This study protocol outlines a qualitative case study that aims to explore the barriers and enablers to implementing antimicrobial stewardship (AMS) programmes for upper respiratory tract infections (URTIs) in primary care in Kosovo. URTIs are one of the most common reasons for primary care visits, yet often do not require treatment with antibiotics. Antibiotic use is associated with side effects and the development of antibiotic resistance. Antimicrobial stewardship (AMS) programmes are essential to mitigate this issue. Many countries, including Kosovo, an upper-middle-income country, have not yet implemented AMS programmes. The implementation of AMS in Kosovo is shaped by economic, social, technological and legal factors. However, it is the structural weaknesses within the health system that pose the most significant barriers.
The study will conduct interviews and focus groups across six primary care sites and central health institutions. Stakeholders will include healthcare workers, patients, patient representatives, and policymakers. Guided by the Consolidated Framework for Implementation Research, the study will analyse barriers and enablers to AMS for URTIs using framework analysis.
