Table 3.

Challenges faced by healthcare workers in implementing AMS activities.

AMS core element	Challenges faced by healthcare facilities in implementing AMS programs
Leadership commitment	Lack of leadership commitment to AMS Facility action plans have no AMS activities No funding for AMS activities No dedicated AMS leader with a job description for AMS
Accountability and responsibilities	No active AMS multidisciplinary team
AMS actions	Inadequate technical personnel needed for implementation of AMS Challenges/barriers in mechanisms of dissemination of AMS information No standard and updated treatment guidelines (STGs) in the facility Lack of AMS ward rounds and antibiotic review audit Lack of AWaRe tool for antibiotics Lack of facility AMS policy Lack of standardized prescription charts.
Education and training	The facility does not include AMS programs on optimizing antibiotic therapy, prescribing, dispensing, and administration of antibiotics. Inadequate training of staff on AMS
Monitoring and surveillance	Absence of antibiograms Lack of antibiotic sensitivity discs to effectively conduct surveillance No evidence-based practice from point prevalence surveys In hospitals that had antibiograms, they lacked regular updates due to poor surveillance
Reporting feedback	Inadequate communication on the resolutions of the DTC or AMS committees to the prescribers and other health workers