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Toolbox

Raise Awareness

The RAISE AWARENESS focus area describes the practical steps to begin or strengthen awareness raising initiatives on antibiotic use and resistance, and provides tools and inspiration for the work.

Why raise awareness?

The goal of raising awareness is to change behaviors and social norms that fuel the problem of antibiotic resistance.

There are behaviors, beliefs and practices that are common to many people which can be very inappropriate when it comes to antibiotic use. There are also many misconceptions about what antibiotic resistance is, how it spreads or what impact it has.

For example, patients may self-medicate and demand antibiotics when they are not needed, and healthcare providers may prescribe or recommend antibiotics unnecessarily. Antibiotics are also used in large amounts for non-medical purposes, such as for routine mass-medication of healthy food animals. In many parts of the world antibiotics are also still used as growth promoters in food-animal production.

There are many reasons for inappropriate behavior, including a lack of understanding of the issue and intensive marketing campaigns that promote antibiotic use.

The importance of effective awareness raising

Below are examples from studies that describe the lack of understanding about antibiotics and resistance. They highlight the need for continuous and effective awareness raising initiatives aimed at changing behaviors.

  • More than 75% of respondents across 12 countries included in the WHO multi-country public awareness survey incorrectly believed that antibiotic resistance occurs when their body becomes resistant to antibiotics, whereas in fact bacteria, not humans, become antibiotic resistant .
  • “Even if participants knew about the possible adverse effects of antibiotics, 57% would recommend antibiotics to their friends and families” (cross-sectional survey in Al-Ahsa community, Saudi Arabia).
  • “87% of the study participants listed viral diseases as an indication for antibiotics” (cross-sectional questionnaire-based survey among Iraqis residing in Amman, Jordan).
  • In the Eurobarometer survey, nearly half of the 26,680 participants across 27 European nations did not know that antibiotics are ineffective against viruses. 41% did not know that they are ineffective against colds and flu.

Approach

Decisions influenced by human behavior are made before prescribing, dispensing, consuming or discarding antibiotics. In order to change deep-rooted behaviors connected to antibiotic use, social and cultural norms related to health and medicine first must be understood.

Effective advocacy and communication, education and training, and empowerment and networking can lead to improved awareness and understanding of antibiotic resistance and can facilitate behavior change.

Antibiotic resistance is a complex phenomenon that has an impact on human health, animal health and the environment. It is thus important to address the problem from a holistic, or One Health perspective.

Who to target?

Efforts can be aimed at the general public, healthcare professionals, educators, industry, food business operators, civil society organizations, policy makers or opinion leaders, to name a few.

1.
European Commission. Special Eurobarometer 407 Antimicrobial resistance 2013 [Internet]. European Commission; 2013 [cited 2016 Feb 16]. Available from: http://ec.europa.eu/health/antimicrobial_resistance/docs/ebs_407_en.pdf
1.
World Health Organization - WHO. Antibiotic resistance: Multi-country public awareness survey [Internet]. Geneva, Switzerland: World Health Organization - WHO; 2015 Nov [cited 2015 Nov 20] p. 51. Available from: http://www.who.int/drugresistance/documents/baselinesurveynov2015/en/
1.
Emeka PM, Al-Omar M, Khan TM. Public attitude and justification to purchase antibiotics in the Eastern region Al Ahsa of Saudi Arabia. Saudi Pharm J [Internet]. 2014 Dec;22(6):550–4. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25561868
1.
Darwish DA, Abdelmalek S, Abu Dayyih W, Hamadi S. Awareness of antibiotic use and antimicrobial resistance in the Iraqi community in Jordan. J Infect Dev Ctries [Internet]. 2014 May;8(5):616–23. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24820466
1.
Stålsby Lundborg C, Tamhankar AJ. Understanding and changing human behaviour--antibiotic mainstreaming as an approach to facilitate modification of provider and consumer behaviour. Ups J Med Sci [Internet]. 2014 May;119(2):125–33. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034549/
1.
Organisation for Economic Co-operation and Development - OECD. Global Antimicrobial Use in the Livestock Sector [Internet]. Organisation for Economic Co-operation and Development - OECD; 2015 Feb. Available from: http://www.oecd.org/officialdocuments/publicdisplaydocumentpdf/?cote=TAD/CA/APM/WP(2014)34/FINAL&docLanguage=En
1.
Okeke IN, Lamikanra A, Edelman R. Socioeconomic and behavioral factors leading to acquired bacterial resistance to antibiotics in developing countries. Emerg Infect Dis [Internet]. 1999 [cited 2014 Oct 5];5(1):18–27. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2627681/