Situational analysis of antibiotic use and resistance in Ghana: policy and regulation

BMC Public Health

Niels Frimodt-Møller¹  Richard B. Biritwum²  Martha Gyansa-Lutterodt³  Kwame Ohene Buabeng⁴  Berko Panyin Anto⁴  Saviour Kwame Yevutsey⁴  Moses Aikins⁵ 

[1] Department of Clinical Microbiology;Department of Community Health, University of Ghana;Director of Pharmaceutical Services, Ministry of Health;Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Department of Pharmacy Practice, Kwame Nkrumah University of Sciences and Technology;School of Public Health, College of Health Sciences, University of Ghana;

关键词: Antibiotics;    Regulation;    Policy;    Situational analysis;    Ghana;   

DOI  :  10.1186/s12889-017-4910-7

来源: DOAJ

【 摘 要 】

Abstract Background Antibiotics have played an essential role in decreasing morbidity and mortality from infectious diseases. However, indiscriminate use and unrestricted access is contributing to the emergence of bacterial resistance. This paper reports on a situational analysis of antimicrobial use and resistance in Ghana, with focus on policy and regulation. Methods Relevant policy documents, reports, regulations and enactments were reviewed. PubMed and Google search engines were used to extract relevant published papers. Websites of stakeholders such as Ministry of Health (MOH) and its agencies were also reviewed. An interview guide was used to elicit responses from selected officials from these sectors. Results Laws and guidelines to control the use of antimicrobials in humans were available but not for animals. There was no National Antimicrobial Policy (NAP). A health practice regulatory law mandates Physicians, Physician Assistants, Midwives and trained Nurses to prescribe antimicrobials. However, antibiotics are widely prescribed and dispensed by unauthorised persons, suggesting weak enforcement of the laws. Antibiotics were also supplied to and from unapproved medicine outlets. The Standard Treatment Guidelines (STG), Essential Medicines List (EML) and the National Health Insurance Scheme Medicines List (NHISML) provide restrictions regarding levels of prescribing of antimicrobials. However, existing guidelines on antibiotic use are mostly not adhered to. The use of Automatic Stop Orders to avoid wastage in the hospitals is also not practiced. Data on use of antibiotics for individuals are not readily available in most facilities. Again, there are no standards or guidelines on veterinary use of antibiotics. Surveillance systems for consumption of antibiotics and resistance monitoring were not in place in most health facilities. However, there is an ongoing national action to create awareness on bacteria resistance, strengthening knowledge through research and surveillance and development of NAP in line with global action plan on antimicrobial resistance. Conclusion Absence of national antimicrobial policy, weak regulatory environment and non-adherence to practice standards may have contributed to increased and unregulated access to antimicrobials in Ghana, a catalyst for development and spread of antimicrobial resistance.

【 授权许可】

Unknown