Antimicrobial resistance (AMR) is a critical global health issue, especially in low-resource settings. A One Health-based community engagement approach, such as the Antibiotic-Wise Village (SAJAKA) model, offers a potential solution. This study assessed SAJAKA's implementation in four Bali villages, evaluating its impact on knowledge and antibiotic use behavior. The intervention included workshops, school programs, poultry feed/water analysis, and medical audits. Using a pre-test/post-test design, 769 participants including household mothers, schoolchildren, farmers, healthcare workers were surveyed. Results showed significant knowledge improvements, particularly among farmers (30.69%) and household mothers (26.65%). Behaviorally, household antibiotic storage declined (3.39%), and addition antibiotics in poultry feed were eliminated. However, irrational prescribing by healthcare workers persisted. Water tests revealed faecal contamination but no resistant E. coli to third-generation cephalosporins was detected. Of the four villages, Buwit achieved 'Antibiotic-Wise Village' status (score = 7). The SAJAKA model successfully boosted AMR awareness and promoted responsible antibiotic use. To expand impact, healthcare workers engagement and sustained community efforts are crucial for AMR containment.
Saputra et al. (2026) studied this question.