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Antibiotics 2018, 7(4), 95; https://doi.org/10.3390/antibiotics7040095

The Consequences of AMR Education and Awareness Raising: Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR

1
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, UK
2
CABDyN Complexity Centre, Saïd Business School, University of Oxford, Park End Street, Oxford OX1 1HP, UK
3
Green Templeton College, 43 Woodstock Road, Oxford OX2 6HG, UK
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Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, 3/F, 60th Anniversary Chalermprakiat Building, 420/6 Rajvithi Road, Bangkok 10400, Thailand
5
Department of Peace and Conflict Studies, University for Peace, P.O. Box 138-6100, San José, Costa Rica
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Department of Political Science, School of Social Science, Ateneo de Manila University, 1108 Metro Manila, Philippines
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Lao Oxford Mahosot Wellcome Trust Research Unit (LOMWRU), Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
*
Author to whom correspondence should be addressed.
Received: 2 September 2018 / Revised: 19 October 2018 / Accepted: 30 October 2018 / Published: 1 November 2018
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Abstract

Education and awareness raising are the primary tools of global health policy to change public behaviour and tackle antimicrobial resistance. Considering the limitations of an awareness agenda, and the lack of social research to inform alternative approaches, our objective was to generate new empirical evidence on the consequences of antibiotic-related awareness raising in a low-income country context. We implemented an educational activity in two Lao villages to share general antibiotic-related messages and also to learn about people’s conceptions and health behaviours. Two rounds of census survey data enabled us to assess the activity’s outputs, its knowledge outcomes, and its immediate behavioural impacts in a difference-in-difference design. Our panel data covered 1130 adults over two rounds, including 58 activity participants and 208 villagers exposed indirectly via conversations in the village. We found that activity-related communication circulated among more privileged groups, which limited its indirect effects. Among participants, the educational activity influenced the awareness and understanding of “drug resistance”, whereas the effects on attitudes were minor. The evidence on the behavioural impacts was sparse and mixed, but the range of possible consequences included a disproportionate uptake of antibiotics from formal healthcare providers. Our study casts doubt on the continued dominance of awareness raising as a behavioural tool to address antibiotic resistance. View Full-Text
Keywords: antimicrobial resistance; antibiotics; health behaviour; health education; survey; development studies; rural; LMICs; Lao PDR antimicrobial resistance; antibiotics; health behaviour; health education; survey; development studies; rural; LMICs; Lao PDR
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Haenssgen, M.J.; Xayavong, T.; Charoenboon, N.; Warapikuptanun, P.; Khine Zaw, Y. The Consequences of AMR Education and Awareness Raising: Outputs, Outcomes, and Behavioural Impacts of an Antibiotic-Related Educational Activity in Lao PDR. Antibiotics 2018, 7, 95.

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