Journals Information
Universal Journal of Public Health Vol. 13(5), pp. 1121 - 1134
DOI: 10.13189/ujph.2025.130504
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The Antibiotic-Wise Village: A Multisectoral One Health Approach for Local AMR Mitigation
I Wayan Agus Gede Manik Saputra 1,2, Ni Komang Semara Yanti 3,4,*, Ni Made Sri Nopiyani 5, Cokorda Bagus Jaya Lesmana 6, Muhammad Nasrum Massi 7, I Wayan Weta 8, I Wayan Suardana 9, Anak Agung Sagung Sawitri 5, Made Agus Hendrayana 10, I Made Ady Wirawan 3,5, Ni Nyoman Sri Budayanti 10
1 Doctoral Study Program, Faculty of Medicine, Udayana University, Indonesia
2 Bali Mandara General Hospital, Denpasar 80227, Denpasar, Bali, Indonesia
3 Udayana One Health Collaborating Centre, Indonesia
4 Department of Health Information Management, Bali International University, Indonesia
5 Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Indonesia
6 Department of Psychiatry, Faculty of Medicine, Udayana University, Indonesia
7 Department of Microbiology, Faculty of Medicine, University of Hasanuddin, Indonesia
8 Department of Clinical Nutrition, Faculty of Medicine, Udayana University, Indonesia
9 Faculty of Veterinary Medicine, Udayana University, Indonesia
10 Department of Microbiology, Faculty of Medicine, Udayana University, Indonesia
ABSTRACT
Antimicrobial resistance (AMR) is a global public health problem threatening the availability of antimicrobial drugs and endangering the health of humans, animals, and the environment. While current efforts to address AMR focus on hospitals as the downstream consequences of the problem, a more effective strategy would target upstream drivers through a One Health approach and community. Therefore, this study aimed to develop "Antibiotic-Wise Village" or "Desa Bijak Antibiotika" (SAJAKA) model as a tool to address AMR in community settings by promoting judicious antibiotic use across humans, animals, and the environment through active community participation tailored to local issues. The SAJAKA model was developed using a multi-method approach comprising a preliminary study as a baseline assessment to explore AMR issues in the community, a systematic review to assess AMR community-based interventions, and a Delphi study to define the indicators. Training modules were then developed based on these indicators. The model was subsequently validated through implementation in four rural villages in Bali, Indonesia, involving healthcare workers, housewives, schoolchildren, and farmers. These methods ensured alignment with the study's objective and sustained village-level interventions. SAJAKA model is a valuable and adaptable tool for addressing AMR in community settings. The indicators of SAJAKA model covering human, animal, and environmental health, were established through Delphi Study that reached consensus (Median ≥ 4, IQR ≤ 1.25, agreement rate ≥ 80%). Community engagement-related interventions aimed at fighting AMR were favored over simple interventions. Therefore, SAJAKA model scoring system, which was built on a collaborative and consultative framework, was tested to assess classification status in four villages in rural Bali, Indonesia. The SAJAKA model represented a tool that could be used in community settings to foster public awareness about antibiotic use and the risks of AMR. Implementing the One Health approach, combined with efforts to address the challenges posed by AMR in the community, could lead to significant advancements in the prevention of AMR.
KEYWORDS
Antimicrobial-Resistant, Antibiotic-Wise Village, SAJAKA, One Health, Community Engagement
Cite This Paper in IEEE or APA Citation Styles
(a). IEEE Format:
[1] I Wayan Agus Gede Manik Saputra , Ni Komang Semara Yanti , Ni Made Sri Nopiyani , Cokorda Bagus Jaya Lesmana , Muhammad Nasrum Massi , I Wayan Weta , I Wayan Suardana , Anak Agung Sagung Sawitri , Made Agus Hendrayana , I Made Ady Wirawan , Ni Nyoman Sri Budayanti , "The Antibiotic-Wise Village: A Multisectoral One Health Approach for Local AMR Mitigation," Universal Journal of Public Health, Vol. 13, No. 5, pp. 1121 - 1134, 2025. DOI: 10.13189/ujph.2025.130504.
(b). APA Format:
I Wayan Agus Gede Manik Saputra , Ni Komang Semara Yanti , Ni Made Sri Nopiyani , Cokorda Bagus Jaya Lesmana , Muhammad Nasrum Massi , I Wayan Weta , I Wayan Suardana , Anak Agung Sagung Sawitri , Made Agus Hendrayana , I Made Ady Wirawan , Ni Nyoman Sri Budayanti (2025). The Antibiotic-Wise Village: A Multisectoral One Health Approach for Local AMR Mitigation. Universal Journal of Public Health, 13(5), 1121 - 1134. DOI: 10.13189/ujph.2025.130504.