Nuffield Centre for International Health and Development, University of Leeds, Woodhouse, UK.
Centre for World Cinema and Digital Cultures, University of Leeds, Woodhouse, UK.
Glob Public Health. 2022 Nov;17(11):2647-2664. doi: 10.1080/17441692.2021.2003839. Epub 2021 Dec 9.
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. .
抗微生物药物耐药性(AMR)是一个涉及多个领域的健康问题,其背后有复杂的驱动因素和行为。在中低收入国家(LMICs)尤其如此,这些国家的社会和系统因素助长了(错误)使用和推动 AMR 的行为。围绕抗微生物药物使用的行为改变可以保护现有的和未来的治疗方法。然而,改变行为需要与人们接触,了解他们的经验。本出版物描述了一个由六个基于中低收入国家的项目组成的知识交流集群,这些项目共同设计并回答了一系列关于在 AMR 中使用社区参与(CE)的研究问题。研究结果表明,CE 可以促进 AMR 行为的改变,特别是在 LMICs,因为它是一种基于背景的方法,可以支持社区制定具有本地意义的解决方案。然而,目前的 CE 干预措施侧重于 AMR 的人类方面和需求方驱动因素。我们的集群表明,应该更加关注 AMR 作为一个涉及多个领域的健康问题。混合方法方法在现有的针对 AMR 的 CE 干预措施中的普及表明,在 CE 的采用方面存在跨学科的兴趣。不幸的是,CE 的特异性和背景相关性可能使其难以评估和扩展。尽管如此,我们认为,在综合 CE 的经验教训时,我们可以发展对其在各个背景下解决 AMR 问题的范围的集体理解。