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.

中文翻译：

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三个中低收入国家的抗菌素耐药性挑战专业学习

目的

抗菌素耐药性 (AMR) 是一项巨大的全球挑战，需要改变医疗保健环境中的学习和工作方式。本研究的目的是检查亚洲和非洲三个低收入和中等收入国家 (LMIC) 中参与 AMR 的专业人员所表达的紧张情绪。

设计/方法/方法

定性研究基于三个中低收入国家的 60 次面对面或在线访谈。访谈通过主题分析和活动系统要素分析进行​​分析。

发现

分析了活动系统内的许多紧张关系，揭示了阻碍重新概念化工作对象和转向新活动的关键问题。该研究提出了四种相反的力量：(1) 成本效率和良好的公共卫生目标；(2) 历史和文化上发展的等级制度和良好的公共卫生目标；（三）个人责任和机构责任；(4) 在分析环境中开展学习和工作活动时，分散的设置和活动的整体观点至关重要。

原创性/价值

本研究通过使用文化历史活动理论框架的系统方法，将学习需求的分析扩展到个人技能和知识之外。它表明个人、组织和国家层面都需要围绕 AMR 进行学习。