Community engagement: The key to tackling Antimicrobial Resistance (AMR) across a One Health context?

ABSTRACT

Antimicrobial resistance (AMR) is a One Health problem underpinned by complex drivers and behaviours. This is particularly so in low – and middle-income countries (LMICs), where social and systemic factors fuel (mis)use and drive AMR. Behavioural change around antimicrobial use could safeguard both existing and future treatments. However, changing behaviour necessitates engaging with people to understand their experiences. This publication describes a knowledge-exchange cluster of six LMIC-based projects who co-designed and answered a series of research questions around the usage of Community Engagement (CE) within AMR. Findings suggest that CE can facilitate AMR behaviour change, specifically in LMICs, because it is a contextualised approach which supports communities to develop locally meaningful solutions. However, current CE interventions focus on human aspects, and demand-side drivers, of AMR. Our cluster suggests that broader attention should be paid to AMR as a One Health issue. The popularity of mixed methods approaches within existing CE for AMR interventions suggests there is interdisciplinary interest in the uptake of CE. Unfortunately, the specificity and context-dependency of CE can make it difficult to evaluate and scale. Nevertheless, we suggest that in synthesising learnings from CE, we can develop a collective understanding of its scope to tackle AMR across contexts.   

KEYWORDS:

• Antimicrobial resistance
• community engagement
• One Health
• context
• knowledge exchange

Acknowledgements

Authors would like to thank the wider members of each author’s host institution and projects for their contributions to designing and answering the Research Questions which form the basis of this paper. Special thanks to Dr Naomi Bull for her involvement in the early phases of this project. Thanks to Asiya Odugleh-Kolev, Lucy McDowell, Dr Sophia Latham, Jo Zaremba and Dr Madhusudan Subedi for providing insights on Community Engagement in AMR during our online workshop in September 2020. We also thank the two anonymous reviewers who provided comments and feedback on the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by the EPSRCs GCRF Challenge Cluster funding under [grant number EP/T02335x/1] beginning June 2020.