Improving Antibiotic Prophylaxis in Cesarean Section in Jordanian Hospitals: SIAPS Technical Report

The U.S. Agency for International Development-funded Strengthening Pharmaceutical Systems (SPS) program, and its follow-on Systems for Improved Access to Pharmaceuticals and Services (SIAPS), provided technical assistance to help strengthen these practices at three MOH hospitals in Jordan—Prince Hussein Hospital, Prince Faisal Hospital, and Dr. Jameel Al Totanji Hospital. The initial phase of the program involved orienting each facility's key stakeholders on the objectives and scope of the program. Following this, SPS provided technical assistance for creating detailed mapping and profiling of CS-related practices at each facility, including generation of baseline data on antibiotic prophylaxis in CS. This phase was crucial in engaging the hospital teams and building in the key principles of multi-stakeholder collaboration, local ownership, and long-term program sustainability. During this phase, the hospital teams became more involved and aware of the program goals and expected outcomes. The SPS team also put together the latest international evidence and recommendations on antibiotic prophylaxis for women undergoing CS. Available local studies or references were also included, and this information was summarized and presented to the hospital stakeholders as one of the tools for the development of their own protocols. With the baseline information mapped out, and the relevant evidence-based material summarized, the hospital teams were ready to develop their own CS prophylactic antibiotic protocol and procedures (P&P). The SPS team helped develop several tools to facilitate the development process, including a System Redesign Worksheet. The multi-disciplinary stakeholder group at each hospital worked together to develop their own protocols and procedures for antibiotic prophylaxis in cesarean sections. This involved reviewing the latest international evidence and recommendations, as well as the baseline data on antibiotic prophylaxis in CS. The hospital teams also used the System Redesign Worksheet to identify areas for improvement and develop strategies for implementing the new protocols and procedures. The new protocols and procedures for antibiotic prophylaxis in cesarean sections were developed in collaboration with the hospital teams and stakeholders. The protocols and procedures were designed to ensure that antibiotic prophylaxis is used appropriately and effectively in cesarean sections, and to reduce the risk of surgical site infections. The implementation of the new protocols and procedures for antibiotic prophylaxis in cesarean sections was a key component of the program. The SPS team worked with the hospital teams to develop a plan for implementing the new protocols and procedures, and to ensure that they were put into practice. The hospital teams also received training and support to help them implement the new protocols and procedures effectively. The program also included a monitoring and evaluation component to track the implementation of the new protocols and procedures for antibiotic prophylaxis in cesarean sections. The SPS team worked with the hospital teams to develop a monitoring and evaluation plan, and to collect data on the implementation of the new protocols and procedures. The data collected during the monitoring and evaluation phase showed that the implementation of the new protocols and procedures for antibiotic prophylaxis in cesarean sections was successful. The hospital teams reported a significant reduction in the use of antibiotics in cesarean sections, and a corresponding reduction in the risk of surgical site infections. The data also showed that the hospital teams were able to implement the new protocols and procedures effectively, and that they were able to sustain the improvements over time. The program's success was due in part to the strong collaboration between the SPS team and the hospital teams. The SPS team provided technical assistance and support to the hospital teams, and helped them to develop the new protocols and procedures for antibiotic prophylaxis in cesarean sections. The hospital teams, in turn, were able to implement the new protocols and procedures effectively, and to sustain the improvements over time. The program's success also highlights the importance of multi-stakeholder collaboration and local ownership in improving healthcare practices. The program's approach, which involved engaging the hospital teams and stakeholders from the outset, was key to its success. The program's focus on building the capacity of the hospital teams and stakeholders also helped to ensure that the improvements were sustainable over time. Overall, the program's success demonstrates the potential for technical assistance and support to improve healthcare practices in low- and middle-income countries. The program's approach, which involved engaging the hospital teams and stakeholders from the outset, and building their capacity to implement and sustain improvements, was key to its success.