Title:Health Policy Analysis on the Containment of Antimicrobial Resistance
(AMR) in India: A Mixed Methods Study of Antimicrobial Stewardship as
a Pivotal Intervention in Tackling AMR
Volume: 22
Issue: 4
Author(s): Chetan Singh*, Anita Pandey and Lubhan Singh
Affiliation:
- London School of Hygiene and Tropical Medicine, Kepple Street, London, WC1E 7HT, United Kingdom
Keywords:
Antimicrobial stewardship program, antimicrobial resistance surveillance and research network, antimicrobial resistance national action plan, quantative interview, microbiology laboratories, data extraction.
Abstract:
Objective: This policy report aimed at two goals, that is, to report the findings of the
literature review and explore the perceptions of the key stakeholders in seeking better insight into
the antimicrobial stewardship program (AMSP), and to develop antimicrobial resistance (AMR)
policy recommendations for the Ministry of Health and Family Welfare (MoHFW), India, based
on the findings from the rapid systematic review of the literature (both published and grey) and
the views of key stakeholders.
Methods: A mixed method approach using literature review and qualitative interviews has been
applied. A rapid systematic literature review focusing on the antimicrobial stewardship program’s
key achievements and its implementation and impact, implementation challenges, gaps
and barriers, and opportunities, has been carried out, which has been followed by conducting
interviews of key stakeholders and reporting the findings along with the recommendations.
Results: The findings have shown significant progress towards AMSP, such as expanding to 90
secondary-level hospitals and district-level hospitals/nursing homes, and the Indian Council of
Medical Research antimicrobial resistance surveillance and research network (ICMR AMRSN)
program. Education, training, and microbiological testing have been found to be the current focus
areas. However, there exist challenges, including a lack of leadership support, diagnostic stewardship,
and staffing of clinical pharmacists and infectious control nurses. Key gaps and barriers
identified include setting up microbiology laboratories and hiring ICN nurses and clinical pharmacists.
Opportunities have also been identified. Based on these findings, we have made succinct
recommendations to address the themes and issues identified.
Conclusion: Without new medicines, India will struggle to manage antimicrobial resistance. This
situation calls for national oversight. This study has demonstrated AMSP as crucial for fighting
this silent pandemic. The Indian government and policymakers must swiftly address critical challenges,
gaps, and opportunities. These findings and recommendations might potentially
strengthen the future antimicrobial resistance national action plan (AMR NAP).