Mathew Philip, Sivaraman Satya, Chandy Sujith
ReAct Asia Pacific and Department of Community Medicine, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India.
ReAct Asia Pacific, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2019 Jun;8(6):1867-1871. doi: 10.4103/jfmpc.jfmpc_263_19.
Antimicrobial resistance (AMR) is now a global public health issue and is projected to affect the longevity of people and increase health expenditure of countries. Its impact is going to be higher in low-middle income countries as the healthcare systems are suboptimal and ill-equipped to deal with the issue. As antibiotic misuse is the primary driver for AMR, there is an acute need to create awareness among general public regarding antibiotic misuse. This calls for a comprehensive communication strategy, which takes into account the various drivers of AMR and the solutions associated with it. In the short term, the focus of communication strategies can be on raising awareness in specific interest groups. It can help in channeling limited resources to achieve specific objectives for raising awareness among these groups, thereby improving the chances of behavior change. The general public can be targeted at a later stage or as a second phase with definite strategies and messages. But, it is erroneous to assume that a higher level of awareness will translate into a positive change in behavior. We propose that behavior change is the final fruit of a long and dynamic process. This process should rest on four pillars: adequate awareness, robust regulatory environment, emotional or material incentives, and an enabling social structure. Unless all these domains are satisfactorily addressed, the communication strategy will not be able to bring about a discernible change in behavior in terms of antibiotic use.
抗菌药物耐药性（AMR）如今已成为一个全球性的公共卫生问题，预计将影响人们的寿命，并增加各国的医疗支出。在中低收入国家，其影响将更为严重，因为这些国家的医疗体系欠佳，应对该问题的设备不足。由于抗生素滥用是AMR的主要驱动因素，因此迫切需要提高公众对抗生素滥用的认识。这就需要制定一项全面的传播策略，该策略要考虑到AMR的各种驱动因素及其相关解决方案。短期内，传播策略的重点可以是提高特定利益群体的认识。这有助于集中有限资源，实现提高这些群体认识的特定目标，从而增加行为改变的可能性。普通公众可以在稍后阶段或作为第二阶段，通过明确的策略和信息进行针对性宣传。但是，认为更高的认识水平会转化为行为上的积极改变，这种假设是错误的。我们认为，行为改变是一个漫长而动态过程的最终成果。这个过程应该基于四个支柱：充分的认识、健全的监管环境、情感或物质激励以及有利的社会结构。除非所有这些领域都得到令人满意的解决，否则传播策略将无法在抗生素使用方面带来明显的行为改变。
