## 4 Discussion  
We were able to assess baseline knowledge of antibiotic use and AMR among health professionals in the study hospital. We were also able to demonstrate the impact of an educational intervention on knowledge and awareness of AMR. The healthcare providers described the training as educative and helpful, and they found it useful in their practice with antibiotics. The training generally increased knowledge about antibiotic use and AMR/AMS, and it led to a better understanding of different aspects of antibiotics use, including the importance of proper patient education. After the training, some self-reported changes in practice in the hospital included a reduction in antibiotic use and empirical prescription, as well as better patient counselling and education on antibiotic use. AMR training and related educational programmes for HCPs have been previously employed in different settings to improve the use of antimicrobials [14, 15]. In addition to improved knowledge and changes in practices, the HCPs confirmed that they felt more confident in contributing to AMR topics during rounds. The GPPS that was conducted made the prescribers more aware of their prescribing with regard to antibiotics. There was reduced empirical and broad-spectrum antibiotic prescribing. Similar findings have been reported in Saudi Arabia, where comprehensive training and education of HCPs enabled them to implement and deliver AMS services more confidently [16]. However, the majority of the HCPs that attended the earlier training vaguely remembered the WHO's classification of antibiotics, and a few were still unsure, indicating that continuous AMR training should be organised. Effective antimicrobial stewardship delivery in hospitals requires a multidisciplinary team effort that includes the medical doctors, who mostly prescribe, pharmacists, nurses, \begin{table}
\begin{tabular}{l c c} \hline \hline \multirow{2}{*}{_Themes_} & _BCW Framework_ & _Sources of Behaviour_ \\ \cline{2-3}  & _Intervention Functions_ & _Policy Category_ & _(COM-B)_ \\ \hline \multicolumn{3}{l}{_Factors contributing to irrational use of antibiotics include_} \\ \hline Lack of continuous AMR training & _Training_ & _Social planning_ & _Psychological capabilities_ \\ \hline Poor AMR knowledge & _Enablement_ & _Psychological capabilities_ \\ \hline Limited diagnostic services & _Service provision_ & _Physical capabilities_ \\ \hline Staff shortages & _Service provision_ & \\ \hline Pressure from patients & _Persuasion/Cocretion_ & _Reflective motivation_ \\ \hline Incentives from pharmaceutical & _Incentvision_ & _Communication/marketing_ \\ \hline \multicolumn{3}{l}{_Recommended strategies to improve antibiotic use_} \\ \hline Education to increase awareness & _Education/Enablement_ & _Automatic motivation_ \\ \hline Checks/audits/monitoring antibiotic use & & _Regulations_ \\ \hline Upgrade laboratory services/purchase & _Environmental restructuring_ & _Physical opportunity_ \\ \hline Policies & _Enablement_ & _Guidelines_ & _Automatic motivation_ \\ \hline Training for prescribers & _Training/Enablement_ & _Automatic motivation_ \\ \hline Employ more staff to build workforce & _Environmental restructuring_ & _Social planning/Service_ _provision_ & _Physical opportunity_ \\ \hline \multicolumn{3}{l}{_Barriers to implementing these AMS intervention_} \\ \hline Lack of funding in healthcare & & _Fiscal measures_ \\ \hline Staff shortages & & \\ \hline Failure to enforce laws & & _Regulation/Legislation_ \\ \hline \hline AMR—Antimicrobial Resistance; _BCW—_Behaviour Change Wheel; COM-B—_Capability, Opportunity and Motivation on Behaviours._ \\ \hline \end{tabular}
\end{table} 
Table 5: Mapping codes and themes to the BCW and COM-B model. microbiology teams and others. Our training included these different groups of HCPs. Pharmacists are the custodians of drugs within the hospital and can ensure safe and effective use of antibiotics by providing information to other HCPs, as well as counselling patients.