How do health professionals in a Kenyan health facility learn to tackle Antimicrobial Resistance?

Tegama, Natalie (2023). How do health professionals in a Kenyan health facility learn to tackle Antimicrobial Resistance? PhD thesis The Open University.



In 2015, the World Health Organisation set the goal to reduce Antimicrobial Resistance (AMR) as a global priority on their agenda. It is estimated that AMR could kill as many 10 million people per year. Tackling AMR requires concerted efforts of which many recommended approaches highlight the important role of the workforce. This has been pivotal in directing the line of inquiry for this thesis.

This thesis uses mixed methods research to examine the challenge of AMR in Kenya. Mapping its underpinning historical and social roots with the view to explore how health professionals in a peri-urban, Kenyan health facility learn to tackle AMR using learning technologies. The thesis demonstrates the development of a body work that negotiates the tension between western methodologies that are emblematic of the modern university with African ways of knowing, thinking, and living. It engages with the materiality and praxis of decolonisation as grounded in resistance, adroitly creating small ruptures from Eurocentrism to conceptualise the challenge of AMR though an African lens in an attempt to comprehensively answer the following questions:

• To what extent and through what methods do health professionals engage with continuous professional development ?
• What socioeconomic factors impact learning for health professionals?
• What are the barriers and facilitators to learning about and practicing AMR stewardship?

The thesis methodologically demonstrates critical engagement with theoretical tools and develops a conceptual framework that leverages Cultural-Historical Activity Theory and Design based research in mapping context, informing design, and facilitating analysis. The theoretical framework furthers a sociocultural and sociomaterial understanding of practice and practice-based learning and illustrates a decolonial approach that centres spatiotemporal nuances in ethics, culture, and practice to develop a feasible and contextually appropriate solution to tackling AMR through the use of e-learning.

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