{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:03:08Z","timestamp":1785416588872,"version":"3.56.0"},"reference-count":39,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,7,26]],"date-time":"2025-07-26T00:00:00Z","timestamp":1753488000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background:\u00a0Antimicrobial resistance (AMR) is a significant global public health threat that undermines sustainable development. In Benin, high AMR rates to common antibiotics, including last-resort treatments, exacerbate infection outcomes and healthcare costs. Inappropriate antibiotic use worsens this challenge. To address these issues, Benin implemented its National Multisectoral AMR Action Plan 2019\u20132024.\n\nAim:\u00a0This study aims to assess the implementation of Benin\u2019s National AMR Action Plan 2019\u20132024 and identify critical gaps for future updates.\n\nSetting:\u00a0The evaluation covered six of Benin\u2019s 12 departments, engaging stakeholders from human, animal and environmental health sectors.\n\nMethods:\u00a0A retrospective cross-sectional evaluation was performed from 05 August 2024 to 30 September 2024. Data were collected through a documentary review, standardised questionnaires, semi-structured interviews and group discussions. An executed scoring grid and a Strengths, Weaknesses, Opportunities and Threats analysis were used.\n\nResults:\u00a0Of the 224 planned activities, 40.18% were not initiated, 31.25% had started, 19.64% were partially executed, 5.36% were nearly completed and only 3.57% were fully implemented. Critical gaps included the lack of a fully operational multisectoral coordination group, limited financial resources, inadequate surveillance systems, insufficient communication and education initiatives and the absence of infection prevention and control (IPC) programmes.\n\nConclusion:\u00a0Despite progress in regulatory frameworks, gaps in coordination, resources, surveillance and IPC hinder effective AMR control in Benin. Strengthening governance, communication and addressing other identified gaps are critical for future success.\n\nContribution:\u00a0This evaluation provides evidence-based recommendations to update Benin\u2019s AMR strategy within a \u2018One Health\u2019 framework.<\/jats:p>","DOI":"10.4102\/jphia.v16i1.1332","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T14:19:52Z","timestamp":1753280392000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Overview of antimicrobial resistance mitigation efforts in Benin 2024"],"prefix":"10.4102","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4828-0462","authenticated-orcid":false,"given":"Alain K.","family":"Aissi","sequence":"first","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3147-4710","authenticated-orcid":false,"given":"Tokpanou E.C.","family":"Koudjo","sequence":"additional","affiliation":[{"name":"Beninese Society of Hospital Hygiene and Infection Prevention and Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2043-0131","authenticated-orcid":false,"given":"Fil\u00e9mon T.","family":"Tokponnon","sequence":"additional","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3803-8739","authenticated-orcid":false,"given":"Al Fattah","family":"Onifade","sequence":"additional","affiliation":[{"name":"World Health Organization"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1928-3795","authenticated-orcid":false,"given":"Akpeedje A.C.","family":"Wadagni","sequence":"additional","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6404-0026","authenticated-orcid":false,"given":"G\u00e9raud S.R.","family":"Padonou","sequence":"additional","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4904-2522","authenticated-orcid":false,"given":"Herv\u00e9 A.","family":"Gbegnide","sequence":"additional","affiliation":[{"name":"Ministry of Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2771-7960","authenticated-orcid":false,"given":"L\u00e9opold A.","family":"Azakpa","sequence":"additional","affiliation":[{"name":"Beninese Society of Hospital Hygiene and Infection Prevention and Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7456-180X","authenticated-orcid":false,"given":"Adrien M.","family":"Hodonou","sequence":"additional","affiliation":[{"name":"Beninese Society of Hospital Hygiene and Infection Prevention and Control"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7827-8182","authenticated-orcid":false,"given":"Roch C.","family":"Johnson","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03gzr6j88","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 d'Abomey-Calavi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8266-7129","authenticated-orcid":false,"given":"Francis M.","family":"Dossou","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03gzr6j88","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 d'Abomey-Calavi"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,7,26]]},"reference":[{"key":"ref0","unstructured":"WHO, WOAH, FAO, UNEP. Antimicrobial resistance and UN Sustainable Development Cooperation Framework: Guidance for UN Country Teams [homepage on the Internet]. 2021. Available from: https:\/\/www.woah.org\/app\/uploads\/2021\/10\/unsdcf-amr-guidance-web-final-fr.pdf"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Naghavi M, Vollset SE, Ikuta KS, et al. Global burden of bacterial antimicrobial resistance 1990\u20132021: A systematic analysis with forecasts to 2050. Lancet. 2024;404(10459):1199\u20131226. https:\/\/doi.org\/10.1016\/S0140-6736(24)01867-1","DOI":"10.1016\/S0140-6736(24)01867-1"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Murray CJL, Ikuta KS, Sharara F, et al. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet. 2022;399(10325):629\u2013655. https:\/\/doi.org\/10.1016\/S0140-6736(21)02724-0","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"ref3","unstructured":"O\u2019Neill J. Antimicrobial resistance: Tackling a crisis for the health and wealth of nations. London: HM Government, 2014; p. 20."},{"key":"ref4","unstructured":"WHO. UN General Assembly High-Level Meeting on antimicrobial resistance 2024 [homepage on the Internet]. 2024 [cited 2025 Jan 12]. Available from: https:\/\/www.who.int\/news-room\/events\/detail\/2024\/09\/26\/default-calendar\/un-general-assembly-high-level-meeting-on-antimicrobial-resistance-2024"},{"key":"ref5","unstructured":"Africa CDC. Africa CDC framework for antimicrobial resistance 2018\u20132023. Addis Ababa: Africa CDC, 2018; p. 25."},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Sariola S, Butcher A, Ca\u00f1ada JA, A\u00efkp\u00e9 M, Compaore A. Closing the GAP in Antimicrobial Resistance Policy in Benin and Burkina Faso. mSystems. 2022;7(4):e00150-22. https:\/\/doi.org\/10.1128\/msystems.00150-22","DOI":"10.1128\/msystems.00150-22"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Mitchell J. Antimicrobial resistance (AMR) as a form of human\u2013wildlife conflict: Why and how nondomesticated species should be incorporated into AMR guidance. Ecol Evol. 2023;13(9):e10421. https:\/\/doi.org\/10.1002\/ece3.10421","DOI":"10.1002\/ece3.10421"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Ahoyo TA, Bankol\u00e9 HS, Ad\u00e9oti FM, et al. Prevalence of nosocomial infections and anti-infective therapy in Benin: Results of the first nationwide survey in 2012. Antimicrob Resist Infect Control. 2014;3(1):17. https:\/\/doi.org\/10.1186\/2047-2994-3-17","DOI":"10.1186\/2047-2994-3-17"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Yehouenou CL, Kpangon AA, Affolabi D, et al. Antimicrobial resistance in hospitalized surgical patients: A silently emerging public health concern in Benin. Ann Clin Microbiol Antimicrob. 2020;19(1):54. https:\/\/doi.org\/10.1186\/s12941-020-00398-4","DOI":"10.1186\/s12941-020-00398-4"},{"key":"ref10","unstructured":"Nouwakpo N, Hedji N, Tchewle A, Assogba C, Goudjo W. Antibiotic resistance: Current status in the Pediatrics department at CHD Zou in 2023. Beninese J Infect Dis. 2024;3(1):S36."},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Yehouenou CL, Soleimani R, Kpangon AA, Simon A, Dossou FM, Dalleur O. Carbapenem-resistant organisms isolated in surgical site infections in Benin: A public health problem. TropicalMed. 2022;7(8):200. https:\/\/doi.org\/10.3390\/tropicalmed7080200","DOI":"10.3390\/tropicalmed7080200"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Da L, Som\u00e9 D, Yehouenou C, et al. State of antibiotic resistance in sub-Saharan Africa. M\u00e9d Mal Infect Formation. 2023;2(1):3\u201312. https:\/\/doi.org\/10.1016\/j.mmifmc.2023.01.003","DOI":"10.1016\/j.mmifmc.2023.01.003"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Gay N, Rabenandrasana MAN, Panandiniaina HP, et al. One Health compartment analysis of ESBL-producing Escherichia coli reveals multiple transmission events in a rural area of Madagascar. J Antimicrob Chemother. 2023;78(8):1848\u20131858. https:\/\/doi.org\/10.1093\/jac\/dkad125","DOI":"10.1093\/jac\/dkad125"},{"key":"ref14","unstructured":"Ministry of Health of Benin. National multisectoral action plan to combat antimicrobial resistance in the Republic of Benin. Cotonou: Ministry of Health of Benin; 2019. 92 p. [cited 2025 Jan 12]. Available from: https:\/\/cdn.who.int\/media\/docs\/default-source\/antimicrobial-resistance\/amr-spc-npm\/nap-library\/pan-ram-benin_2019-2024.pdf?sfvrsn=f8d14041_3&download=true."},{"key":"ref15","unstructured":"A\u00efssi KA, Gandjeto E, D\u00e9gbey C, et al. Challenges related to the development process of the National Action Plan to Combat Antimicrobial Resistance in Benin. XXIX National Congress of the French Society of Hospital Hygiene. Montpellier: SF2H; 2018."},{"key":"ref16","unstructured":"Petitclerc M, Tourette I, Gautier P. PVS gap analysis report in the Republic of Benin [homepage on the Internet]. Cotonou: World Organisation for Animal Health; 2014 [cited 2024 Nov 30]; p. 214. Available from: https:\/\/rr-africa.woah.org\/app\/uploads\/2019\/11\/pvs_gap_analysis_report_benin.pdf"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Sandberg M, Hesp A, Aenishaenslin C, et al. Assessment of evaluation tools for integrated surveillance of antimicrobial use and resistance based on selected case studies. Front Vet Sci. 2021;8:620998. https:\/\/doi.org\/10.3389\/fvets.2021.620998","DOI":"10.3389\/fvets.2021.620998"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Frumence G, Mboera LEG, Sindato C, et al. The governance and implementation of the national action plan on antimicrobial resistance in Tanzania: A qualitative study. Antibiotics. 2021;10(3):273. https:\/\/doi.org\/10.3390\/antibiotics10030273","DOI":"10.3390\/antibiotics10030273"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Yahaya AA, Fuller W, Kithinji D, Mazengiya YD, Gahimbare L, Bishikwabo-Nsarhaza K. Perspectives on the regional strategy for implementation of national action plans on antimicrobial resistance in the WHO African Region. Antibiotics. 2024;13(10):943. https:\/\/doi.org\/10.3390\/antibiotics13100943","DOI":"10.3390\/antibiotics13100943"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Ba\u00f1o J, Rossolini GM, Schultsz C, et al. Key considerations on the potential impacts of the COVID-19 pandemic on antimicrobial resistance research and surveillance. Trans R Soc Trop Med Hyg. 2021;115(10):1122\u20131129. https:\/\/doi.org\/10.1093\/trstmh\/trab048","DOI":"10.1093\/trstmh\/trab048"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Ye Z, Long F, Gao J, Zheng H, Meng X. How epidemic information and policy information impact anti-infection behaviors: A cross-cultural study under social influence framing. J Soc Psychol. 2024;164(4):433\u2013446. https:\/\/doi.org\/10.1080\/00224545.2022.2095967","DOI":"10.1080\/00224545.2022.2095967"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Ahmed SM, Naher N, Tune SNBK, Islam BZ. The Implementation of National Action Plan (NAP) on Antimicrobial Resistance (AMR) in Bangladesh: Challenges and lessons learned from a cross-sectional qualitative study. Antibiotics. 2022;11(5):690. https:\/\/doi.org\/10.3390\/antibiotics11050690","DOI":"10.3390\/antibiotics11050690"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Walia K, Mendelson M, Kang G, et al. How can lessons from the COVID-19 pandemic enhance antimicrobial resistance surveillance and stewardship? Lancet Infect Dis. 2023;23(8):e301\u2013e309. https:\/\/doi.org\/10.1016\/S1473-3099(23)00124-X","DOI":"10.1016\/S1473-3099(23)00124-X"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Allabi AC, Agbo AG, Boya B, Mudenda S. Antimicrobial stewardship: Knowledge and attitudes of pharmacy staff on antibiotic dispensing patterns, use and resistance in Benin. PP. 2023;14(06):189\u2013214. https:\/\/doi.org\/10.4236\/pp.2023.146014","DOI":"10.4236\/pp.2023.146014"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Fuller W, Kapona O, Aboderin AO, et al. Education and awareness on antimicrobial resistance in the WHO African Region: A systematic review. Antibiotics. 2023;12(11):1613. https:\/\/doi.org\/10.3390\/antibiotics12111613","DOI":"10.3390\/antibiotics12111613"},{"key":"ref26","unstructured":"Attinsounon C, Chatue Youmssi JL, Alassani CA, Sak\u00e9 K, Ad\u00e9 SS, Dovonou CA. Analysis of antibiotic prescriptions in private health facilities in the city of Parakou in 2023. Beninese J Infect Dis. 2024; 3(1):S26\u2013S78."},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Gnimavo MS, Boya B, Mudenda S, Allabi AC. Antibiotic use at the Centre Hospitalier Universitaire de Zone d\u2019Abomey Calavi\/S\u00f4-Ava (CHUZ\/AS) in Benin: A point prevalence survey. JAC Antimicrob Resist. 2025;7(1):dlae220. https:\/\/doi.org\/10.1093\/jacamr\/dlae220","DOI":"10.1093\/jacamr\/dlae220"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Tomczyk S, Storr J, Kilpatrick C, Allegranzi B. Infection prevention and control (IPC) implementation in low-resource settings: A qualitative analysis. Antimicrob Resist Infect Control. 2021;10(1):113. https:\/\/doi.org\/10.1186\/s13756-021-00962-3","DOI":"10.1186\/s13756-021-00962-3"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Storr J, Zingg W, Damani N, et al. Core components for effective infection prevention and control programmes: New WHO evidence-based recommendations. Antimicrob Resist Infect Control. 2017;6(1):6. https:\/\/doi.org\/10.1186\/s13756-016-0149-9","DOI":"10.1186\/s13756-016-0149-9"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Ciss\u00e9 DM, Laure EEM, Blaise KA, et al. Evaluation of the implementation of hospital hygiene components in 30 health-care facilities in the autonomous district of Abidjan (Cote d\u2019Ivoire) with the WHO Infection Prevention and Control Assessment Framework (IPCAF). BMC Health Serv Res. 2023;23(1):870. https:\/\/doi.org\/10.1186\/s12913-023-09853-2","DOI":"10.1186\/s12913-023-09853-2"},{"key":"ref31","unstructured":"WHO, WOAH, FAO. Technical guidance note on water, sanitation and hygiene and wastewater management to prevent infections and reduce the spread of antimicrobial resistance. Geneva: World Health Organization; 2020."},{"key":"ref32","unstructured":"Adogoni MB, Dotche I, Ahouans\u00e9NSE GAG, Youssao IAK. Evaluation of good hygiene practices and slaughtering processes for the production and distribution of rabbit carcasses in South Benin. Rev Mar Sci Agron V\u00e9t. 2021;9(1):37\u201349."},{"key":"ref33","unstructured":"Dognon SR, Douny C, Salifou C, et al. Quality of veterinary antibiotics used in West Africa and methods for detecting their residues in food. J Anim Plant Sci. 2018;36(2):5858\u20135877."},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Vidjro S, Guiet Mati F, Ouoba K, Amonkou AC, Amari AS, Pabst JY. Regulation of the pharmaceutical sector in the WAEMU area: From national legislations towards a high-impact community legal framework. JATPB. 2022;1(1):27\u201336. https:\/\/doi.org\/10.57220\/jatpb.v1i1.4","DOI":"10.57220\/jatpb.v1i1.4"},{"key":"ref35","unstructured":"Duteil Q. Counterfeit medicines: From definition to repression [homepage on the Internet]. Universit\u00e9 Paris-Saclay; 2021. [cited 2025 Jan 12]. Available from: https:\/\/www.theses.fr\/2021UPASQ049.pdf"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Jaime G, Hobeika A, Figui\u00e9 M. Access to veterinary drugs in sub-Saharan Africa: Roadblocks and current solutions. Front Vet Sci. 2022;8:558973. https:\/\/doi.org\/10.3389\/fvets.2021.558973","DOI":"10.3389\/fvets.2021.558973"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Velazquez-Meza ME, Galarde-L\u00f3pez M, Carrillo-Quir\u00f3z B, Alpuche-Aranda CM. Antimicrobial resistance: One Health approach. Vet World. 2022;15(3):743\u2013749. https:\/\/doi.org\/10.14202\/vetworld.2022.743-749","DOI":"10.14202\/vetworld.2022.743-749"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Malan L, Labuschagne Q, Brechtelsbauer E, Goff DA, Schellack N. Sustainable access to antimicrobials; A missing component to antimicrobial stewardship \u2013 A tale of two countries. Front Public Health. 2018;6:324. https:\/\/doi.org\/10.3389\/fpubh.2018.00324","DOI":"10.3389\/fpubh.2018.00324"}],"container-title":["Journal of Public Health in Africa"],"original-title":[],"deposited":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T14:19:59Z","timestamp":1753280399000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/view\/1332"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,26]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/jphia.v16i1.1332","relation":{},"ISSN":["2038-9922","2038-9930"],"issn-type":[{"value":"2038-9922","type":"print"},{"value":"2038-9930","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,26]]},"article-number":"a1332"}}