Do you take antibiotics only when prescribed by your doctor? A population-based survey in Armenia

WHO and partners posed this question, together with many others related to antimicrobial resistance (AMR), to people in Armenia’s public spaces with the highest foot traffic – such as malls, metro station exits, and entrances to universities and hospitals – in October and November 2022.

The questions were part of the Survey on Knowledge, Attitudes, Behaviour on Antimicrobial Resistance (KAB Survey), a WHO initiative conducted for the first time in the eastern part of the WHO European Region, including the Caucasus and central Asia. The survey took place alongside many other awareness-raising activities in connection with the World Antimicrobial Awareness Week global campaign.

The KAB Survey

The KAB Survey offers comprehensive information on public perception, knowledge and attitudes related to AMR. This will feed into global action towards the elimination of AMR based on identified behavioural patterns and insights. The Survey asked people about:

• their use of antibiotics
• their reasons for taking antibiotics
• their practice of taking prescription-only antibiotics
• the laboratory tests and other investigations they underwent before deciding to take antibiotics
• their knowledge about antibiotics
• their sources of information
• the impact of the COVID-19 pandemic on their use of antibiotics.
• Furthermore, the Survey explored participants’ knowledge and attitude about the use of antibiotics in farm animals, and its effects.

“It was a great opportunity to talk to people and learn about their practices directly from them,” shared Ms Lala Margaryan, one of the interviewers and an expert at the Scientific Center of Drug and Medical Technology Expertise of the Ministry of Health of Armenia. “Many of the people interviewed mentioned that they already learned more about AMR while answering the survey questions, and some also came up with suggestions for questions to be included in the KAB Survey in the future.”

The Survey was conducted by a team from the Scientific Center that received training from WHO/Europe and the WHO Country Office in Armenia in survey protocol and the use of an online platform for conducting interviews.

Survey results to inform future actions

“In Armenia, the Survey echoed the positive results of the awareness-raising activities implemented so far, specifically related to taking antibiotics. It also revealed so many aspects that need further intervention – for example, the One Health approach, which recognizes that human, animal and environmental health are interrelated,” added Dr Lilit Ghazaryan, Deputy Director of the Scientific Center.

The results of the Survey will inform future awareness-raising and behaviour-change interventions in Armenia, which are planned within a new multisectoral strategy for the prevention and control of AMR in 2023–2027. The new strategy will be implemented under the umbrella of the One Health approach. It will go beyond current efforts and place more emphasis on education and the environmental sector to promote human and animal health. 

“Only a multisectoral approach can address AMR, because the health of humans, animals and the environment are closely interrelated,” emphasized Dr Kristina Gyurjyan, AMR Focal Point and Head of the Department of Human Resources Development at the Ministry of Health. “The Ministry of Health attaches great importance to interagency cooperation and protecting the health and well-being of all by enhancing cooperation among doctors, veterinarians, representatives of academia and environmental specialists.”