# A Multi-sectoral Institutional Action to Boost Integrated Antimicrobial Stewardship to Curtail Antimicrobial Resistance: A World Antimicrobial Resistance Awareness Week (WAAW) Initiative in North India

## TL;DR

A hospital in India launched a week-long program during WAAW 2024 to improve antimicrobial use through training, policy changes, and community outreach.

## Contribution

A scalable institutional model for antimicrobial stewardship combining policy, training, and community engagement was implemented and evaluated.

## Key findings

- Targeted training reached over 300 healthcare workers, with over 1,000 trained in bedside stewardship practices.
- Institution-wide engagement involved over 3,000 participants, including public outreach to 1,500 community members.
- The program identified a high-performing clinical unit and individual stewardship champions across professional categories.

## Abstract

During World Antimicrobial Resistance Awareness Week (WAAW) 2024, All India Institute of Medical Sciences (AIIMS) Rishikesh implemented a structured, multi-sectoral Institutional Action Plan (IAP) to transition from conventional awareness activities to an integrated antimicrobial stewardship approach. The initiative emphasized coordinated institutional action through education, advocacy, and practice-based interventions involving healthcare workers, hospital administration, and the community. The seven-day program included institutional capacity building, assessment and incentivization, and public and community outreach activities. Evaluation was conducted using predefined indicators assessing healthcare worker knowledge enhancement through pre- and post-intervention assessments, compliance with bedside antimicrobial stewardship practices via interactive audits, adoption of standardized prescribing tools, and community outreach through educational roleplays and talks. Targeted training was delivered to over 300 healthcare workers, including focused stewardship training for pharmacists. The program achieved institution-wide engagement involving more than 3,000 participants. Key antimicrobial stewardship policy documents were released during the inauguration, reflecting administrative commitment. Bedside stewardship activities audited and trained over 1,000 healthcare workers across more than 40 clinical areas, leading to the identification of a high-performing clinical unit as the institutional stewardship champion. Core stewardship practices were reinforced through an institutional pledge taken by over 2,000 healthcare workers, and individual stewardship champions were identified across professional categories. Structured workshops strengthened stewardship competencies among selected participants, while public outreach activities reached over 1,500 community members. Media engagement further amplified program visibility and messaging. The IAP implemented during WAAW 2024 demonstrated a feasible, scalable, and integrated institutional model for antimicrobial stewardship. By combining policy reinforcement, structured training, performance recognition, and community engagement, the initiative fostered measurable behavior change across institutional and public domains. This technical framework may be adapted by other tertiary-care institutions to strengthen antimicrobial stewardship implementation and sustain long-term efforts to contain Antimicrobial Resistance (AMR).