Low- and middle-income countries are vulnerable to gaps in skilled workers and institutions at many levels. Approximately 85% of World Health Organization (WHO) Member States report having less than one pharmaceutical personnel per 1,000 population, while only 10% of the 138 countries that responded to the WHO Global Health Observatory survey reported more than one biomedical engineer and/or technician per 10,000 population. Many government departments face critical and chronic shortages of managerial and technical experts for key pharmaceutical system functions in regional and local facilities. As a result, institutional capacity building among pharmaceutical system stakeholders is needed to improve human resource management and operations.
USAID MTaPS collaborated with low-and-middle income countries to build the skills and knowledge of their health workers and institutions. Here are a few key achievements:
For example, USAID MTaPS engaged civil society organizations to educate and mobilize Ethiopian women in the fight against antimicrobials. To identify information gaps, MTaPS conducted a knowledge and behavior assessment of Addis Ababa Women Federation members and engaged leaders of the Ethiopian Youth and Women Federations on the global antimicrobial challenges and the role civil society organizations can play in combatting antimicrobial. MTaPS conducted a two-day training with the Ethiopian Youth and Women Federations, sharing basic knowledge on antimicrobials so they could promote awareness within their communities, reaching 520 members on the appropriate use of antimicrobials.
For example in Mali, USAID MTaPS built the skills and expertise of health workers on infection, prevention, and control through e-learning. This was a priority as a 2021 WHO infection prevention and control (IPC) assessment found only 3 of 16 health facilities adequately preventing and controlling infections. In response, MTaPS supported the Government of Mali in implementing an e-learning platform to host an IPC course for healthcare professionals. This included technical support to organizations hosting the platform, as well as education and training for platform managers administering the IPC course to health professionals and students.
A year after the launch of the platform, registration increased by more than 50% with many receiving certificates of completion. The certificates honored participants' efforts on best international clinical practices for preventing and managing infections caused by multi-resistant bacteria.
In Kenya for example, MTaPS collaborated with Kenya’s Ministry of Health to combat AMR in the country where the problem is dire. There are already high levels of resistance to common first-line drugs and rising infections from life-threatening pathogens, including those leading to pneumonia, salmonella, and gonorrhea.
In response, USAID MTaPS introduced an antimicrobial stewardship (AMS) program in 16 health facilities after initial market research found that AMS was an unknown concept. MTaPS conducted skills building sessions for Medicines and Therapeutics Committees on using evidence-based methods to improve how antimicrobials are prescribed. Newly laid work plans were set in place. Participating hospitals successfully made strides in appropriate use, including one hospital that experienced a 10% decrease in antibiotic prescribing over the course of three months alone.
The work on antimicrobial stewardship extended to preservice pharmaceutical management, and MTaPS worked with the University of Nairobi School of Pharmacy to reform the preservice curriculum to integrate AMS-related topics. The MTaPS program also provided ongoing technical assistance to the Pharmaceutical Society of Kenya to develop an AMS training course linked to continuing professional development and re-licensure for delivery through the professional association.
