Abstract
Antimicrobial resistance (AMR), which affects humans, animals and the environment, is a global issue, but sub-Saharan Africa (SSA) has the highest burden. This thesis aimed to explore and design interventions combatting AMR focusing on the Nigerian poultry sector, the second largest in SSA. The aims were addressed through five chapters, with a relevant literature review before and a discussion after. Chapter 2, a scoping review of AMR interventions (n=90) in the animal health sector globally, found that only 19% of interventions between 2013 and 2022 took place in low and middle-income countries. Chapter 3, a systematic review, provided an in-depth examination of AMR interventions in the animal health sector in SSA (n=5). The findings indicated that changes in knowledge were the most common outcome of these interventions, and doing the right thing served as a motivator for engagement. However, a lack of finance was identified as a barrier. Chapter 4, a qualitative study using semi-structured interviews (n=22), explored, through thematic analysis, the motivators and barriers to engaging with AMR intervention in the Nigerian poultry sector. This established that the key themes were i) issues of access, ii) lack of knowledge, and iii) taking responsibility. Chapter 5 aimed to co-produce a feasible AMR intervention for the Nigerian poultry sector through interviews (n=22), a survey (n=25), and stakeholder discussions (n=7). An educational intervention focused on AMR, AMU, and biosecurity was deemed the most feasible. Chapter 6 implemented and evaluated the intervention using a before-and-after design with animal health professionals (n=23) and poultry farmers (n=69). There were limited changes to knowledge, attitudes and practices, but the response was positive and highlighted the strength of co-producing interventions. Generally, this thesis indicated that despite barriers, there is an interest in AMR interventions in the Nigerian poultry sector, with learnings for research, policy, and practice.