Antimicrobial resistance (AMR) is rising rapidly in Bangladesh, posing a serious threat to healthcare. To address this challenge, ARK Foundation, with support from CDC-DGHS and WHO Bangladesh, is piloting an Antimicrobial Stewardship (AMS) initiative at primary, secondary, and tertiary facilities in Cumilla and Dinajpur districts.
The project started with a national-level inception meeting, followed by district-level sensitization meetings to introduce the national AMS guideline and engage hospital leadership and key clinical departments. Following this, a baseline assessment – combining desk reviews, situation analyses, a Point Prevalence Survey (PPS), and Key Informant Interviews (KIIs) mapped antibiotic prescribing patterns, diagnostic practices, and existing AMS structures.
To build capacity, nearly 150 clinicians, nurses, pharmacists, and managers attended hands-on workshops covering the AMS framework, disease specific standard treatment guidelines (STG), and infection prevention and control (IPC). AMS committees and facility-based teams are now established at all participating sites.
A key feature is the deployment of ARK’s Project Research Physicians (PRPs), who visit each facility regularly to support to AMS committees, assist in monitoring prescribing trends using a digital tool (REDCap), and provide on-the-job training. Prescription survey forms from the national guideline are distributed across all departments. PRPs ensure these are completed, reviewed by department heads, and used to provide feedback.
All facilities are organizing feedback meetings to review progress and guide decisions. A major outcome in one of the feedback meetings was the formal adoption of formulary restrictions and pre-authorization requirements for selected antibiotics.
Information, Education, and Communication (IEC) materials have been displayed in key hospital areas to reinforce messages. These materials aim to remind and guide health professionals in their daily practice.
This pilot initiative is creating real-time change within hospital systems and has already led to increased awareness, structured practices, and stronger collaboration among healthcare providers. ARK Foundation is proud to contribute to Bangladesh’s national effort to combat AMR through practical, locally-led stewardship interventions.
