TY - JOUR
T1 - Mitigating antimicrobial resistance (AMR) using implementation research
T2 - a development funder's approach
AU - Khurana, Mark P.
AU - Essack, Sabiha
AU - Zoubiane, Ghada
AU - Sreenivasan, Nandini
AU - Cordoba, Gloria Cristina
AU - Westwood, Erica
AU - Dalsgaard, Anders
AU - Mdegela, Robinson H.
AU - Mpundu, Mirfin
AU - Scotini, Rodrigo
AU - Matondo, Augustine B.
AU - Mzula, Alexanda
AU - Chanishvili, Nina
AU - Gogebashvili, Dimitri
AU - Beruashvili, Maia
AU - Tsereteli, Marika
AU - Sooronbaev, Talant
AU - Kjærgaard, Jesper
AU - Bloch, Joakim
AU - Isaeva, Elvira
AU - Mainda, Geoffrey
AU - Muuka, Geoffrey
AU - Mudenda, Ntombi B.
AU - Goma, Fusya Y.
AU - Chu, Duc-Huy
AU - Chanda, Duncan
AU - Chirwa, Uchizi
AU - Yamba, Kaunda
AU - Kapolowe, Kenneth
AU - Fwoloshi, Sombo
AU - Mwenge, Lawrence
AU - Skov, Robert
PY - 2023
Y1 - 2023
N2 - Despite the escalating burden of antimicrobial resistance (AMR), the global response has not sufficiently matched the scale and scope of the issue, especially in low- and middle-income countries (LMICs). While many countries have adopted national action plans to combat AMR, their implementation has lagged due to resource constraints, dysfunctional multisectoral coordination mechanisms and, importantly, an under-recognized lack of technical capacity to adapt evidence-based AMR mitigation interventions to local contexts. AMR interventions should be tailored, context-specific, cost-effective and sustainable. The implementation and subsequent scale-up of these interventions require multidisciplinary intervention-implementation research (IIR). IIR involves both quantitative and qualitative approaches, occurs across a three-phase continuum (proof of concept, proof of implementation and informing scale-up), and across four context domains (inner setting, outer setting, stakeholders and the implementation process). We describe the theoretical underpinnings of implementation research (IR), its various components, and how to construct different IR strategies to facilitate sustainable uptake of AMR interventions. Additionally, we provide real-world examples of AMR strategies and interventions to demonstrate these principles in practice. IR provides a practical framework to implement evidence-based and sustainable AMR mitigation interventions.
AB - Despite the escalating burden of antimicrobial resistance (AMR), the global response has not sufficiently matched the scale and scope of the issue, especially in low- and middle-income countries (LMICs). While many countries have adopted national action plans to combat AMR, their implementation has lagged due to resource constraints, dysfunctional multisectoral coordination mechanisms and, importantly, an under-recognized lack of technical capacity to adapt evidence-based AMR mitigation interventions to local contexts. AMR interventions should be tailored, context-specific, cost-effective and sustainable. The implementation and subsequent scale-up of these interventions require multidisciplinary intervention-implementation research (IIR). IIR involves both quantitative and qualitative approaches, occurs across a three-phase continuum (proof of concept, proof of implementation and informing scale-up), and across four context domains (inner setting, outer setting, stakeholders and the implementation process). We describe the theoretical underpinnings of implementation research (IR), its various components, and how to construct different IR strategies to facilitate sustainable uptake of AMR interventions. Additionally, we provide real-world examples of AMR strategies and interventions to demonstrate these principles in practice. IR provides a practical framework to implement evidence-based and sustainable AMR mitigation interventions.
KW - ANTIBIOTIC-RESISTANCE
KW - PENICILLIN
U2 - 10.1093/jacamr/dlad031
DO - 10.1093/jacamr/dlad031
M3 - Journal article
C2 - 36994233
VL - 5
JO - JAC-Antimicrobial Resistance
JF - JAC-Antimicrobial Resistance
SN - 2632-1823
IS - 2
M1 - 031
ER -