The World Health Organization’s AMR Secretariat organized a consultation meeting on behavior change in antimicrobial resistance, on 6-7 June 2018 in Geneva. Dr. Philip Mathew, ReAct Asia Pacific , represented the network at the meeting. The meeting discussed various aspects of behavior change communication, along with models for intervention from various regions. The rationale behind AWaRe (Access, Watch and Reserve) classification of antibiotics, AMR Global Framework for Development & Stewardship and WHO’s Competency Framework for Healthcare workers, were also discussed at the meeting.
There were extensive discussions based on the experiences from various socio-cultural contexts:
- The WHO’s Regional Office for Europe presented their work on the pioneering initiative titled Tailoring Antimicrobial Resistance Programmes (TAP), which is a step-by-step guide to identify challenges and adapt interventions based on it.
- Peter Yeboah, Executive Director of Christian Health Association of Ghana, elaborated the interventions that they have adopted in their hospitals and healthcare centres, to influence behavior change among the various categories of health workers.
- Dan Metcalfe of the Wellcome Trust gave an outline of the literature review commissioned by them, which looked at all the interventions to reduce the prescribing and sale of antibiotics. He also gave an overview of the ‘Human Centered Design’ process, which is being used to design practical interventions in a time-bound manner.
The meeting also discussed the development of the Global Survey tool, which will eventually be used to quantify antimicrobial resistance awareness among health workers.
Sharing experiences on stakeholder engagement
Philip Mathew presented on the topic ‘Activating in-country networks and relevant stakeholders for action’, in which he explained the approach taken by ReAct group towards achieving behavior change. He outlined the stakeholder engagement in various ReAct nodes, and how it has created momentum in the regional contexts. Philip also described the importance of capitalizing on the existing networks, and gave examples of how ReAct Asia Pacific used the network approach to leverage behavior change in larger groups. He also presented a conceptual framework on network engagement, which can be used for building a coalition in various countries. Philip Mathew says:
“It will be quite naïve to assume that increase in awareness will spur change in behavior. We also need to focus on building an enabling social environment, a robust regulatory framework and also design incentives for behavior change.”
Next consultation by end 2018
The group discussions over the two day meeting focused on making recommendations on approaches to behaviour change, among various categories of healthcare workers from prescribers to public health managers. Since there is a need to further refine the approaches and reach a consensus on conceptualizing messaging for behavior change in AMR, it was decided to have another consultation meeting towards the end of the year. The group agreed that it is important to identify the most important stakeholders and to create a framework of targeting them on a sustained basis. For this, we need to develop a platform to share the experiences regarding such interventions in different contexts.
ReAct was also invited to attend a meeting hosted by WHO on “Antibiotic Stewardship Program in hospitals in LMICs” on 18-19 June. Dr. Mirfin Mpundu, Head of ReAct Africa and Prof. Sujith Chandy, Head of ReAct Asia Pacific participated in this meeting. The main themes for the meeting were: education and training, structures, human resource and interventions for stewardship. Around 30 experts which included members from WHO, Regional WHO offices, academic institutions, and governments (all of whom have been working on antibiotic stewardship) attended the event.