Achievements, challenges and enablers of Ghana’s National Action Plan on Antimicrobial Resistance during 2017-2021: A mixed-methods study :

Augustina Koduah; Jessica Anim Boadi; Eric Nanteer-Oteng; Joycelyn Azeez; Saviour Yevutsey; Brian Adu Asare; Martha Gyansa-Lutterodt; Kwame Ohene Buabeng; Irene Akwo Kretchy; Belynda Amankwa

doi:10.46829/hsijournal.2026.3.8.1.1374-1383

Augustina Koduah Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Accra, Ghana
Jessica Anim Boadi Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Accra, Ghana
Eric Nanteer-Oteng Department of Psychology, University of Ghana, Legon, Ghana
Joycelyn Azeez Pharmacy Directorate, Ministry of Health, Accra, Ghana
Saviour Yevutsey Pharmacy Directorate, Ministry of Health, Accra, Ghana
Brian Adu Asare Pharmacy Directorate, Ministry of Health, Accra, Ghana
Martha Gyansa-Lutterodt Pharmacy Directorate, Ministry of Health, Accra, Ghana
Kwame Ohene Buabeng Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Irene Akwo Kretchy Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Accra, Ghana
Belynda Amankwa United Nations Development Programme (UNDP), Accra, Ghana

DOI: https://doi.org/10.46829/hsijournal.2026.3.8.1.1374-1383

Keywords: Antimicrobial Resistance, Ghana, National Action Plan Implementation, One Health

Abstract

Introduction: Antimicrobial resistance (AMR) is a complex national and global challenge. Many countries have implemented or are implementing AMR policy and national action plan (NAP) in “One Health” to ensure the appropriate use of antimicrobials. Understanding how countries implemented their NAP is important as these provide lessons for the next phase of the NAP implementation and other countries. In this paper, we analyzed Ghana’s AMR national action plan (2017-2022) achievements, challenges, and enablers.

Methodology: We employed a case study approach to collect and analyze data. Data were collected through document review (n=20), in-depth interviews (n=27), and a questionnaire. The data was thematically and descriptively analyzed based on the NAP’s five strategic objectives.

Results: The results show that the overall level of completion for all activities per stated deliverables and targets was 66.21%. Strategic objective three which focused on the reduction of the incidence of infection through sanitation, hygiene, infection prevention measures, and biosecurity practices was most implemented with 77% of completed activities. Strategic two, had the least, with 56.11% of activities completed aimed at generating knowledge and evidence from surveillance systems and laboratory services to inform policy and practice. Some identified implementation barriers were lengthy and complex institutional procedures, packed NAP activities, and inadequate funding. However, dedicated AMR champions, mainstreaming of NAP activities into implementing institutions programme, and continuous dialogue through the multisectoral AMR platform were some identified enablers.

Conclusions: Implementing national plans to curb AMR is a complex process involving multiple sectors and stakeholders with diverse institutional arrangements, interests, and resources. Therefore, aligning NAP activities with existing institutional plans and securing adequate funding for implementation is critical for sustainable gains in AMR prevention and control. As the NAP implementation analysis may be relevant across other settings, we hope this paper contributes to learning in Ghana and other countries.