Title: Sourcing Community Solutions to Antibiotic Resistance in Nepal
Funder: Arts and Humanities Research Council

Abstract: This project will develop, pilot test and evaluate a high-quality intervention aimed at preventing and controlling antibiotic resistance in Nepal. Community-led solutions to the growing problem of antibiotic resistance will be promoted through a participatory digital film-making intervention that will lead to a health-education campaign within communities, and to an advocacy campaign targeting policy makers. This will directly support the delivery of the UN's Sustainable Development Goals, in particular SDG 3: 'ensuring healthy lives and promoting well-being for all at all ages'. In Nepal, antibiotic-treatable infections are a significant public health burden. A recent review of studies examining antibiotic resistance to common bacterial diseases in Nepal indicates that antibiotic resistance is a growing threat to public health (Basnyat 2015: 6-10). Indeed globally, as the World Health Organisation warns, "without urgent action we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill" (WHO 2016). Although the development of new medicines is critical, without behaviour change antibiotic resistance will continue to be a major threat to population health. Our project seeks rigorously to evaluate the potential of participatory arts interventions in supporting such behaviour change. The project has three phases. Phase One will focus on the development of methodologies of co-production and participatory film-making, a health-education campaign, and an advocacy campaign. Phase Two will focus on pilot-testing the participatory film-making, health-education campaign and advocacy campaign in one urban and one rural setting, and on evaluating the approach for reach, implementation fidelity, and acceptability to a variety of stakeholders. Phase Three will focus on refining the approach prior to scale-up, evaluation of outcomes and impact. Our specific intervention consists of four stages: 1) The co-production of short comics (drawing on the 'grass-roots comics for development' methodology) which identify critical barriers to preventing and controlling antibiotic resistance at the individual, household and community levels, and which develop community-led solutions to overcoming those barriers. 2) The development of these comics into documentary films that can be utilised both as health-education tools, which are appropriately tailored for the locality, and as advocacy tools, which are aimed at policy makers at the district and national levels; 3) The utilisation of the documentary films in a health-education campaign within localities; 4) The delivery of an advocacy campaign at the district and national levels. Working at the intersection of humanities, social sciences and public health, and bringing together the expertise of The Centre for World Cinemas and Digital Cultures (Paul Cooke, PI), the Nuffield Centre for International Health and Development (James Newell and Rebecca King, Co-Is) and HERD International (Sushil Baral, Sudeepa Khanal, Co-Is), and working in collaboration with the Ministry of Health and Population in Nepal, this partnership will pilot an innovative approach to dealing with a significant public-health issue. Drawing on participatory-arts methodologies of co-production with community stakeholders, we aim to explore the powerful socio-cultural, political and economic issues at play in the misuse of antibiotics and support the development of community-led solutions to this issue, thus helping to increase the effectiveness of, and adding significant value to, government-led campaigns. The project will, moreover, help build capacity for the use of participatory arts as a tool for public-health campaigning, synergising the expertise of the project team to produce an outcome that none of the partners could achieve on their own.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: INFECTION