers and facilitators to implementing antimicrobial stewardship (AMS) in a Chinese tertiary hospital: a qualitative study based on the Consolidated Framework for Implementation Research (CFIR).BMC infectious diseases · 2026Article
- Barriers and Facilitators in the Implementation of a Syndromic Antibiogram for Pediatric Patients Hospitalized in Maputo, Mozambique: A Qualitative Study Using the Dynamic Adaptation Process (DAP) Framework.Antibiotics (Basel, Switzerland) · 2026Article
- Article
- Antimicrobial stewardship in community pharmacies in Uyo, Akwa Ibom State: practices, barriers, and facilitators.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Impact of Multidisciplinary-Led Implementation of Antimicrobial Stewardship Programs in Zambia: Findings and Implications.Antibiotics (Basel, Switzerland) · 2025Article
- Antimicrobial Stewardship Program Implementation, Perceptions, and Barriers in Zambia: A Cross-Sectional Study Among Healthcare Professionals.Antibiotics (Basel, Switzerland) · 2025Article
- Article
- Implementation status and challenges affecting antimicrobial stewardship programmes in private hospitals in Kampala, Uganda: Insights from a cross-sectional descriptive survey.PLOS global public health · 2025Article
- A global investigation into antimicrobial knowledge in medicine, pharmacy, nursing, dentistry and veterinary undergraduate students: A scoping review to inform future planetary health multidisciplinary education.BMC medical education · 2024Article
- Antibiotic use and adherence to the WHO AWaRe guidelines across 16 hospitals in Zambia: a point prevalence survey.JAC-antimicrobial resistance · 2024Article
- Barriers, facilitators, perceptions and impact of interventions in implementing antimicrobial stewardship programs in hospitals of low-middle and middle countries: a scoping review.Antimicrobial resistance and infection control · 2024Article
- Antimicrobial stewardship situation analysis in selected hospitals in Zambia: findings and implications from a national survey.Frontiers in public health · 2024Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: The South African National Department of Health released guidelines and recommendations for antimicrobial stewardship (AMS) programs to be established in public healthcare facilities. Their implementation remains challenged, especially in North West Province, where the public health system functions under severe strain. This research explored and interpreted the facilitators that strengthen and barriers that hinder the implementation of the national AMS program in public hospitals in North West Province. Design: A qualitative design and interpretive descriptive approach enabled insight into the realities of AMS program implementation. Setting: Public hospitals in North West Province, sampled through criterion sampling (n = 5). Participants: Purposive criterion sampling of healthcare practitioners (n = 30) actively participating in AMS programs in the 5 sampled public hospitals. Method: Qualitative, interpretive description with semi-structured individual interviews that were digitally recorded and transcribed. The ATLAS.ti version 8 software facilitated content analysis, followed by second-level analysis. Results: In total, 4 themes, 13 categories, and 25 subcategories emerged. We detected dissonance between government AMS ideals and the realities of AMS program implementation in public hospitals. A multilevel AMS leadership and governance vacuum exists in a dysfunctional health ecosystem in which AMS must operate. Healthcare practitioners agreed on the importance of AMS despite different understandings of AMS and ineffective multidisciplinary teams. Discipline-specific education and training are essential for all AMS participants. Conclusions: AMS is essential yet complex, and its contextualization and implementation are underestimated in public hospitals. Recommendations are focused on a supportive organizational culture, contextualized AMS program implementation plans, and changes in management.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.