Education and Intervention Strategies for Tackling Antimicrobial Resistance in Primary Health Care: Evidence from Africa

Abstract

<title>Abstract</title> <bold>BACKGROUND</bold> Antimicrobial resistance (AMR) is an increasing threat to public health systems worldwide, particularly in Africa, where primary health care (PHC) settings often serve as the initial point of interaction for the majority of the population. These settings are especially exposed to AMR due to widespread antimicrobial misuse, insufficient diagnostic tools and resources, lack of knowledge and limited understanding among health care providers and the public. This review aims to synthesize existing evidence on education and intervention strategies aimed at mitigating AMR in PHC systems across African countries. <bold>METHODS</bold> This scoping review followed the framework proposed by Arksey &amp; O’Malley and PRISMA-ScR. A systematic search was conducted across four databases which are PubMed, Google Scholar, SCOPUS, and AJOL for reviewed articles published between January 1, 2015 and April 11, 2025. Studies involving AMR-related educational or interventional strategies involving PHC workers, patients, or communities in Africa were included in this review. This encompassed strategies such as antimicrobial stewardship (AMS) initiatives, diagnostic improvements, and regulatory or policy measures with defined intervention or feedback mechanisms. Data from eligible studies were analyzed and summarized. <bold>RESULT</bold> A total of 20 studies were included. The majority of studies originated from Ghana and South Africa. Most interventions focused on healthcare provider training, public awareness campaigns via social media, and Antimicrobial stewardship (AMS) programs. Key implementers were health workers (35%) and public health authorities (20%). Barriers included restrictive policies, resource constraints, health worker resistance, and poor guideline compliance. Enablers like diagnostics and funding supported implementation. Outcomes showed improved prescribing practices and increased AMR awareness, but sustainability was limited by short-term funding and lack of system-wide integration. <bold>CONCLUSION</bold> This review highlights significant efforts in recent years to address AMR in African PHC systems through education and intervention strategies. However, due to the small scale, short duration, and lack of long-term planning in many interventions there is a need for more robust, scalable, and clear solutions. Effective AMR control requires not only continuous training and public engagement but also strong policy support, adequate resources, and the integration of AMS frameworks customized to PHC settings.