## 3 Results
### AMR Practice
#### 3.5.1 Phase 2: Interviews with Healthcare Providers in the HTH Participant Characteristics  
For the second phase, we interviewed a total of 18 participants, which included four medical doctors, five pharmacists, four nurses, two midwives and three biomedical scientists. Among the participants were 10 males and eight females, with ages ranging from 27 to 56 years. Knowledge/Awareness of Antimicrobial Resistance Post-Training  
The majority of the interviewed participants confirmed that the training on AMR/AMS was very helpful and increased their understanding of AMR. This, in turn, led to changes in their practice, such as reduced empirical prescription of antibiotics and more detailed counselling for patients on antibiotic use. Healthcare Providers' Roles  
The healthcare providers across different specialties explained that they felt more confident carrying out AMS roles after the training. The nurses were competent in antibiotic drug administration and acted as patient advocates to question the antibiotics being prescribed. The pharmacists were also competent in delivering AMS roles and providing information on medications for the rational prescription of antibiotics. Both nurses and \begin{table}
\begin{tabular}{c c c c c c c c} \hline \hline  & & & & & & & & \\ \cline{3-8}
**Sr No** & **Indicator** & \multicolumn{3}{c}{**Strongly**} & \multicolumn{3}{c}{**Agree**} & **Not Sure** & **Disagree** & **Strongly** \\ \hline \multirow{2}{*}{1} & Antibiotic resistance occurs when your body becomes resistant to antibiotics, and they no longer work as well & Before & 42 & 20 & 4 & 12 & 18 \\  & & After & 45 & 10 & 3 & 23 & 20 \\ \hline \multirow{2}{*}{2} & Antibiotic resistance is an issue in other countries, but not here & Before & 0 & 2 & 6 & 24 & 68 \\  & & After & 2 & 2 & 0 & 17 & 78 \\ \hline \multirow{2}{*}{3} & Antibiotic resistance is an issue that could affect me or my family & Before & 76 & 24 & 0 & 0 & 0 \\  & & After & 85 & 15 & 0 & 0 & 0 \\ \hline \multirow{2}{*}{4} & Antibiotic resistance is only a problem for people who take antibiotics & Before & 4 & 12 & 8 & 28 & 48 \\  & regularly & After & 5 & 5 & 0 & 30 & 60 \\ \hline \multirow{2}{*}{5} & Antibiotic-resistant infections could make medical procedures such as surgery, organ transplants and cancer treatment much more dangerous & Before & 58 & 30 & 6 & 2 & 4 \\  & & After & 88 & 10 & 0 & 0 & 2 \\ \hline \multirow{2}{*}{6} & Bacteria that are resistant to antibiotics can be spread from person to person & Before & 30 & 34 & 4 & 12 & 16 \\  & & After & 54 & 32 & 2 & 7 & 5 \\ \hline \multirow{2}{*}{7} & Many infections are becoming increasingly resistant to treatment by antibiotics & Before & 54 & 42 & 2 & 2 & 0 \\  & & After & 68 & 27 & 2 & 2 & 0 \\ \hline \multirow{2}{*}{8} & If bacteria are resistant to antibiotics, it can be very difficult or impossible to treat the infections they cause & Before & 72 & 24 & 0 & 4 & 0 \\  & & After & 73 & 24 & 0 & 2 & 0 \\ \hline \multirow{2}{*}{9} & Inappropriate use of antibiotics can lead to antibiotic resistance & Before & 72 & 26 & 0 & 0 & 2 \\  & & After & 90 & 7 & 0 & 0 & 2 \\ \hline \multirow{2}{*}{10} & Inappropriate use of antibiotics can lead to increased adverse effects and & Before & 56 & 32 & 6 & 4 & 2 \\  & additional burden & After & 76 & 22 & 0 & 2 & 0 \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Awareness of health professionals of AMR. pharmacists could support antibiotic prescription decisions, especially when they involve junior doctors. Current Situation with Antibiotic Use in Ghana  
The interviewed participants reported general overuse of antibiotics in Ghana with highly empirical and broad-spectrum prescribing. Factors that contribute to this observed practice with antibiotics include a lack of continuous training for prescribers and other healthcare providers (HCPs), poor compliance with guidelines, limited diagnostic services, staff shortages, pressure from patients and the influence of drug companies.