Community Health Workers Key Stakeholders in Fighting Antimicrobial Resistance

OPINION: World Health Organisation shows that Antimicrobial Resistance (AMR) is a major public health threat across the world affecting humans, animals, and the environment due to an increase in resistant microbial strains in human and animal populations. It is described as a treatment failure and this is always problematic in many field settings with high rates of counterfeits and lack of patient follow-up. 

A global report on tackling drug-resistant infections revealed that resistance to antimicrobials is a naturally occurring process. However, it has increasingly threatened public health in recent years due to improper use of antimicrobials, yet there are no new drugs to challenge these superbugs. Apparently, 700,000 people die annually and 10 million lives are estimated to be lost annually by 2050 as a result of antimicrobial resistance from drugs.

Community Health Workers (CHWs) can be utilised in addressing antimicrobial resistance. The research conducted on antimicrobial resistance stewardship in Uganda found out that community health workers are the frontline health cadres which makes them key stakeholders in fighting antimicrobial resistance by ensuring proper antimicrobial use in their communities. 

In the recently concluded Heroes in Health Awards (HIHA), it was exciting to see different Community Health workers being rewarded for their commendable work. These were introduced in 2006 by the World Health Organization to deliver affordable primary health care services in different communities. Research shows that community health workers greatly impact rural and underserved communities with increased Public Health services regardless of being inadequately trained. 

The WHO framework for health workers’ education and training on antimicrobial resistance further revealed the various factors contributing to misuse or overuse of antimicrobials, such as; less or complete lack of knowledge on antimicrobial resistance and antimicrobial use, inability to identify the type of infection resulting in patient pressure to demand an antimicrobial prescription, non-adherence to antimicrobial prescription and use guidelines, availability of varieties of antimicrobials in facility stores that allow for financial benefit from the supply, inadequate water, sanitation, and hygiene (WASH) practices, and other infection, prevention and control (IPC) measures in communities and health facilities increasing the spread of infections.

The Uganda National Action Plan for Antimicrobial Resistance incorporated community health workers and other relevant animal health entities to promote local participation and implementation of antimicrobial resistance interventions in communities. The results from the research conducted on rational use of antibiotics by community health workers further pointed out that community health workers play a key role in antimicrobial resistance stewardship through promotion and adherence to Water, Sanitation, Hygiene practices and other Infection, Prevention and Control measures, proper antimicrobial prescriptions, use of simple job aids with effective clinical algorithms, diagnostic tools, support supervision, patient follow up, encouraging and counseling patients and caregivers to adhere to correct treatment regimens including giving them proper and clear instructions regarding drug dosage.

Therefore, community health workers should be prioritized, trained, given up-to-date information regarding antimicrobial use and other necessary resources in fighting antimicrobial resistance.

This article was co-authored by: Poleen Kyakunzire and Mathius Amperiize: Environmental Health Scientists