Antimicrobial resistance (AMR) is a major threat to global health, food sustainability and security, and socio-economic development. It is estimated that AMR infections currently cause approximately 700,000 deaths each year globally, a figure that is set to rise to 10 million by 2050, if no action is taken. AMR does not recognize geographic or human/animal borders. Public awareness and/or public education on AMR is highlighted in most international guidance. However, it is critically important to go beyond raising public awareness of AMR to actively engaging with individuals and communities, enabling them to identify, develop and implement community-led and contextually relevant sustainable solutions. Community engagement (CE) to address AMR is an under-used and under-researched strategy for addressing AMR globally, and receives little mention in global policy.
We interpret CE to mean a participatory process through which equitable partnerships are developed with community stakeholders, who by using existing or available resources are enabled to identify, develop and implement community-led sustainable solutions to issues that are of concern to them and to the wider global community. Community stakeholders include actors, such as farmers, drug sellers and traditional medicine practitioners, whose behavior is relevant in the context of addressing the drivers of AMR. One of the principal mechanisms of CE is social and behaviour change (SBC) i.e. changes in the behaviour of individuals which, in turn, lead to changes at societal level. CE has the potential to interact with and impact on all other critical AMR initiatives, due to its capacity to identify barriers to addressing AMR within community settings and identify contextualized community-led solutions to overcome those barriers.
OBJECTIVES OF THE PROJECT
To co-create, implement and robustly evaluate an innovative intervention that addresses the contextual drivers of AMR through a ‘One Health’ approach, community engagement, awareness raising, and build an infrastructure for knowledge exchange, which ultimately impacts on national and global policy.
- To develop contextualized intervention materials for community engagement (CE) that address AMR through a One Health perspective.
- To implement contextually developed materials for community engagement via community dialogue approach (CDA).
- To evaluate an approach to CE that tackles AMR at the community level in terms of its feasibility and acceptability to a range of stakeholders and community people.
- To implement a robust research uptake strategy in order to increase the visibility of CE approaches within, and its potential impact on, the wider AMR research landscape
This community research project will be completed in a series of phases with both quantitative and qualitative components in it Household Survey (quantitative), Participatory video (PV) and Community Dialogue Approach (CDA), Rapid Ethnography Studies (RES) and qualitative study. Adaptations of the CDA will be based on rigorous formative research, which will include an exploratory qualitative study using the PV, RES methods household survey, semi structured interviews and focus group discussions. Within PV approach, a small group of people from each community will be introduced to the issue of AMR and to international guidance on how to prevent it through a series of workshops. They will be simultaneously trained in the principles of film production. The group then uses its knowledge about AMR to explore with their community through a series of short films that they collectively produce. This approach will be followed by RES, semi-structured interviews and focus group discussions which will be conducted in order to identify appropriate intervention delivery mechanisms. The survey will be conducted to quantify key contextual factors in rural Nepal related to AMR including antibiotic usage in humans and animals and awareness of AMR issues. These data sources will inform critical intervention content for CDA. We will convene an intervention development workshop with key stakeholders and community people to explore if the proposed material are appropriate for the community and cultural context, and materials will be modified accordingly
- Publications in peer reviewed journals
- Conference presentations
- Policy outputs in the form of policy briefs
- Intervention materials in the form of adapted context-specific intervention packages (CD and PV manuals)
- Online outputs in the form of a website and regular blogs
- Visual outputs in the form of films
Associated Team Members
Abriti ArjyalResearch Manager: Qualitative and Multidisciplinary Science
Key Expertise Ms. Abriti Arjyal works as Research Manager – Multidisciplinary Qualitative Research – at HERD International and has experience in the area of public health, health system and service delivery research, social science and gender, and equity. She is an emerging young researcher with more than seven years of experience leading formative and operational field studies, evaluation studies, and literature reviews, with expertise in design and implementation of qualitative research, and various community and participatory based approaches. She has sound knowledge [...]Learn more
Shreeman SharmaResearch Uptake Manager
Shreeman Sharma is an experienced professional with specialization in development Communication and knowledge management. Having dual master degree on Journalism and Mass Communication and Development Management, he has more than 15 years of experience in journalistic practice, public communication, Knowledge Management, advocacy and network buildings. He has experience of working with civil society networks and international non-government organization with major responsibility of designing and implementing advocacy and communication strategy, evidence uptake – communicating programmes’ impacts to the stakeholders and building [...]Learn more
Sanju BhattaraiResearch Manager
Personal bio She is an trained epidemiologist with more than 10 years’ experience in managing public health research projects in Nepal. She has strong technical expertise in designing and conducting implementation research using mixed methods approach. She has coordinated randomized trials looking at effects of lifestyle intervention to prevent cardiometabolic risks; and use of mobile health app to improve birth outcome among pregnant women with gestational diabetes; and pilot implementation study to prevent cervical cancer in Nepal. Additionally, she also [...]Learn more
Ashim ShresthaProject Officer - Audio Visual and Communication
Personal Bio Ashim Shrestha is filmmaking enthusiast who joined HERD INTERNATIONAL as filmmaker and researcher for CARAN (Community Arts Against Antibiotic Resistance in Nepal) project. Prior to joining HERD, he worked as independent filmmaker. Work undertaken that best describes illustrates capability to handle tags assigned CARAN: (Feb 2018 to July 2019), Funded by University of Leeds. Role: Developed a CARAN introductory video, Designed Logo for Project, Coordination with the authorities in the respective sites for conducting workshop for project, designed the presentations on [...]Learn more
Ayuska ParajuliResearch Officer
Personal bio A public health professional and a registered nurse with more than three years of research and program experience in the health sector. Involved in several projects in sectors such as non-communicable diseases, sexual and reproductive health of HIV infected women, ART adherence among people living with HIV, social health insurance scheme in selected districts of Nepal and GESI with a sound knowledge and experience in research (Mixed methods). Robust research skills in coordinating research activities with relevant stakeholders, [...]Learn more