Get inspired - A pilot qualitative study of global health volunteering with commonwealth partnerships for antimicrobial stewardship
Authors: Brandish C , Nabiryo M , Cavanagh S , Rutter V , Kassimatis S , Rosado H 
Published: November 2024

Abstract

Introduction
The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS), funded by the UK Department of Health and Social Care's Fleming Fund, managed by the Commonwealth Pharmacists Association and Tropical Health and Education Trust, aim to build antimicrobial stewardship (AMS) capacity in low/middle-income countries (LMICs) through health-partnerships with the UK.1 CwPAMS-Phase-2 (CwPAMS2) was launched in March 2023, and supports 24 UK-LMIC partnerships delivering AMS interventions in 73 health facilities across eight African countries: Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia. Since CwPAMS1 inception (2019), UK NHS volunteers have actively provided support for capacity building in LMIC-partner organisations.2,3

Aim
To explore the impact of CwPAMS volunteering, in particular, to understand potential benefits and how it could be better integrated into NHS systems.

Methods
UK volunteers were identified through CwPAMS2 participation and leadership roles. Non-probabilistic, purposive sampling was used; a small number of volunteers were approached via email to pilot the qualitative, semi-structured interview. Data were collected between April/May-2024 with 5 UK volunteers, as well as their line managers; all agreed to scheduled, recorded discussions indicating consent. Interviews focused on the impact of volunteering experiences on UK NHS institutions, and how these could be more formally integrated into continuous professional development (CPD) pathways. Qualitative data was thematically analysed. No ethical approval was required for this study (programme evaluation).

Results
Volunteers had just begun their direct work in CwPAMS2, with &gt;1000 combined days contributed, and &lt;1000 more needed to reach anticipated outcomes. Interviewees reported benefits to the NHS through shifts in health workforce attitude, perspective and behaviours, consequently influencing wider teams (horizontally and vertically). Changes were regarded as extremely relevant and impactful to the NHS and staff CPD goals.
A prominent theme from interviews was the significant impact of global health volunteering on recruitment and retention. Individuals spoke about an injection of motivation, passion and enthusiasm into work - a reminder of the importance of their roles and the reason for staying in their jobs longer: ‘it is a reason to come and join the team and a reason to stay’. A ‘can do’, problem-solving attitude also evolved, in stark contrast with non-volunteering staff e.g. volunteers identified/solved problems rather than reporting them to senior staff, as described by one manager.
There was widespread appreciation for the NHS and the resources available in the UK, compared to LMICs. Shared examples of new systems, processes and clinical skills gained and transferred from LMICs into the NHS included: the ability to make alcohol hand gel in-house; dealing with malaria cases; improving stock management systems.

Discussion/Conclusion
Staff retention is a considerable challenge for the NHS. Volunteering is a great opportunity for personal/professional growth, fostering leadership and motivation, whilst simultaneously improving healthcare practices. Global health volunteering could be integrated into formal CPD pathways in the NHS to capitalise on the relatively small investment in staff time in return for knowledge and skills development. Full implementation of the questionnaire to assess the impact of CwPAMS volunteering on individuals and institutions is planned for delivery at the end of the programme.

References
1. Ashiru-Oredope D, Nabiryo M, et al. Tackling antimicrobial resistance: developing and implementing antimicrobial stewardship interventions in four African commonwealth countries through a health partnership model. Journal of Public Health in Africa, 2023;14(3).
2. Brandish C, Garraghan F, et al. Assessing the Impact of a Global Health Fellowship on Pharmacists' Leadership Skills and Consideration of Benefits to the National Health Service (NHS) in the United Kingdom. Healthcare (Basel), 2021; 9(7):890. DOI:10.3390/healthcare9070890.
3. Brandish C, Kamere N, et al. Views and experiences of volunteers for the Commonwealth Partnerships for Antimicrobial Stewardship Extension Programme. International Journal of Pharmacy Practice, 2023; 31(2):ii10–ii11. DOI:10.1093/ijpp/riad074.012.