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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.


Table of Contents


Purpose of Outreach.


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.


  Health Screening.

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






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.


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


  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.


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.


 Activities held in NOVEMBER 2017

Picture: Some Kayayei in a group photo after their start-up training to become family planning peer educators and distributors of health protection products (Credit HealthKeepers Network)





Key activities implemented by HealthKeepers Network (HKN) in November 2017 are outlined below. The report has been organized under the headings: Recruitment, Training, Supervision, Outreaches, and Supplies. It also includes some other activities that were undertaken during the reporting month.


In November, HKN held three recruitment sessions to select HealthKeepers in the North Tongu and Mion Districts and Kayayei in the La-Nkwanang District and the Accra Metro Area.  During recruitment, participants were briefed on the HKN program, its benefits to them, their families and their community when they join the program; and what would be expected of them. In all, 79 CBDs were recruited in the four 4 districts visited as shown in detail in Table 1 below.


Table 1: Category of CBDs recruited, their numbers and their districts

DistrictCategory of Community-based Distributor (CBDs)Number of CBDS
North TonguHealthKeepers5914
La NkwantanangKayayei1414
AMA (Agbobloshie Zongo)Kayayei77
AMA (Mallam Atta)Kayayei99



Six (6) start-up training was held in November. One of the training was organized for HealthKeepers, four for Youths-in-School and one for Kayayei (Youth-out-of-School) as shown in Table 2 below. Of this number of training, two were held in the Savelugu-Nanton District and one in the Mion District both in the Northern region. And in the Volta region, one training was held in Akatsi South district, one in North Tongu district and one in Central Tongu. A total of 264 participants were trained.


Table 2: Number of CBDs Trained

DateDistrictCategory of CBDsNumber of CBDS Trained     



16/11/17Youth Peer Educators202040
17/11/17MionYouth Peer Educators182240
22/11/17Akatsi SouthYouth Peer Educators202040
23/11/17North TonguYouth Peer Educators152540
24/11/17Central TonguYouth Peer Educators192342




The training for HealthKeepers in November was held in the Savelugu Nanton District for 22 participants made up of eight (8) females and fourteen (14) males. The participants who were recruited from existing Health volunteer groups were drawn from thirteen (13) communities under the Pong-Tamale and Diare sub-districts. The communities are Nakpanzoo, Nabugu, Ying, Pong-Tamale, Tibali, Tunaayili, Pigu, Kukuobila, Kpalung, Diare, Disiga, Dipali, and Adaayili.

The training was also attended by three (3) Community Health Nurse from two Health Centers where the volunteers work. These Community Health Nurses are expected to assist HKN in supervising the activities of the volunteers since they are in the communities with them and report any challenges to HKN.


In collaboration with the District Health Directorate and District Education Services, HKN successfully undertook five (5) Youth Peer-Educators training in November as shown in Table 3 below.

Table 3: Youth Peer Educators training in November by HKN

Date of training




Participating schools

Number of participants
16th November



1. Experimental Junior High School,

2. Yoo R/C Junior High School and

3. Rawdatulatful Junior School.

17th NovemberMion

1. Sang Zakaria Primary and Junior High School,

2. Sang Girls Model Junior High School,

3. ST. Anthony R/C Primary,

4. Burhan Deen Islamic Primary and

5. Sang ISL. Junior High School.

22nd NovemberAkatsi South

1. Yaluvi Basic School,

2. Live Basic School,

3. Atidzive D/A Basic school and

4. Monome D/A Basic School.

23rd NovemberNorth Tongu

1. Battor D/A Junior High school,

2. Mepe R/C Junior High School,

3. Presby Junior high school and

4. United D/A Methodist Junior High School

24th NovemberCentral Tongu

1. Adidome Senior High School and

2. Manfi-Kumase Senior High Technical School



Most of the students who participated in the training were recruited from existing but dormant Adolescent School Clubs.  Their training was attended by District Public Health Nurses, District School Health Education Promotion (SHEP) Coordinators and Girls Education Officers. Also in attendance during the training were teachers, one each from a school where the students were selected from. The teachers are expected to organize and monitor activities of the peer educators in their school to sustain interest.

Photos 1a &1b: left – training of some students and (right) some newly trained Youth Peer Educators



Start-up training for the first batch of Kayayei HealthKeepers began in November 2017. It was held for two (2) days at the Ghana Registered Nurses Association Guest House in Accra. Participants were from Mallam Atta, Old Fadama, Agbogbloshie Zongo, Darkuman, and Madina. In all forty -two (42) Kayayei whose ages ranged from 15 to 28 years participated in the training.

Also in attendance were Executives from the Kayayei Youth Association and leaders of the Kayayei communities. They took turns to talk to the Kayayei about the benefits of the Kayayei HealthKeeper program and encouraged them to give it their best shot. One of the leaders informed them that they should not listen to ridicule from their peers and other people in their communities as the program could be the start of great things for them.

A pre-test was administered to ascertain the participants’ knowledge before the training. Some of the topics discussed during the training, included Adolescence and the changes that occur during that period, Menstruation, Pregnancy, consequences of Teenage Pregnancy, STIs, Abstinence, Family Planning, and its benefits, Available methods in Ghana with emphasis on the Oral contraceptive pills and condoms and USAID Family Planning Compliance.

Use was made of group exercises and presentations to build participant’s capacity to educate their peers effectively. The facilitator also used demonstrations and contextual illustrations to ensure a deeper understanding of the topics discussed. Notably, almost all participants admitted it will be difficult to abstain and thus were more interested in the family planning methods. Facilitators took time to clarify a number of misconceptions, particularly about the long-term methods. Participants were implored to always talk about the benefits of family planning and how it affects their immediate community and the nation at large.

Photo 2a & 2b: Kayayei listening to their facilitator during their training

Participants were also then taken through HKN’s reporting and referral forms. They were grouped according to their communities and given case studies to practice.  A post-test administered after the training showed there was knowledge transfer.

Photos 3a &3b: Some Kayayei in group discussions during their training

The last activity on the agenda was the supply and supervision of the products. The facilitator for this session explained HKN’s policies on product supply and distribution. She stressed on proper handling and storage of the products and also their appearance when they go out to sell. Together with participants, they cross-checked their initial products supplied against their invoices to ensure that everything was correct and in good order before taken custody. They were also taken through how to pay their product loans using mobile money. Some questions asked by the Kayayei during their training are listed below:

  • Why do some women cease menstruating when they are on the injectable?
  • Why do some people become infertile after they stop using family planning?
  • Is it okay when one reaches adolescence and does not have sex?
  • Why is it that some women experience painful menstruation in older age relative to when they are young?



The field supervision team of HKN scheduled and visited seventeen (17) Districts/Municipalities across all the five project regions during the month under review. Overall the team visited sixteen (16) HealthKeepers groups, nine (9) OTCMS groups, two (2) StationGuard/Barber groups and one (1) Youth Peer Educator group. Table 4 below is a table with details of the monitoring visits.

Table 4: HKN monitoring visits in November

Date of VisitRegionDistrict/MunicipalityType of Agent Visited
4/11/17NorthernWest MamprusiHealthKeepers
7/11/17VoltaAkatsi SouthHealthKeepers
9/11/17VoltaKetu SouthHealthKeepers
10/11/17VoltaAdakluYouth Peer Educators
10/11/17VoltaSouth TonguOTCMS
15/11/17VoltaAkatsi SouthOTCMS
16/11/17VoltaKetu SouthOTCMS
22/11/17CentralAwutu Senya EastOTCMS
27/11/17Greater AccraGa WestHealthKeepers
28/11/17Greater AccraGa EastHealthKeepers
29/11/17WesternWassa EastHealthKeepers
30/11/17WesternTarkwa NsuaemHealthKeepers


The field team inspected the baskets/bags of CBDs to ascertain at first-hand the situation on the ground. It is refreshing to note that all the agents visited had their baskets in good conditions and the commodities also well kept. All CBDs were reminded about the USAID family planning compliance.

They were also given onsite refresher education on some of the major topics taught during the training period. Topics such as how Secure® oral contraceptive pills are used, which clients should not be given the Secure® pill, what to do if one misses a pill, benefits of family planning and how to wear male condom, etc. are usually discussed during such field trips.


Outcomes of the supervisions

  • HealthKeepers in the Mion and Karaga districts have made a great start in their community-based family planning programming. During the supervision visit, it was noticed that most of them had sold their commodities and were also educating people.
  • The majority of them also completed and submitted their reporting M&E and referral forms.
    • Out of 28 HealthKeepers trained in the Mion district, the team visited 24 of them in 11 communities in the district. All the 24 visited submitted their M&E forms. Half of the number visited bought commodities like CD condoms, Secure® pills, ORS and Zinc tablets.
    • In the Karaga district, HKN trained 24 HealthKeepers. During the field visit, 21 of them were met. All 21 HealthKeepers submitted their M&E forms and 9 referral forms. All the referrals were for the injectable method.
  • The youth peer educators visited in Adaklu were taken through HKN’s reporting forms and encouraged to continue the adolescent education with their peers and document their activities on the HKN reporting form.



Two community outreaches were organized in November in the Central Tongu and Sagnerigu districts. Both outreaches were organized in collaboration with the District Health Directorates, Chief, Elders, Assemblymen and other identifiable and influential groups in the host community.

Outcome from Central Tongu Outreach

  • The outreach in the Central Tongu District was held at Mafi Zongo. It was attended by One hundred and seventy-four (174) community members made up of one hundred and twenty-three (123) females and fifty-one (51) males.
  • The services offered at the outreach included but not limited to family planning education and counseling, HIV testing and counseling, Blood pressure and body mass index measurements
  • One hundred and forty-three (143) community members made up of thirty (30) males and one hundred and thirteen (113) females were counseled on family planning during the outreach.
  • One hundred and fifty-nine (159) persons took the voluntary HIV test. Three (3) persons i.e. a male and two females tested positive. They were referred to the Adidome Hospital.
  • Twenty-one (21) trained HealthKeepers were present to receive their certificates.

Outcome of the Sagnerigu Outreach

  • The outreach in Sagnerugu Districts was held at Gurugu in front of the Chief’s palace. Amongst the invited guests was the Gurugu Chief Naa Issaka Neidow and eight of his elders and Mrs. Augustine Maami the in charge at the Choggu Health Center.
  • Seventy-five (75) community people made up of 25 males and 53 females and fifteen (15) HealthKeepers from the district attended the program.
  • Fifty-five (55) people (10 males and 45 females) accessed family planning counseling.
  • Seventy (70) people did the HIV test and counseling. No positive case was recorded at the outreach.

Some questions asked during the outreach

  • Why do some people experience itches when they use a condom?
  • Can the male condom get stuck inside the vagina?
  • Can pre- ejaculation impregnate a woman?
  • Can the implants get lost in the arm?



Resupply of commodities to CBDs continued in November 2017. The supply team visited 27 districts/municipalities. A total CYP contribution of 4,442.33 was made from the condom and oral contraceptive pills distribution in November. Tables 5 and 6 below provide a breakdown in CYP contributions and the places visited for resupplies in the month.

Table 5:  HKN CYP Contributions

DateNo Logo condomsProtector condomsTotal for condomsOral contraceptives PillsMonthly Total
1-30 Nov. 2017  270 53.33 323.33  4,119.00  4,442.33
HKN’s Total CYP contributions from June 2013 to 30th November 2017432,812.23


Table 6: Details of resupply visits in November 2017

 DATERegionDistrict/ MunicipalityCategory Of Community Agents





1/11/17Greater AccraAccra Barbers
2/11/17Greater AccraAda East HealthKeepers/OTCMS
8/11/17CentralAwutu-Senya WestHealthKeepers/OTCMS
8/11/17Greater AccraLEKMAHealthKeepers/ OTCMS
9/11/17Greater AccraAshiamanHealthKeepers
13/11/17Greater AccraGa SouthHealthKeepers
14/11/17Ga SouthOTCMS
16/11/17CentralGomoa EastHealthKeepers
16/11/17VoltaKetu SouthOTCMS
22/11/17TolonOTCMS /HKS
23/11/17Greater AccraAdenta HealthKeepers
24/11/17Gomoa WestHealthKeepers
27/11/17Greater AccraGa WestHealthKeepers/OTCMS
27-30/11/17WesternShama/Tnma/Stma/Wassa EastOTCMS/ HealthKeepers/ StattionGuards
28/11/17Greater AccraGa EastHealthKeepers
29/11/17CentralAgona EastHeathKeepers/OTCMS
30/11/17CentralAwutu-Senya East OTCMS


  • 1st and 2nd November: HKN participated in USAID HPNO and its IP meeting
  • 13th November: HKN participated in a meeting between USAID/Washington, USAID Ghana, PSI and HKN on FP commodities supply chain issues.



HealthKeepers Network community-based family planning and HIV prevention project is going according to the work plan and on track to achieving its overall goal. HKN greatly values the management and technical assistance it is obtaining from JSI-RTI and USAID-Ghana as well as the funding support of USAID, its partnerships with the various MMDAs, MoH/GHS, Ghana Education Services, GAC and others which has made such progress possible. Thank you.







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