Suchergebnisse

Abstract A review of the published and unpublished literature on bacterial resistance in human and animals was performed. Sixty-eight articles/reports from the Democratic Republic of Congo (DRC), Mozambique, Tanzania and Zambia were reviewed. The majority of these articles were from Tanzania. There is an increasing trend in the incidence of antibiotic resistance; of major concern is the increase in multidrug- resistant Escherichia coli , Klebsiella pneumoniae , Staphylococcus aureus , Vibrio cholera , non-typhoid Salmonella and other pathogens responsible for nosocomial infections. The increase in methicillin- resistant Staphylococcus aureus and extended-spectrum beta-lactamase (ESBL) producers in the countries under review confirms the spread of these clones worldwide. Clinical microbiology services in these countries need to be strengthened in order to allow a coordinated surveillance for antimicrobial resistance and provide data for local treatment guidelines and for national policies to control antimicrobial resistance. While the present study does not provide conclusive evidence to associate the increasing trend in antibiotic resistance in humans with the use of antibiotics in animals, either as feed additives or veterinary prescription, we strongly recommend a one-health approach of systematic surveillance across the public and animal health sectors, as well as the adherence to the FAO (Food and Agriculture Organization)-OIE (World Organization of animal Health) –WHO(World Health Organization) recommendations for non-human antimicrobial usage.

There is increasing policy demand for real-time evaluations of research and capacity-building programmes reflecting a recognition of the management, governance and impact gains that can result. However, the evidence base on how to successfully implement real-time evaluations of complex interventions in international development efforts is scarce. There is therefore a need for reflective work that considers methodologies in context. This article shares learning from the experience of conducting a participatory, real-time, 'theory driven' evaluation of the African Institutions Initiative, a Wellcome Trust-funded programme that aimed to build sustainable health research capacity in Africa at institutional and network levels, across seven research consortia. We reflect on the key challenges experienced and ways of managing them, highlight opportunities and critical success factors associated with this evaluation approach, compared with alternative evaluation approaches.

Animal health surveillance plays a vital role in ensuring public health, animal welfare, and sustainable food production by monitoring disease trends, early detecting (new) hazards, facilitating disease control and infection, and providing data for risk analysis. Good stakeholder collaboration across the sector can lead to better communication, better science and decision-making and more effective surveillance and response. An understanding of relevant stakeholders, their interests and their power can facilitate such collaboration. While information on key stakeholders in animal health surveillance is available at the national level in Tanzania, it is missing at the subnational level. The study aimed to explore the existing stakeholders' collaborations and influences at the subnational level through stakeholder mapping and to determine potential leverage points for improving the national animal health surveillance system. A qualitative design was used, involving consultative workshops with government animal health practitioners in Sumbawanga, Sikonge and Kilombero districts of Tanzania from December 2020 to January 2021. Data were collected using an adapted USAID stakeholder collaboration mapping tool with the following steps: (i) Define the objective (ii) Identify all stakeholders (iii) Take stock of the current relationships (iv) Determine resource-based influence (v) Determine non-resource based influence and (vi) Review and revise the collaboration map. Forty-five stakeholders were identified in all three districts and grouped into four categories: private sector and non-government organizations (n = 16), government (n = 16), community (n = 9) and political leaders (n = 4). Animal health practitioners had a stronger relationship with community stakeholders as compared to other categories. The results also showed that most of the stakeholders have non-resource-based influence compared to resource-based influence. The private sector and non-government organizations have a relatively higher number of ...

Objective To explore and describe the perceptions of policy actors and practitioners on antimicrobial use and resistance in human and animal health in Tanzania. Methods This was an exploratory qualitative study, which involved semi-structured interviews with nine policy makers and 102 practitioners. Results Improved multisectoral collaboration and coordination among experts from the animal and human sectors, government will, improved infrastructures, existence of public awareness campaigns on appropriate use of antimicrobials and existence of antimicrobial stewardship were identified as strengths for the implementation of National Action Plan on Antimicrobial Resistance (NAP-AMR) in Tanzania. Despite these strengths, insufficient public awareness of AMR, limited community engagement and inadequate human resources were among the reported weaknesses. A number of opportunities for the implementation of NAP-AMR were also reported including the presence of integrated disease surveillance and response strategy in health sector and development of a coordinated surveillance system. Furthermore, the inadequate laboratory capacity and poor resource mobilization were identified as challenges facing the implementation of NAP-AMR. Conclusion The future policies of AMR need to capitalize on the identified strengths and opportunities as well as design interventions to improve public awareness of AMR and community engagement, deployment of adequate human resources and ensure adequate resource mobilization to meet AMR needs.

Tanzania launched its first National Action Plan (NAP) on antimicrobial resistance (AMR) in 2017 to reduce the burden of AMR in the country and contribute to the global response. We aimed to analyze the implementation of the NAP on AMR in Tanzania using the governance framework. In-depth interviews were conducted with human and animal health practitioners and national-level policy actors. We adapted Chua's AMR governance framework to analyze the development and implementation of the NAP in Tanzania. Implementation of the NAP has realized several achievements, including: (i) the establishment of a functioning Multi-Sectoral Coordinating Committee for coordinating the implementation of AMR activities; (ii) existence of governance structure; (iii) establishment of human and animal surveillance sites; (iv) creation of AMR awareness in the community and (v) availability of guidelines at the health facility level to ensure AMR stewardship. However, some dimensions of the governance areas, including reporting and feedback mechanisms, accountability, transparency and sustainability of AMR plans, are not effectively implemented. Addressing these challenges should involve strengthening the collaboration of the different sectors involved at different NAP implementation levels by careful planning and coordination, and provision of adequate resources to ensure sustainability.

Tanzania launched its first National Action Plan (NAP) on antimicrobial resistance (AMR) in 2017 to reduce the burden of AMR in the country and contribute to the global response. We aimed to analyze the implementation of the NAP on AMR in Tanzania using the governance framework. In-depth interviews were conducted with human and animal health practitioners and national-level policy actors. We adapted Chua's AMR governance framework to analyze the development and implementation of the NAP in Tanzania. Implementation of the NAP has realized several achievements, including: (i) the establishment of a functioning Multi-Sectoral Coordinating Committee for coordinating the implementation of AMR activities; (ii) existence of governance structure; (iii) establishment of human and animal surveillance sites; (iv) creation of AMR awareness in the community and (v) availability of guidelines at the health facility level to ensure AMR stewardship. However, some dimensions of the governance areas, including reporting and feedback mechanisms, accountability, transparency and sustainability of AMR plans, are not effectively implemented. Addressing these challenges should involve strengthening the collaboration of the different sectors involved at different NAP implementation levels by careful planning and coordination, and provision of adequate resources to ensure sustainability.