Study 2 - A multi-stakeholder approach to optimise antibiotic use in mixed health system community settings
Study Background:
The research project 'One Health Antibiotic Stewardship in Society' (OASIS) uses a One Health approach to understand antibiotic usage and its drivers in human and animal health and co-design an antibiotic stewardship intervention through multi-stakeholder engagement. The overall vision of this project is to a) generate a holistic understanding of the social, economic, structural and policy related drivers of antibiotic misuse and overuse in community settings, and b) develop an inclusive approach to address the key drivers; this will also include achieving shifts in people's thinking and addressing policy barriers.
The study consortium includes a multidisciplinary research team of five partner organisations in India and the United Kingdom. These include the London School of Hygiene and Tropical Medicine (UK), the Public Health Foundation of India in Gurugram (India), Institute of Development Studies in Brighton (UK), Royal Veterinary College in London (UK) and the West Bengal University of Animal and Fishery Sciences in Kolkata (India).
Funding agencies: Health Systems Research Initiative (HSRI) jointly funded by the Medical Research Council, UK; Economic and Social Research Council, UK; Wellcome Trust and Department for International Development.
Aim :
- To understand antibiotic use and its drivers in human and animal health in India.
Objectives :
- To understand patterns and drivers of antibiotic provision by formal and informal providers. Use a One Health approach to understand antibiotic usage and its drivers in human and animal health and co-design an antibiotic stewardship intervention through multi-stakeholder engagement
- To address outstanding evidence gaps relevant to the development of an IP ABU stewardship intervention, in relation to: (a) ABU in backyard livestock production and its overlaps with human ABU (b) pharmaceutical supply and value chains (c) local AMR prevalence and (d) community awareness and educational platforms
- To assess the positions, vested interests and priorities and levels of influence of stakeholders from the formal health and veterinary sectors, the government health regulatory departments, the pharmaceutical industry and community leaders.
- To co-design, with multiple stakeholders (including government and non-government ones), interventions for AMR for primary care providers, based on principles of antibiotic stewardship, and to assess the feasibility of such an intervention through a small-scale pilot.
- Phase 1(January - April, 2021): Online health provider surveys were administered to primary health care physicians and informal providers. Geographic outreach of the survey included remote rural blocks in the district of South 24 parganas, West Bengal. Provider surveys were analysed using R statistical software.
- Phase 2 (April – October, 2021): The OASIS consortium conducted a series of four consultations with various stakeholders within the health and veterinary systems. These included medical and veterinary practitioners (private and public), government policymakers, pharmaceutical industry leaders, health and regulatory departments, and academics and researchers. Outputs of the stakeholder consultations are being qualitatively analysed using NVivo.