10th U6+ Consortium of African Universities International Conference

Antimicrobial Resistance (AMR) is a global health concern, particularly in low- and middle-income countries, leading to increased mortality, prolonged hospital stays, and strained healthcare resources. Antimicrobial stewardship is critical in combating resistant pathogens, but ethical issues surrounding AMR stewardship, particularly in resource-constrained settings such as Kenya, are understudied. Autonomy, justice, and nonmaleficence are frequently overlooked, resulting in unethical behaviour and potential harm to participants or patients. This study explored ethical challenges in AMR stewardship at Kenyatta National Hospital (KNH) and provided context-specific recommendations to improve ethical oversight in LMICs. A descriptive phenomenology design with purposive sampling was used, and 18 in-depth semi-structured interviews were conducted among healthcare professionals at Kenyatta National Hospital. Data were transcribed and analyzed using ATLAS.ti software, while adhering to Colaizzi’s method of phenomenological data analysis. The study involved 18 key informants (27.8% male, 72.2% female). Eight themes emerged: systemic and institutional barriers, privacy and confidentiality, conflict of interest, equity and inclusivity, capacity building, autonomy, multidisciplinary collaboration, and risk-benefit analysis. These themes revealed ethical challenges that hindered AMR stewardship efforts at Kenyatta National Hospital. Ethical principles such as autonomy, justice, and non-maleficence were often compromised due to resource constraints, power imbalances, and external influences. Specific moral dilemmas included surrogate consent for incapacitated patients and failure to adhere to AMR stewardship guidelines. These challenges required urgent reforms and ethical frameworks to prioritize patient rights, collaboration, and equity in AMR stewardship.