Upper respiratory tract infections (URTIs) dominate the list of reasons for visiting primary care, yet treating these ailments with antibiotics often proves unnecessary, exacerbating the risk of side effects and antibiotic resistance. In the heart of this issue lies the importance of Antimicrobial Stewardship (AMS) programs. These initiatives aim to curtail inappropriate antibiotic usage, but in Kosovo—an upper-middle-income nation—such programs remain unestablished. The path to implementation in Kosovo is complex, entwined with economic, social, technological, and legal challenges, yet the most formidable hurdles are rooted in systemic health system weaknesses. This study aims to dissect and understand the specific barriers and potential enablers for AMS programs targeting URTIs within Kosovo’s primary healthcare framework.
Research Methodology and Approach
Drawing from a qualitative case study methodology, the research involves conducting interviews and focus groups across six primary care sites and central health institutions in Kosovo. The inclusion of various stakeholders—healthcare professionals, patients, and health policymakers—ensures a comprehensive insight into perspectives regarding AMS implementation. The Consolidated Framework for Implementation Research serves as a guiding structure for study design, facilitating a nuanced analysis through framework analysis to identify critical themes such as intervention dynamics, contextual environment, participant characteristics, and procedural insights. This methodological approach promises to illuminate the intricate landscape of AMS adoption challenges.
Ethical Considerations and Knowledge Dissemination
With ethics clearance from the Kosovo Doctors Chamber (Reference No 122/2024), the research team prioritizes ethical standards, especially regarding informed consent and data protection. Dissemination of findings will be pursued through peer-reviewed journal publications, aiming to inform both local and international audiences about the intricacies and outcomes of the study, ultimately contributing valuable insights to the global dialogue on AMS practices.
Key takeaways from the study are expected to include:
- Identification of specific structural barriers to AMS program implementation within Kosovo’s health system.
- Insight into economic, social, technological, and legal factors affecting AMS adoption.
- Recognition of stakeholders’ perspectives and potential enablers for successful AMS program execution.
Addressing the implementation of Antimicrobial Stewardship programs in Kosovo emerges as a multifaceted challenge that intricately weaves through various dimensions of healthcare delivery. Overcoming structural health system barriers necessitates not only strategic planning but also cooperation among diverse stakeholders to pave the way for sustainable AMS initiatives. At the core, it demands an acknowledgment and redressal of systemic inefficiencies that hinder progress. Efforts should focus on fostering robust infrastructure, enhancing professional training, and building a supportive policy environment to realize AMS programs effectively. As global antibiotic resistance escalates, the valuable insights derived from this study could guide similar healthcare systems facing analogous challenges, ultimately contributing to a collective effort in safeguarding effective antibiotic use worldwide.
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