Abstract:

Antimicrobial Resistance (AMR) is a global security threat that poses a significant risk to humanity. Addressing AMR requires effective organizations and processes. This study investigates the systems and structures that may contribute to tackling AMR in three Sierra Leonean University Teaching Hospital Complexes.The hospitals were selected based on their high patient load and availability of laboratory facilities for AMR testing, pharmaceuticals, and infection prevention and control (IPC) programs. Healthcare administrators and unit leaders were interviewed using a standardized questionnaire. The reliability of the questionnaires was assessed using Cronbach’s alpha coefficient. The questionnaire was pretested to ensure its validity and reliability. The findings indicate that nurses constitute a significant portion of the health workforce in the three institutions. PCMH Hospital showed the best monitoring system, covering 78% of the essential components, including, IPC guidelines, antibiotic stock verification and waste and antibiotic disposal monitoring. Connaught Hospital also met 56% of these requirements. The study showed a significant correlation between hospital bed capacity and the average patient volume (p < 0.05), with higher bed capacities resulting in higher patient volume. In addition, the correlation analysis revealed a significant association between effective monitoring mechanisms and the presence of an antibiotic stewardship program (p < 0.05). Furthermore, the availability of laboratory departments significantly influenced microbiological culture and sensitivity testing capabilities (p < 0.05), with a higher number of departments resulting in more efficient microbiological testing for antibiotic resistance. This study highlights the importance of enhancing the systems and structures of hospitals, to effectively combat AMR.

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