CoChat
Sign Up
Cited by 65Antibiotic Use and ResistanceInfection Control in HealthcareHealth Policy Implementation Science

A road-map for addressing antimicrobial resistance in low- and middle-income countries: lessons learnt from the public private participation and co-designed antimicrobial stewardship programme in the State of Kerala, India

Open access
Singh, Sanjeev, Charani, Esmita, Devi, Sarada, Sharma, Anuj, Edathadathil, Fabia, Kumar, Anil, Warrier, Anup, Shareek, P. S. +2 more·2021·Antimicrobial Resistance & Infection Control
DOI 10.1186/s13756-020-00873-9PMC PMC7878026
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: The global concern over antimicrobial resistance (AMR) is gathering pace. Low- and middle-income countries (LMICs) are at the epicentre of this growing public health threat and governmental and healthcare organizations are at different stages of implementing action plans to tackle AMR. The South Indian state of Kerala was one of the first in India to implement strategies and prioritize activities to address this public health threat. STRATEGIES: Through a committed and collaborative effort from all healthcare related disciplines and its professional societies from both public and private sector, the Kerala Public Private Partnership (PPP) has been able to deliver a state-wide strategy to tackle AMR A multilevel strategic leadership model and a multilevel implementation approach that included developing state-wide antibiotic clinical guidelines, a revision of post-graduate and undergraduate medical curriculum, and a training program covering all general practitioners within the state the PPP proved to be a successful model for ensuring state-wide implementation of an AMR action plan. Collaborative work of multi-professional groups ensured co-design and development of disease based clinical treatment guidelines and state-wide infection prevention policy. Knowledge exchange though international and national platforms in the form of workshops for sharing of best practices is critical to success. Capacity building at both public and private institutions included addressing practical and local solutions to the barriers e.g. good antibiotic prescription practices from primary to tertiary care facility and infection prevention at all levels. CONCLUSION: Through 7 years of stakeholder engagement, lobbying with government, and driving change through co-development and implementation, the PPP successfully delivered an antimicrobial stewardship plan across the state. The roadmap for the implementation of the Kerala PPP strategic AMR plan can provide learning for other states and countries aiming to implement action plans for AMR.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s13756-020-00873-9

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The paediatric surgical departments functioned in a hospital with established IPC and AMS programmes.

    “The paediatric surgical departments functioned in a hospital with established IPC and AMS programmes.22,25”

    From Rationalizing irrational prescribing—infection-related attitudes and practices across paediatric surgery specialties in a hospital in South India (2024) · cites this paper as [25]

    The ‘Lessons learnt from the Kerala PPP for AMS’ section describes a state- and tertiary-care-level AMS initiative and a state-wide infection prevention policy (page not provided). It does not identify paediatric surgical departments or establish that their particular hospital had IPC and AMS programmes. (LLM, conf=0.75)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. [2]O’Neill J. ‘Review on antimicrobial resistance. Antimicrobial resistance: tackling a crisis for the Health and Wealth of Nations. 2014.
  2. [19]Ranjalkar J, Chandy S. India’s National Action Plan for antimicrobial resistance – An overview of the context, status, and way ahead. J Fam Med Prim Care 2019; 8:1828. http://www.jfmpc.com/text.asp?2019/8/6/1828/261404. Accessed 24 Apr 2020. PMC6618210 31334140

Cited by

Sorted by citations

Related

Authors
Singh, S., Charani, E., Devi, S., Sharma, A., Edathadathil, F., Kumar, A., Warrier, A., Shareek, P. S., Jaykrishnan, A. V., & Ellangovan, K.
Affiliations
  • Amrita Institute of Medical Sciences and Research Centre (IN)
  • Imperial College London (GB)
  • World Health Organization - India (IN)
  • Aster Medcity (IN)
  • Sree Chitra Thirunal Institute for Medical Sciences and Technology (IN)
  • Indian Medical Association (IN)
  • Government of Kerala (IN)
Corresponding author
Singh, Sanjeev
ORCID
Venue
Antimicrobial Resistance & Infection Control
Publisher
Springer Science and Business Media LLC
Published
2021-02-11
Volume
10
Issue
1
Pages
32-32
ISSN
2047-2994 (ISSN-L)
DOI
10.1186/s13756-020-00873-9
PMC
PMC7878026
OpenAlex
W3126999641
Cited by
65
References
31
Citations by year
2026: 9 · 2025: 14 · 2024: 20 · 2023: 9 · 2022: 9 · 2021: 4
FWCI
1.16
Type
journal article
Language
en
Open access
Licence
Locations
  • Antimicrobial Resistance and Infection Control (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Spiral (Imperial College London) (submittedVersion, cc-by-nc-nd)
Funders
  • World Health Organization
  • National Institute for Health Research Health Protection Research Unit (HPRU_2012_10047)
  • National Institute for Health and Care Research (HPRU-2012-10047)
  • Imperial College London (HPRU-2012-10047)
  • Public Health England (HPRU-2012–10047)
  • Economic and Social Research Council (ES/P008313/1)
Topics
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
  • Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
antimicrobial resistance, antimicrobial stewardship, public-private partnerships, co-design, low- and middle-income countries, Kerala, general practice training, infection control policy, capacity building, stakeholder engagement, knowledge sharing
MeSH terms
Antimicrobial Stewardship, Curriculum, Developing Countries, Education, Medical, India, Practice Guidelines as Topic, Drug Resistance, Bacterial, Public-Private Sector Partnerships

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review