Identifying and Addressing Challenges to Antimicrobial Use Surveillance in Low- and Middle-Income Countries: Experiences & Lessons Learned from Tanzania and Uganda

Background: Antimicrobial resistance (AMR) is a global health security threat and is associated with increased morbidity and mortality. One of the key drivers of AMR is the inappropriate use of antibiotics. A key component of improving antibiotic use is conducting antimicrobial use (AMU) surveillance. Methods USAID Medicines Technologies and Pharmaceutical Services Program has supported the implementation of antimicrobial stewardship (AMS) activities, including setting up systems for AMU surveillance in Tanzania and Uganda. Results from both countries have been previously published. However, additional implementation experience and lessons learned from addressing challenges to AMU surveillance have not been previously published and are the subject of this article. Results The team identified challenges including poor quality data, low digitalization of tools, and inadequate human resources including both financial and human resources. To address these gaps, the Program has supported the use of continuous quality improvement approaches addressing gaps in skills, providing tools, and developing guidelines to fill policy gaps in AMU surveillance. Recommendations to fill these gaps, based on the Potter and Brough systematic capacity building model have been proposed. Conclusions Strengthening AMU surveillance through using a capacity-building approach will fill gaps and strengthen efforts for AMR control in both countries.