31/03/2026
In February 2026, partners from LifeArc visited AAR Hospital and witnessed significant progress in strengthening antimicrobial stewardship (AMS) through the Antimicrobial Stewardship through Innovation, Research & Education (ASPIRE) project. ASPIRE is implemented by ReAct Africa in collaboration with LifeArc and AAR Hospital, the initiative is helping healthcare facilities improve antibiotic prescriptions through behavior change and digital support an essential step in tackling antimicrobial resistance (AMR). ASPIRE is a three-phased project; Baseline evaluation,Stewardship interventions, post-intervention evaluation.
Baseline Assessment: Identifying Key Gaps
The baseline assessment conducted at AAR hospital in 2024 revealed several structural and clinical gaps in AMS functionality and prescribing habits, respectively. Based on the World Health Organization’s AMS periodic assessment tool, the hospital recorded an overall functionality score of 39%, indicating limited implementation of structured stewardship practices.
Additionally, heavy reliance on empirical treatment and limited use of microbiology diagnostics was noted. These findings highlighted the need to strengthen governance structures, improve diagnostic stewardship, and introduce clearer prescribing guidance supported by locally generated data.
Stewardship Interventions
Improvements were achieved through a comprehensive package of interventions under the ASPIRE project;
- Strengthened AMS functionality through official appointment with clear terms of reference for AMS members (Strengthened governance structures)
- Introduction of Weekly multi-disciplinary ward round and prospective audits and feedback, thereby enhancing clinical decision-making and accountability.
- Introduction of Standard Treatment Guidelines
- Introduction of Digital tools – Electronic data collection tool with guidance on treatment plan and WhatsApp chatbot providing real-time patient management support to healthcare workers,
- Continuous medical education sessions and infection prevention and control (IPC) initiatives reinforced best practices.
Midline Results: Measurable Improvements
Over a year after stewardship interventions were introduced, a midline assessment was conducted in 2025. Substantial improvements in AMS functionality and clinical practices were observed.
The WHO AMS functionality score rose dramatically from 39% at baseline to 82%, reflecting stronger governance structures and active stewardship implementation.
Key improvements included:
These results demonstrate the powerful synergy between infection prevention and antimicrobial stewardship. Together, these integrated efforts have driven measurable progress, demonstrating the impact of a system-wide approach to combating antimicrobial resistance.