On March 19, 2025, the Ifakara Health Institute met with stakeholders in Zanzibar to roll out the Mobile Health & Clinical Mentorship for Safe Antibiotic Stewardship (MOCA) project. The initiative aims to tackle antimicrobial resistance (AMR) by reducing the overuse of antibiotics in healthcare settings. Key partners include the Ministry of Health, Zanzibar (MOHZ), the Zanzibar Food and Drug Agency, and D-Tree.

In Tanzania, 60-80% of antibiotic prescriptions are unnecessary, accelerating bacterial resistance and making treatments less effective. Dr. Fatuma, Deputy Director of Preventive Services at MOHZ, highlighted the urgency of curbing antibiotic misuse in her opening remarks. Globally, AMR caused 1.3 million deaths in 2019, surpassing deaths from HIV and malaria combined.

To address this crisis, MOCA introduces Digital Clinical Decision Support Algorithms (CDSAs)—tools that help healthcare providers make evidence-based decisions. CDSAs guide clinicians through consultations by prompting them to assess symptoms, signs, and necessary tests before diagnosing and prescribing treatment. This ensures antibiotics are used only when needed, reducing overprescription and improving patient care.

The project will be implemented in 26 health facilities across Zanzibar, covering 9,000 patients as part of a cluster randomized trial. It will also introduce an antibiotic benchmarking dashboard and mentorship programs to support healthcare workers in adopting best prescription practices.

By leveraging digital health tools and promoting responsible antibiotic use, MOCA aims to curb AMR and enhance patient care in Zanzibar, setting a new standard for antibiotic stewardship in the region.