Background: Antimicrobial stewardship (AMS) policy is critical in tackling antimicrobial resistance (AMR). The information is available at the national level in Kenya about AMS policy but needed to be strengthened among the health workers and facilities at the county level. The aim of this study was to conduct a baseline assessment of the Knowledge, Attitude and Practices (KAP) on Antimicrobial Prescription and its Resistance Among Health Care Providers in Resource Poor Settings using Kisii County, Kenya as case study. Methods: A paper-based survey was conducted among Public, Private Health facilities and Community Pharmacies in Kisii County between October and December 2023. The data collected from the respondents were put into Microsoft Excel spreadsheet for coding before being imported to RStudio for analysis. Results: A total of 154 facilities across the 45 wards in Kisii County were included in the study. Most participants 111 (72%) agreed they have not received training and education on AMR and its implications on public health. Similarly,75 (49%) of the respondents said they have no formal procedures for all prescribers to conduct daily reviews of antibiotic selection until a definitive diagnosis and treatment duration are established. And that, they were not aware of AMS policy. However, they would be interested in workshops to educate them on AMR/AMS. Finally, on the level of awareness of the diagnosis and surveillance of AMR mechanisms, 248 (40%) responses said they were not or not very familiar with Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococci (VRE), Extended-Spectrum Beta-Lactamases (ESBLs), Carbapenemase-producing enterobacterales (CPE), Multidrug-resistant tuberculosis (MDR-TB) etc. Conclusion: This study found limited level of AMS implementation/uptake across all the facilities studied in Kisii County, Kenya. The study identified challenges that require urgent action in strengthening AMS policy. AMS training and education would be more effective if they are designed to specific healthcare specialties and communities/facilities in Kisii County.

The authors have declared no competing interest.

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The study received ethics approval from the Institutional Scientific Ethics Review Committee (ISERC) of the University of Eastern Africa Baraton (Application approval number: UEAB/ISERC/02/10/2023). The informed verbal consent was obtained from all study participants. The responses and identities of key informants and survey participants were kept strictly confidential.

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