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Community Engagement On Antimicrobial Resistance At Teshie To Mark 2019 World Antibiotic Awareness Week Celebration.

Community Engagement On Antimicrobial Resistance At Teshie To Mark 2019 World Antibiotic Awareness Week Celebration.

OUTREACH REPORT

Table of Contents

Introduction.

Purpose of Outreach.

Attendance.

The Event

  Welcome Address

  Messages from partners.

  Drama/Role play.

  Community Education.

   Community Education on AMR.

   Community Education on Infection Prevention and hand washing.

  Message from Chief.

  Questions/suggestions.

  Health Screening.

  Distribution of Behaviour Change Communication (BCC) Materials on AMR.

Conclusion.

 

 

 

Introduction

Antimicrobial Resistance (AMR) is one of the greatest threats facing humanity. AMR occurs when microorganisms such as bacteria, fungi, viruses and parasites change when they are exposed to antimicrobial drugs and the drugs become ineffective, infections persist and may spread to others. Even though antimicrobial resistance is a natural phenomenon, misuse of antimicrobials either through ignorance or irresponsible use is speeding the process.

AMR has since been increasingly recognized as a global priority and in May 2015, The World Health Assembly endorsed a Global Action Plan to address the growing problem of resistance to antibiotics and other antimicrobial medicines. Consequently, policies have been formulated at international, regional and national levels. The Government of Ghana has also set clear objectives to achieve this aim in its National Action Plan (NAP) on antimicrobial resistance. The first strategic objective in the NAP is to improve awareness and understanding of antimicrobial resistance through effective communication, education and training. Under this strategic objective, the government intends to collaborate with all stakeholders including civil society organizations, the media etc. to promote responsible use of antimicrobials amongst the general public and in animal husbandary, aquaculture and crop production with emphasis on the dangers of antimicrobial use.

Every year, a week is set aside in November to celebrate awareness of antibiotic resistance worldwide. This year, the World Antibiotic Awareness Week (WAAW) celebration was slated for 18th to 24th November, 2019. The theme for this year’s celebration was “The future of antibiotic depends on us all”. This theme espouses the need to reflect on some unhealthy and unhygienic practices and basic interventions employed to prevent infections which will in turn lessen the misuse of antibiotics and the need for collaboration from partners to fight this menace. As part of the WAAW 2019 week celebrations, HKN in collaboration with the AMR platform, the Ministry of Health (MOH), the Pharmaceutical Society of Ghana (PSGH), Food and Agricultural Organization (FAO) and World Health Organization (WHO) led the organization of a community engagement in Teshie Salem Square in the Greater Accra Region on the 20th of November, 2019 on Antimicrobial Resistance.

Purpose of Outreach

The main purpose of the outreach was to create awareness on AMR and to provide quality health information to individuals on the responsible use of antibiotics.

Attendance

The outreach was attended by community members, Opinion leaders, traditional and religious leaders, health workers, Over-the-Counter Medicine Sellers (OTCMS), poultry and livestock farmers, school teachers and pupils, government and development partners. The event was attended by 231 persons.

Pic1: A cross section of the gathering at the event
Pic1: A cross section of the gathering at the event

 

The Event

Welcome address

The event commenced with a welcome address by Mr. Daniel E. Mensah, The Executive Director, and HealthKeepers Network. He welcomed everyone present, introduced invited guests and explained the purpose of the program.

Pic2: Mr. Daniel E. Mensah delivering the welcome address
Pic2: Mr. Daniel E. Mensah delivering the welcome address

Messages from partners

This was followed by Solidarity messages from the AMR Platform, PSGH and MOH. Dr. Hedidor, Coordinator of the AMR Platform and Technical Officer for AMR, WHO Country Office said that WAAW is celebrated globally every year. He mentioned that AMR is a problem which has been recognized globally and that AMR poses significant threat to all of us including humans and animals. Rev. Awitty representing the Pharmaceutical Society of Ghana and MOH also said in his statement that antibiotic resistance is a threat to all and we should all get involved in the fight against AMR. He implored the public to obtain their antibiotics from accredited facilities, complete the course of antibiotics and desist from treating themselves at home.  

Other officials who attended the program included; Mrs. Joycelyn Azeez of the MOH, Dr. Kofi Afakye, FAO and Mr.  Stephen Corquaye from PSGH.

Pic 3.Rev Dr. Sena Awitty delivering his statement
Pic 3.Rev Dr. Sena Awitty delivering his statement

Drama/Role Play

This was followed by a cultural interlude and a role play performed by the Adinkra Drama Troupe from Teshie. The drama troupe acted out 5 scenarios where the general public is likely to misuse antibiotics. The role play was engaging and focused on unhygienic practices that normally lead to infection, for which reason people misuse antibiotics. Some infection prevention strategies were demonstrated throughout the role play and the general public were taught how to handle antibiotics with care and help prevent the spread of antibiotic resistance.

Pic 4: A lady washing her before eating her meal in the role play
Pic 4: A lady washing her before eating her meal in the role play

Community Education

Community Education on AMR

ACP Dr. Sam from PSGH and a member of the AMR Platform educated the general public on AMR. She spoke about the importance of antibiotics in treating diseases e.g. coughs. She explained that antibiotics that could previously treat diseases no longer work as they should. Not using antibiotics as we should contributes to antibiotic resistance e.g. antibiotics treat bacterial infections not viral infections. When used to treat viral infections this contributes to antibiotic resistance and this means that it might not work for you when you have a bacterial infection.

Some of the key AMR messages delivered included;

  • Do not use antibiotics that have not been prescribed for you
  • Use antibiotics as prescribed
  • Don’t share antibiotics with family and friends
  • Don’t break antibiotic capsules and apply powder to sores
  • Don’t mix antibiotics with alcoholic beverages/herbal preparations
  • Don’t use antibiotics for colds and flu
  • Don’t buy antibiotics from drug peddlers who have them in the sun

She further entreated the general public to protect the antibiotics left so that they will remain effective. She said if care is not taken when they are really needed in the future they might not work and the result could be deadly.

Dr. Sam also advised the general public to wash their hands before eating and after using the toilet. She also recommended they drink clean water, eat hot and healthy food to prevent infection. She added that the general public should desist from giving poultry and livestock antibiotics but should rather consult the veterinary officer when their animals are unwell.

Pic 5: ACP Dr. Ellen Sam providing education on AMR and appropriate use of antibiotics
Pic 5: ACP Dr. Ellen Sam providing education on AMR and appropriate use of antibiotics

Community Education on Infection Prevention and hand washing

A staff of HealthKeepers Network also provided education on Infection Prevention and Control measures in the community and demonstrated the steps in hand washing.

She mentioned that infection prevention and control (IP&C) measures is one of the 5 key objectives outlined in the Ghana NAP for addressing AMR. It was explained that IP&C is an essential strategy to reduce infection and the subsequent use of antimicrobials. If we are able to prevent these infections, there will be no need   to use antibiotics in the first place and we will in turn be preventing AMR.

Some infection prevention and control measures cited included; Hand hygiene, environmental hygiene, personal hygiene and immunization and examples of how this could be achieved was discussed. The HKN Staff explained that Hand hygiene includes hand washing with soap and water or the use of alcohol hand rub. She said that certain types of microbes were capable of surviving on environmental surfaces for months and hence the need to clean these surfaces with soap and water regularly. Bathrooms, toilets and kitchens must however be cleaned regularly with disinfectant. The general public was advised not to litter the environment with rubbish but to gather it before disposal and to keep garbage containers covered.

On the issue of personal hygiene, the HKN staff spoke about keeping the body clean, bathing, brushing teeth, not sharing personal items and sneezing or coughing in a tissue/handkerchief. She also entreated them to ensure children are vaccinated on schedule every time.

The educational session was followed with a demonstration on how hand washing should be done.

Steps for hand washing are as follows;

  1. Wet hands with water
  2. Apply enough soap to cover all hand surfaces
  3. Rub palms together
  4. Rub right palm over back of left hand with interlaced fingers and vice versa
  5. Rub palm to palm with fingers interlaced to wash in between fingers
  6. Rub back of fingers
  7. Rub left thumb using right palm and vice versa
  8. Wash tips of fingers by rotating, rubbing backwards and forwards clasped fingers of right hand in left palm and vice versa.
  9. Wash left wrist with right hand and vice versa.
  10. Rinse hands under running water
  11. Dry hands thoroughly with a tissue or allow them to air dry.
  12. Use tissue to turn off tap
  13. Hand are now safe.
  14. This procedure should last about 20 seconds
Pic 6: HKN staff demonstrating the steps in hand washing
Pic 6: HKN staff demonstrating the steps in hand washing

Message from Chief

The Teshie Mankralo (Chief), Tsitsi-Tse Nii Klu-Din Okang Nmashie IV of the area also reiterated the importance of using of antibiotics appropriately and proper hand washing. He also emphasized the fact the poverty could contribute to making people ignorant of their health.

Pic 7: The chief of Teshie addressing the audience
Pic 7: The chief of Teshie addressing the audience

Questions/suggestions

  1. How do we wash our hands without a tap as most homes do not have running water from taps
  2. The town councils should be revived and empowered to ensure the maintenance of sanitary and hygienic conditions in homes and communities.

Health Screening

The second part of the program was a health screening. This health screening was included to attract community members to the event and sustain their interest in the program. The services offered during the health screening were AMR counseling, Blood pressure measurement, Body Mass Index, HIV Testing and Counseling, Malaria, Blood sugar and Family planning counseling services.

Out of the 231 persons who benefitted from the AMR education, 174 persons took part in the health screening. All of them accessed the services on offer. During the AMR counseling, community members were made to recall what they learnt during the first part of the program. The key points on rationale drug use and infection prevention were reiterated. They were also encouraged to spread the message on rational use of antibiotics and be advocates for the preservation of antibiotics.

Among those who tested for HIV, four (4) reacted to the first response test and were referred to the Teshie Community Clinic for further tests.

A physician assistant was present who attended to all the community members and counseled them on the results of the tests undertaken. Those who needed further care were referred and their details were taken for follow up.

Pic 8: HKN Staff counselling clients on AMR
Pic 8: HKN Staff counselling clients on AMR
Pic 8: A community member receiving counselling on Family Planning
Pic 8: A community member receiving counselling on Family Planning

Distribution of Behaviour Change Communication (BCC) Materials on AMR

BCC materials on AMR received from MOH, FAO and WHO were distributed to the audience. Materials included information on bacteria, antibiotics, some practices that contribute to antibiotic resistance, why they should be concerned about antibiotics resistance and what they can do about antibiotic resistance.

Picture 11: Some BCC materials on AMR distributed

Some of the materials also provided information on what the agricultural sector can do to prevent AMR including how farmers can keep animals and people healthy. About 722 BCC materials were distributed. In addition to the BCC materials, FAO also printed and provided T-Shirts for the program.

Conclusion   

The community outreach on antimicrobial resistance was a great success. This success could be attributed to strong partnerships and planning. Interaction with community members indicated that the message on AMR had been understood and behavior change was imminent.

 Group Photographs.

Picture 11: Group photograph- PSGH representatives, MOH Officials, AMR Platform Members, Health Directorate officials and HKN staff
Picture 12: (from L-R) Marcia Safo-Nyame, HKN; Dr. Kofi Afakye, FAO; Patience Owusu, HKN; and Mrs. Joycelyn Azeez, MOH.

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