From classrooms to practice: does pre-service training for one health professions provide readiness for antimicrobial stewardship?

Abstract

BACKGROUND: One Health (OH) professions, specifically doctors, pharmacists and veterinarians, play central roles in antimicrobial stewardship (AMS), serving as the primary gatekeepers of antimicrobial use. Considering that antimicrobial resistance (AMR) is a global health priority, it is essential that these gatekeepers are equipped with the necessary skills for effective AMS at day-one. As part of the Ducit Blue Foundation (DBF) programme, this study assesses the level of day-one competencies for AMS in pre-service curricula across OH professions using the respective global competency frameworks. METHODS: Pre-service training curricula for OH professions in five African countries were compared to their respective World Health Organization (WHO) and World Organisation for Animal Health (WOAH) competency frameworks to determine alignment with specific AMS competencies. Intersectoral comparisons were also conducted to understand variations across OH sectors. RESULTS: AMS preparedness among OH graduates in Africa was not determined by profession alone, as alignment varied both within and across the OH professions reviewed. The strongest alignment was observed in UniLorin veterinary medicine (77%), UniPort pharmacy (67%), and ABU Zaria medicine (51%), showing that stronger AMS integration is achievable across professional groups. However, lower alignment was also observed across the same professions, including Addis Ababa University medicine (33%), UniLomé pharmacy (39%), and EISMV veterinary medicine (48%). While the AMS components of WHO AMR competency framework emphasises a clinical and research focus, the WOAH competency recommendations extend further by adding OH and public health focus. CONCLUSION: These findings suggest that AMS preparedness depends less on professional category and more on how explicitly and consistently AMS competencies are embedded within each curriculum. There is a need to strengthen pre-service AMR education across OH professions in Africa. Regional initiatives such as DBF internship programme that target early-career OH professionals for AMR training are essential for bridging existing gaps in pre-service AMR education in Africa and beyond.