Implementing the national action plans on antimicrobial resistance in Jordan: document analysis and policymakers' perspectives.
- 1Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
- 2Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
- 3Management and Policy Division, Alliance Manchester Business School, The University of Manchester, Manchester, UK.
Abstract
Background
The World Health Organization (WHO) developed the Global Action Plan (GAP) on Antimicrobial Resistance (AMR) in response to its growing threat to human, animal, and agricultural health. Countries worldwide were encouraged to implement National Action Plans (NAPs) to combat AMR. However, low- and middle-income countries (LMICs) face difficulties in implementing NAPs. This study aimed to investigate the implementation of AMR policy in Jordan and assess progress under its NAP.Methods
Using the Implementation Research (IR) framework, this study involved documentary analysis of five policy documents and 17 semi-structured interviews with policymakers. Guided by the IR framework's three phases (proof of concept, proof of implementation, informing scale-up), document analysis was conducted deductively, while the interviews were analysed inductively and deductively using thematic analysis supported by NVivo.Results
Three key themes emerged: implementation challenges, strategy design, and outcome evaluation. Problem identification and context analysis showed that while Jordan's NAP aligns with the WHO's GAP, poor intersectoral coordination, limited stakeholder engagement, and weak enforcement hinder implementation. Participants noted unclear roles for policymakers, creating accountability gaps and inefficiencies. Implementation strategies showed that AMR interventions focus on hospitals, with little attention to other sectors (community pharmacy and primary care). Differences between public and private hospitals led to inconsistent enforcement, while unenforced community pharmacy regulation allowed for unregulated access to antibiotics. Monitoring and evaluating AMR interventions remain key gaps, with a lack of standardised frameworks, fragmented surveillance data, and insufficient monitoring capacity.Conclusion
Although aligned with WHO's GAP, AMR policy implementation in Jordan is hindered by systemic barriers: weak enforcement, limited stakeholder engagement, and fragmented accountability. A focus on hospitals left other settings with limited action or reinforcement. The findings highlighted the need for cross-sector coordination and robust monitoring. While context-specific, these insights may inform AMR governance in comparable settings.
Related
- The One Health national policy network to combat antimicrobial resistance in Senegal
- Divergent stakeholder perspectives on antimicrobial resistance and One Health in Ghana: a qualitative study
- Stakeholder perspectives on implementing geographic information systems for leprosy elimination in Pakistan: A qualitative study
- Antimicrobial Resistance (AMR) Surveillance: Ten Years On.
- Editorial: Evolution of antimicrobial resistance in intracellular bacterial pathogens: a genomic and historical perspective
BibTeX
@article{alqudah2026implementing,
title = {{Implementing the national action plans on antimicrobial resistance in Jordan: document analysis and policymakers' perspectives.}},
author = {Raja'a Al-Qudah and Sarah C Willis and Ellen I Schafheutle},
journal = {Journal of pharmaceutical policy and practice},
year = {2026},
month = oct,
doi = {10.1080/20523211.2026.2735525},
url = {https://europepmc.org/article/MED/42910335},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Implementing the national action plans on antimicrobial resistance in Jordan: document analysis and policymakers' perspectives.
AU - Raja'a Al-Qudah
AU - Sarah C Willis
AU - Ellen I Schafheutle
PY - 2026
DA - 2026/10/20
JO - Journal of pharmaceutical policy and practice
DO - 10.1080/20523211.2026.2735525
UR - https://europepmc.org/article/MED/42910335
AB - Background The World Health Organization (WHO) developed the Global Action Plan (GAP) on Antimicrobial Resistance (AMR) in response to its growing threat to human, animal, and agricultural health. Countries worldwide were encouraged to implement National Action Plans (NAPs) to combat AMR. However, low- and middle-income countries (LMICs) face difficulties in implementing NAPs. This study aimed to investigate the implementation of AMR policy in Jordan and assess progress under its NAP.Methods Using the Implementation Research (IR) framework, this study involved documentary analysis of five policy documents and 17 semi-structured interviews with policymakers. Guided by the IR framework's three phases (proof of concept, proof of implementation, informing scale-up), document analysis was conducted deductively, while the interviews were analysed inductively and deductively using thematic analysis supported by NVivo.Results Three key themes emerged: implementation challenges, strategy design, and outcome evaluation. Problem identification and context analysis showed that while Jordan's NAP aligns with the WHO's GAP, poor intersectoral coordination, limited stakeholder engagement, and weak enforcement hinder implementation. Participants noted unclear roles for policymakers, creating accountability gaps and inefficiencies. Implementation strategies showed that AMR interventions focus on hospitals, with little attention to other sectors (community pharmacy and primary care). Differences between public and private hospitals led to inconsistent enforcement, while unenforced community pharmacy regulation allowed for unregulated access to antibiotics. Monitoring and evaluating AMR interventions remain key gaps, with a lack of standardised frameworks, fragmented surveillance data, and insufficient monitoring capacity.Conclusion Although aligned with WHO's GAP, AMR policy implementation in Jordan is hindered by systemic barriers: weak enforcement, limited stakeholder engagement, and fragmented accountability. A focus on hospitals left other settings with limited action or reinforcement. The findings highlighted the need for cross-sector coordination and robust monitoring. While context-specific, these insights may inform AMR governance in comparable settings.
SN - 2052-3211
ER -