What is it about?

To understand the role of education and awareness campaigns to fight drug resistance, we carried out educational workshops in three northern Thai villages. We translated concepts of drug resistance and antibiotics into the local language and the local conceptions around illness and medicine. Extensive survey work, interviews, and workshop observations enabled us to make a comprehensive assessment of the educational outcomes. On the face of it, the educational activity appeared successful, for example, increasing the awareness of the words “drug resistance” from 56% to 86% (+30%) among all participants, compared to an improvement from 46% to 63% (+17%) in the villages more generally. However, our study design also enabled us to documents outcomes that are often overlooked. In one village, rumours arose that we were going to deprive people of their medicine; in another village, one workshop participant felt so confident about the newly acquired information that she started selling antibiotics. However, perhaps even more important was the observation that people whose family members helped them through an illness were more likely to behave in the way that global policy documents recommend - going to a registered doctor and taking antibiotics under professional supervision. Our study therefore suggests that mass education campaigns can easily backfire (though we may not see these effects under the seeming success of increased awareness) and that contextual change like stronger village social networks may be similarly if not more effective in fighting drug resistance.

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Why is it important?

Antimicrobial resistant superbugs are a global health crisis arising from widespread use of antibiotics and other antimicrobials in medicine, agriculture, and their leakage into the environment. Tolerance built up by this exposure is making it increasingly difficult to treat common infectious diseases and has been described as potentially “the end of modern medicine as we know it” (Professor Dame Sally Davis)

Perspectives

Ern Nutcha Charoenboon (lead author): “We all have heard about being ‘lost in translation’, but it is something easily forgotten in educational programmes or awareness-raising campaigns. Our project enabled us to observe the process and the outcomes of lay people translating AMR knowledge into their own concepts and practices. It turns out that we might have to redefine and approach public problems differently because mass education campaigns could create more harm than good.” Marco J Haenssgen (project leader): “As the field of global health is gradually developing into ‘planetary health,’ we will depend increasingly on transdisciplinary research, comprehensive evaluation methods, and the voices of local populations. Projects like ours enable us to challenge established wisdom in health policy, understand social and contextual aspects of health behaviour, and to find innovative solutions for global challenges.”

Dr Marco J Haenssgen
University of Warwick

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This page is a summary of: Translating antimicrobial resistance: a case study of context and consequences of antibiotic-related communication in three northern Thai villages, Palgrave Communications, February 2019, Springer Science + Business Media, DOI: 10.1057/s41599-019-0226-9.
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