## 3 Results
### Checklist Implementation  
Quantitative Improvements Following the AMS Intervention  
Table 1 shows a comparison of the core checklist results pre and post the CwPAMS AMS strengthening intervention, delivered through the partnerships. The five additional sites in Uganda (without the CwPAMS project interventions) only completed the checklist once and are therefore excluded from this comparison. Their checklist results can be found in a separate table in Supplementary Material S4. \begin{table}
\begin{tabular}{p{113.8 pt} p{28.5 pt} p{28.5 pt} p{28.5 pt} p{28.5 pt} p{28.5 pt}} \hline \hline  & \multicolumn{2}{c}{**Pre-AMS**} & \multicolumn{2}{c}{**Post-AMS**} & \multicolumn{2}{c}{**Percentage**} \\  & **Intervention** & **\(N=14\)** & **Intervention** & **\(N=14\)** & **Difference** \\ \hline Has your hospital management formally identified AMS as a priority objective for the institution and included it in its key performance indicators? & **2** & 14\% & 10 & 71\% & +57\% \\ \hline Is there dedicated, sustainable and sufficient budgeted financial support for AMS activities (e.g., support for salary, training, or IT (information technology) support)? & 1 & 7\% & 3 & 21\% & +14\% \\ \hline Does your hospital have a formal organisational multidisciplinary structure responsible for AMS? & 3 & 21\% & 14 & 100\% & +79\% \\ \hline Does your hospital have a dedicated committee focussed on antimicrobial use? & 2 & 14\% & 8 & 57\% & +43\% \\ \hline Is there a healthcare professional identified as a leader for AMS activities at your hospital and responsible for implementing the programme? & 4 & 29\% & 12 & 86\% & +57\% \\ \hline Is a multidisciplinary AMS team available at your hospital (e.g., greater than one trained staff member supporting clinical decisions to ensure appropriate antimicrobial use) to implement your stewardship strategy? & 1 & 7\% & 10 & 71\% & +64\% \\ \hline Are clinicians, nurses or pharmacists, other than those part of the AMS team (e.g., from the ICU, Internal Medicine and Surgery) involved in the AMS committee? & 1 & 7\% & 9 & 64\% & +57\% \\ \hline Do you have access to laboratory/imaging services to be able to support the diagnosis of the most common infections at your hospital? & 8 & 57\% & 9 & 64\% & +7\% \\ \hline Are the results available in a timely manner to be able to support diagnosis of most common infections? & 3 & 21\% & 6 & 43\% & +22\% \\ \hline In your hospital are there, or do you have access to healthcare professionals in infection management and stewardship willing to constitute an antimicrobial stewardship team? & 9 & 64\% & 12 & 86\% & +22\% \\ \hline Does your hospital offer access to educational resources to support staff training on how to optimise antimicrobial prescribing? & 2 & 14\% & 6 & 43\% & +29\% \\ \hline Does your hospital monitor the quantity of antimicrobials prescribed/dispensed/purchased at the unit and/or hospital wide level? & 5 & 36\% & 9 & 64\% & +28\% \\ \hline Does your stewardship programme monitor compliance with one or more of the specific interventions put in place by the stewardship team (e.g., indication captured in the medical record for all antimicrobial prescriptions, or antibiotic prescribed follows hospital guidelines)? & 1 & 7\% & 7 & 50\% & +43\% \\ \hline \hline \end{tabular}
\end{table} 
Table 1: Comparison of selected AMS checklist results pre- and post-AMS intervention that formed part of the CwPAMS projects. The numbers indicate the total number of sites that agreed with the item in question. Percentages (out of 14 sites) are provided alongside the numbers. The final column shows post-intervention improvement through the percentage increase. Improvements were reported across all core indicators of the AMS checklist. The largest improvements pertained to the core AMS checklist element on the multidisciplinary organisational structures responsible for AMS. Before the AMS intervention, only three healthcare sites reported having such a formal AMS structure.