Identifying components for antimicrobial stewardship in primary healthcare centres in Nigeria: findings from an open call

Abstract

BACKGROUND: Primary Health Centres (PHCs) in low- and middle-income countries (LMICs) struggle with the inappropriate use of antimicrobials, contributing to antimicrobial resistance (AMR). Antimicrobial Stewardship Programmes (ASPs) in these regions are often designed by experts from high-income countries, undermining their relevance to local settings. Crowdsourcing could be an effective strategy to engage local stakeholders and generate strategies that inform ASPs tailored to their specific contexts. METHODS: A six-week crowdsourcing open call was conducted from 15 April to 30 May 2024, following the WHO/TDR six-stage framework. Eligible submissions were evaluated based on a pre-specified judging rubric. Inductive thematic analysis was performed on high-scoring submissions, while descriptive analysis was carried out on demographic data. RESULTS: The call received 75 submissions from 19 countries, 45 of which were selected for thematic analysis. Six key themes emerged: Leadership and structure, Capacity building and communication, Digital tools and technology, Monitoring and evaluation, Collaboration and partnership, and Policies and guidelines. CONCLUSIONS: Insights obtained through this open call can serve as foundational components of an ASP framework relevant to the unique contexts of PHCs in Nigeria. However, further validation is required to ensure the practical applicability of these proposed components.