Engaging communities in addressing antimicrobial resistance: Co-producing locally relevant public health messages.

Antimicrobial resistance (AMR) is a critical global health challenge that weakens the effective treatment of common infections and threatens health system functioning, particularly in settings where access to affordable healthcare and regulated medicines is limited. This study explores whether grassroots, community-driven approaches can improve the reception of AMR communication materials. Using Arts-Based Participatory Action research methods, 30 community members in Enugu, Nigeria collaborated in creative workshops to co-produce locally relevant AMR messages through posters, jingles, and a short film, delivering messages that promote responsible antibiotic use. These materials were subsequently evaluated through a wider public engagement and exhibition event involving 66 community members, where pre- and post- event surveys assessed community members' perceptions of the acceptability, cultural appropriateness, and their likely effectiveness in influencing public perception and behaviour. This exploratory study finds that co-produced materials were well received, with participants describing them as culturally embedded, socially acceptable, and potentially effective in raising awareness about antimicrobial resistance. The findings reveal that participatory design of public health communication can enhance message relevance, improve public engagement, and foster community ownership in AMR awareness efforts. However, challenges such as resource constraints, and scalability limitations highlight the complexities of community-driven public health interventions. By employing both qualitative and quantitative methods, the study calls for a shift from conventional expert-led campaigns to inclusive, community-driven strategies in tackling AMR. Curtailing AMR demands public health interventions that are engaging and responsive to the specific social and structural contexts in which antibiotic use occurs.