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Charitonos, Koula and Littlejohn, Allison
(2022).
DOI: https://doi.org/10.1080/0158037X.2021.1883577
Abstract
This article examines tensions that professionals in healthcare settings in low-to-middle income countries (LMICs) face in the evolving field around surveillance of antimicrobial resistance (AMR). Few public health problems are of greater global importance today than AMR, that poses a threat to our ability to treat infections. In this context, the microbiology laboratory occupies a prominent place and the knowledge field of microbiology is expanding. In the study we interviewed twenty-three (n=23) professionals with expertise on AMR and public health systems to synthesise knowledge on strengthening AMR surveillance in LMICs. By drawing on a practice approach (Schatzki, 2001) combined with socio-cultural and cultural-historical theories (CHAT) (Engeström, 1987) and using the theoretical lens of the model of interconnected activity systems, the analysis reveals seven tensions between elements of the systems and discusses how such tensions serve to frame implications for implementing a capacity strengthening programme. The analysis shows that the novelty of the AMR as well as being a multi-disease and multisectoral by nature challenges existing forms of professional practice in healthcare settings. It also suggests that AMR requires to be dealt with through inter-professional and inter-sectoral approaches, while maintaining a focus across the local, national, and global systems, which is essential for initiatives that are set to address challenges to global health.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)
