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The Clinical Engagement (CE) Program – The UK Aid Fleming Fund Country Grant II, led by the remarkable team at Indus Hospital and Health Network (IHHN), a consortium partner of DAI, won the second annual AMR Industry Alliance award.
The Second Annual Stewardship Prize was awarded by the AMR Industry Alliance, one of the world’s largest private sector coalitions tackling antimicrobial resistance (AMR), with over 100 diagnostic and pharmaceutical companies joining forces. The Alliance promotes innovative and scalable approaches to AMR stewardship in low- and middle-income countries (LMIC).
Background
The Fleming Fund is an initiative by the UK Government to tackle AMR, especially in LMICs. The Fleming Fund has been actively working with Pakistan’s human and animal health sector since 2019. As the lead grantee, DAI is facilitating the Government of Pakistan to become a model for AMR One Health interventions. As one of the partners, Indus Hospital and Health Network (IHHN) is working on empowering healthcare practitioners (HCP) by implementing the CE program.
The Clinical Engagement (CE) program has aimed to enhance interaction between the laboratory and all clinical care providers since January 2021 to improve several aspects identified in AMR containment action plans at six tertiary care public hospitals across Pakistan. These include Jinnah Postgraduate Medical Center (JPMC) and Dr. Ruth K. M. Pfau Civil Hospital Karachi (CHK) in Karachi, Sindh; Sheikh Zayed Hospital (SZH) Lahore and Nishtar Medical University Hospital (NMUH) Multan in Punjab, Medical Teaching Institute Hayatabad Medical Complex (MTI-HMC) in Peshawar, Khyber Pakhtunkhwa, and Provincial Headquarters Hospital in Gilgit, Baltistan (PHQ-GB).
Our Work – Clinical Engagement (CE) Program
The basic framework of the program focuses on three areas: Diagnostics Stewardship, Antibiotic Use, and Infection Prevention and Control (IPC).
The program’s main activities included conducting a Baseline survey based on WHO PPS methodology on antibiotic utilization in target hospitals to measure Antimicrobial Use (AMU) in healthcare facilities. The survey found that Ceftriaxone, a third-generation Cephalosporin, is the most prescribed antibiotic among all six sites and that clinical teams in most hospitals lack the capacity to oversee and implement AMR and AMU surveillance due to poor infrastructure for Antimicrobial Stewardship. Advocacy meetings with higher management have been held, leading to the development of antibiograms to facilitate the selection of empirical therapy, the development of antimicrobial prescription guidelines, and the establishment of a robust antimicrobial stewardship and Infection Prevention and Control (IPC) program in the health care facility. Teaching and training sessions for HCPs have also been conducted.
An endline survey has also been conducted to determine the impact of the CE program. Communications material and teaching aids related to AMR, AMU, and IPC have been disseminated at all these hospitals. Capacity building of the facility-based Microbiology labs is being done at JPMC (ISO 15189 preparedness), NMUH (SOP development and enhancing Internal Quality Control (QC) Practices), and PHQ-GB (Initiation of Microbiology Lab after seven years of dormancy).
Our Team
Indus Hospital and Health Network is proud of its incredible team that has brought international recognition to the CE Program and made it a resounding success.
The program’s senior leadership includes Dr. Saba Jamal, Senior Director of Laboratory and Blood Transfusion Services at IHHN, and Project Director, CE Program; Dr. Nazia Khursheed, Chair Pathology at IHHN, and Principle Investigator in the Fleming Fund Country Grant II: CE program; and Dr. Madeeha Fatima, Project Manager, CE Program.
The program’s six site managers include Dr. Ali Raza, Hayatabad Medical Complex; Dr. Kamran Ahmed Farooqui, Dr. Ruth K. M. Pfau Civil Hospital Karachi; Dr. Sadia Iqbal, Nishtar Medical University Hospital; Dr. Salima Rattani, Sheikh Zayed Hospital Lahore; Dr. Sidra Khan Ghouri, Jinnah Postgraduate Medical Center; Imdad Hussain, Site Coordinator, Provincial Headquarters Hospital; Asim Arif, Grant Coordinator and Finance; and Malik Faheem, Finance.