The Antimicrobial Resistance Campaigns Reach and Community Engagement Evidence from Tanzania One Health Initiatives

Objectives: Antimicrobial resistance (AMR) is no longer a future health problem but rather a present public health crisis. For over a decade, national AMR awareness initiatives have been undertaken in Tanzania to implement National Action Plans (NAPs). However, the assessment of whether these initiatives have reached the target population is still limited. This study evaluated physical reach, public perception and community participation in national AMR awareness campaigns in two regions in Tanzania. Methodology: This is a quantitative, community based, cross sectional study in Dar es Salaam and Mwanza regions, Tanzania. The multistage technique was used to sample 2,672 questionnaire respondents. Participant characteristics and perceptions of the campaign were summarised using descriptive statistics. Multivariable logistic and Firth regression were used to establish predictors of high AMR campaign perception and physical campaign reach. Results: Only 81 (3.03%) respondents reported being reached by AMR awareness physical campaigns. Physical reach was strongly linked with high education and skilled occupation. Respondents in Mwanza were less likely to be reached by campaigns compared to Dar es Salaam. Despite limited physical reach, the overall perception of the campaigns was positive. The majority of the respondents agreed on the importance of community involvement (91.6%), AMR education should be brought into schools (98.9%), believed the campaign messages were accurate (79.6%) and would like to get involved with future campaigns (91.4%). Higher odds for favourable perception were found to be independently associated with physical campaign reach (AOR=2.77, 95% CI: 1.40 to 5.49). Conclusions: The Promotion of AMR awareness campaigns in Tanzania seems to be well accepted by the public despite limited reach. Future campaigns need to shift away from one off activities and towards ongoing and inclusive community engagement, leveraging schools, community leaders, community based structures, and systematically tracking reach and behaviours.