Knowledge, attitudes, and practices regarding antimicrobial resistance and antimicrobial stewardship among healthcare workers in outpatient medical centers in Kenya: a qualitative study.

Objective: Antimicrobial resistance (AMR) is a major global health threat with a projected 10 million deaths globally by 2050. Antimicrobial stewardship (AMS) programs are coordinated efforts involving doctors, nurses, pharmacists, and other healthcare providers. Understanding knowledge, attitudes, and practices of health providers is pivotal for implementing strategies to curb the spread of AMR. The aim of this study was to evaluate knowledge, attitudes, and practices surrounding AMR and AMS among healthcare workers in Kenya. Design: A qualitative study using in-depth semi-structured interviews. Setting: 12 private outpatient clinics in Kenya. Participants: Healthcare workers including administrators and clinicians. Methods: A thematic analysis approach was used; the Capability, Opportunity, and Motivation for Behavior model was used to understand the knowledge, attitudes, and practices surrounding AMR and AMS. Results: Twenty-four participants were interviewed. They had some knowledge regarding AMR but lacked knowledge about AMS and its components. Although participants did not perceive AMR as a problem in their clinics, they reported it was a major problem in the country and globally. There was lack of prioritization of AMS in the clinics. Conclusions: The lack of knowledge on AMS and its components coupled with failure to recognize AMR as a problem in the facilities led to a lack of prioritization of AMS. There is therefore an urgent need to educate healthcare administrators and clinicians on AMR and AMS to foster a sense of ownership of the problem of AMR and to be pro-active in implementing measures to curb it.