Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study
Abstract Background Antimicrobial resistance (AMR) is the process by which microbes evolve mechanisms to survive the medicines designed to destroy them i.e. antimicrobials (AMs). Despite being a natural process, AMR is being hastened by the abuse of AMs. In context of Nepal, there is limited informa...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-023-10470-2 |
| _version_ | 1797355922128896000 |
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| author | Ayuska Parajuli Lidis Garbovan Basudev Bhattarai Abriti Arjyal Sushil Baral Paul Cooke Sophia Latham Dani J. Barrington Jessica Mitchell Rebecca King |
| author_facet | Ayuska Parajuli Lidis Garbovan Basudev Bhattarai Abriti Arjyal Sushil Baral Paul Cooke Sophia Latham Dani J. Barrington Jessica Mitchell Rebecca King |
| author_sort | Ayuska Parajuli |
| collection | DOAJ |
| description | Abstract Background Antimicrobial resistance (AMR) is the process by which microbes evolve mechanisms to survive the medicines designed to destroy them i.e. antimicrobials (AMs). Despite being a natural process, AMR is being hastened by the abuse of AMs. In context of Nepal, there is limited information on drivers of AMR and barriers in addressing it from a community perspective. This study explores the local language and terminology used around AMs in the community, commonly used AMs and reasons for their usage, how these AMs are sourced, and the perceived barriers to addressing AMR via One Health approach. Methods A phenomenological study design was utilized with applied qualitative research theoretically framed as pragmatism. Twelve in-depth interviews and informal discussions with a One Health focus, were purposively conducted with wide range of stakeholders and community resident of Kapilvastu municipality of Nepal during April 2022. The acquired data was analyzed manually via a thematic framework approach. The study obtained ethical approval from ethical review board of Nepal Health Research Council and University of Leeds. Results Nepali and Awadhi languages does not have specific words for AMs or AMR, which is understandable by the community people. Rather, community use full explanatory sentences. People use AMs but have incomplete knowledge about them and they have their own local words for these medicines. The knowledge and usage of AMs across human and animal health is impacted by socio-structural factors, limited Government regulation, inadequate supply of AMs in local government health facilities and the presence of various unregulated health providers that co-exist within the health system. Novel ideas such as the use of visual and smart technology, for instance mobile phones and social media exposure, can enable access to information about AMs and AMR. Conclusion This study shows that terminology that is understandable by the community referring to AMs and AMR in Nepali and Awadhi languages does not exist, but full explanatory sentences and colloquial names are used. Despite regular utilisation, communities have incomplete knowledge regarding AMs. Since, knowledge alone cannot improve behaviour, behavioural interventions are required to address AMR via community engagement to co-produce their own solutions. Trial registration Not applicable. |
| first_indexed | 2024-03-08T14:18:10Z |
| format | Article |
| id | doaj.art-6b685737021444039e0767bbd0468d76 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-03-08T14:18:10Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-6b685737021444039e0767bbd0468d762024-01-14T12:16:51ZengBMCBMC Health Services Research1472-69632024-01-0124111210.1186/s12913-023-10470-2Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative studyAyuska Parajuli0Lidis Garbovan1Basudev Bhattarai2Abriti Arjyal3Sushil Baral4Paul Cooke5Sophia Latham6Dani J. Barrington7Jessica Mitchell8Rebecca King9HERD InternationalCentre for World Cinema and Digital Cultures, University of LeedsHERD InternationalHERD InternationalHERD InternationalCentre for World Cinema and Digital Cultures, University of LeedsInstitute of Infection, Veterinary and Ecological Sciences, University of LiverpoolSchool of Population and Global Health, University of Western AustraliaNuffield Centre for International Health and Development, University of LeedsNuffield Centre for International Health and Development, University of LeedsAbstract Background Antimicrobial resistance (AMR) is the process by which microbes evolve mechanisms to survive the medicines designed to destroy them i.e. antimicrobials (AMs). Despite being a natural process, AMR is being hastened by the abuse of AMs. In context of Nepal, there is limited information on drivers of AMR and barriers in addressing it from a community perspective. This study explores the local language and terminology used around AMs in the community, commonly used AMs and reasons for their usage, how these AMs are sourced, and the perceived barriers to addressing AMR via One Health approach. Methods A phenomenological study design was utilized with applied qualitative research theoretically framed as pragmatism. Twelve in-depth interviews and informal discussions with a One Health focus, were purposively conducted with wide range of stakeholders and community resident of Kapilvastu municipality of Nepal during April 2022. The acquired data was analyzed manually via a thematic framework approach. The study obtained ethical approval from ethical review board of Nepal Health Research Council and University of Leeds. Results Nepali and Awadhi languages does not have specific words for AMs or AMR, which is understandable by the community people. Rather, community use full explanatory sentences. People use AMs but have incomplete knowledge about them and they have their own local words for these medicines. The knowledge and usage of AMs across human and animal health is impacted by socio-structural factors, limited Government regulation, inadequate supply of AMs in local government health facilities and the presence of various unregulated health providers that co-exist within the health system. Novel ideas such as the use of visual and smart technology, for instance mobile phones and social media exposure, can enable access to information about AMs and AMR. Conclusion This study shows that terminology that is understandable by the community referring to AMs and AMR in Nepali and Awadhi languages does not exist, but full explanatory sentences and colloquial names are used. Despite regular utilisation, communities have incomplete knowledge regarding AMs. Since, knowledge alone cannot improve behaviour, behavioural interventions are required to address AMR via community engagement to co-produce their own solutions. Trial registration Not applicable.https://doi.org/10.1186/s12913-023-10470-2Antimicrobial resistanceCommunityNepalQualitative studyDrivers of antimicrobial resistance |
| spellingShingle | Ayuska Parajuli Lidis Garbovan Basudev Bhattarai Abriti Arjyal Sushil Baral Paul Cooke Sophia Latham Dani J. Barrington Jessica Mitchell Rebecca King Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study BMC Health Services Research Antimicrobial resistance Community Nepal Qualitative study Drivers of antimicrobial resistance |
| title | Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study |
| title_full | Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study |
| title_fullStr | Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study |
| title_full_unstemmed | Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study |
| title_short | Exploring community insights on antimicrobial resistance in Nepal: a formative qualitative study |
| title_sort | exploring community insights on antimicrobial resistance in nepal a formative qualitative study |
| topic | Antimicrobial resistance Community Nepal Qualitative study Drivers of antimicrobial resistance |
| url | https://doi.org/10.1186/s12913-023-10470-2 |
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