The Malawi-Wales Antimicrobial Pharmacist Partnership

The Malawi-Wales Antimicrobial Pharmacist Partnership between the Pharmaceutical Society of Malawi (PHASOM) and the Welsh Antimicrobial Pharmacist Group (WAPG) is a newly formed partnership established in July 2021. The partnership was successful in obtaining a CwPAMS extension grant to provide pharmacists with the knowledge and skill to be antimicrobial stewardship (AMS) leads in their healthcare facilities, Kamuzu Central and Mzuzu Central Hospitals. 

Tackling antimicrobial resistance (AMR) is a global health priority, with Malawi experiencing rapid growth in resistance within the last decade. National and international co-operation is essential to support the development and application of robust and sustainable AMS programmes to slow AMR, the silent pandemic. Implementation of AMS programmes has proven to be challenge in low- and middle-income countries (LMIC) with healthcare facilities now faced with an urgent need to set up locally adapted, sustainable and scalable interventions to tackle AMR. One of the five key AMR targets identified in Malawi’s National Action Plan (NAP) was improved awareness and understanding of AMR and ensure optimum use of antimicrobials through effective communication, education and training. The partnership recognised that pharmacists, being the medicines experts, are ideally placed to provide this education and training to raise awareness of AMR and prudent use of antimicrobials, as well as promote the role of the clinical pharmacist within the multi-disciplinary team.  

In response to this the partnership successfully conducted a ‘train the trainer’ approach and provided lead pharmacists within the two sites with the knowledge and skills to conduct cascade training to wide variety of healthcare professionals. Daylong sessions were conducted at both hospitals covered topics such as AMR and the NAP, microbiology laboratory service provision, understanding clinical infection and management and good prescribing practices.  

Dr Winnie Mwakamogho said ‘the training on AMR and AMS was thought provoking and a great tool in mindset change towards AMS. I did previously have an idea on the same but this training brought it to life and much as the challenges are there in our set up, small daily steps done right per patient I believe will make a difference.’  

The partnership recognised that health care professionals would benefit from an AMS toolkit to complement the training sessions and to support the application of the learning and ongoing development and implementation of AMS interventions.  

One of the biggest challenges faced when developing the intervention was identifying the key priority areas to be focused on during the training and within the AMS toolkit. There was very little knowledge of the current antimicrobial prescribing practices and AMS was a relatively new concept within the two hospitals, who had both recently established AMS committees. The partnership overcame some of these issues by completing a virtual AMS baseline assessment which was later complemented by the information and practice observed during an in-country visit by the WAPG team. The Global Point Prevalence Survey (GPPS) was also completed to obtain more in-depth information on the use of antimicrobials and current AMS practices.  

The Malawi-Wales Antimicrobial Pharmacist Partnership has gone from strength to strength.  

Having successfully delivered education and training session and copies of the AMS toolkit to nearly 120 healthcare professionals across the two sites the partnership aim to extend this further.  William Mpute, PHASOM president said ‘having well trained health care workers is very important in the fight against AMR, as a society we are happy that we managed to compliment the efforts of ministry of Health and other partners in equipping healthcare workers with necessary skills to combat AMR, we strongly believe that they will make use of precious knowledge and train others and we hope that many health care workers will be trained in the near future’ Following the completion of the first Malawi GPPS as part of this project, both sites now intent to complete the GPPS every quarter which is a significant step forward in raising the AMS agenda in Malawi.