Effectiveness of a Structured Educational Training Program on Antimicrobial Resistance Among Community Health Workers in India

Globally, antimicrobial resistance (AMR) is escalating due to the frequent and inappropriate consumption of antibiotics. In India, Accredited Social Health Activists (ASHAs) play a vital role in community healthcare and have the potential to promote antimicrobial stewardship practices in their local communities effectively. This study aimed to evaluate the impact of structured training program for ASHAs' on AMR and antibiotic use and its integration into community-level health promotion. A pre-post educational intervention study was conducted among 103 ASHAs from selected Primary Health Centres (PHCs). A three-day structured training was conducted, and pre- and post-training KAP were assessed using a validated questionnaire. Training impact was evaluated through observation checklists, supervisor feedback, and community surveys. Quantitative Data were analyzed using SPSS. 25, and qualitative data were thematically analyzed. Statistically significant improvements were observed across all KAP domains. Misconceptions, such as using antibiotics for viral infections, declined (from 67.9% to 14.6%; p = 0.002), while confidence in providing AMR-related guidance increased to 61.1% (p < 0.001). Practice scores improved significantly (p < 0.001), with post-training responses changing towards “always” and “sometimes.” Spearman’s correlation indicated a positive association between post-training knowledge and both attitude (ρ = 0.14, p = 0.001) and practice (ρ = 0.221, p < 0.001). Community feedback showed high engagement and understanding, with 92% willing to follow ASHAs' advice. Observational data confirmed strong adherence to training content. The training improved ASHAs' skills to promote AMR awareness and rational antibiotic usage, highlighting their importance in community-level antimicrobial stewardship.