Antimicrobial resistance challenging professional learning in three LMICs

Abstract

Purpose Antimicrobial resistance (AMR) is a huge global challenge calling for changes in learning and working in health-care settings. The purpose of this study is to examine tensions expressed by professionals involved in AMR in three low- and middle-income countries (LMIC) in Asia and Africa. Design/methodology/approach The qualitative study was based on 60 face-to-face or online interviews in three LMICs. The interviews were analyzed by thematic analysis and analysis of elements of an activity system. Findings A number of tensions within activity systems were analyzed revealing key issues inhibiting reconceptualization of object of work and moving toward new activity. The study suggests four opposing forces: (1) cost efficiency and good public health objectives; (2) historically and culturally developed hierarchies and good public health objectives; (3) individual responsibility and institutional responsibility; and (4) fragmented set ups and holistic view of activity as critical when developing learning and work activities in analyzed settings. Originality/value This study expands the analysis of learning needs beyond individual skills and knowledge by taking a systemic approach using the cultural-historical activity theory framework. It shows that learning around AMR is needed at individual, organizational and national level.