Beat Bad Microbes: Raising public awareness of antibiotic resistance in Rwanda

Antimicrobial resistance (AMR) in Rwanda

Bear Bad Microbes (BBM) continues from an initial pilot phase and delivers truly iterative and co-designed communications to help community pharmacists in Rwanda engage with their customers and raise awareness of AMR. Pharmacists taking part in the pilot phase were asked for their feedback (qualitative and quantitative) and identified practical and logistical issues with the proto-types. Further design developments working with the wider team resulted in a set of digital materials which were accessible online.

Rwanda Community Pharmacy Union (RCPU) Conference and World Pharmacy Day 2019

On completion of the pilot phase, the study was presented at the RCPU conference and World Pharmacy Day in September 2019. Engagement with the wider pharmacy and healthcare community leaders built stronger relationships and a renewed enthusiasm to develop the programme further and wider to include healthcare centres among the rural communities.

Publication

The project and process in Rwanda is published and available here: Beat Bad Microbes : Raising public awareness of antibiotic resistance in Rwanda

Final thoughts

Remote working across borders to co-design and collaborate on this project set a framework for managing communications well before Covid-19 emerged as a global pandemic.

Rwanda tackles antimicrobial resistance through a pharmacy led campaign

Antimicrobial resistance (AMR) in Rwanda

AMR is a growing global issue and internationally much AMR research and innovative work goes on. Following the success of the Innovative pharmacy solution to antimicrobial resistance in the UK by the Information Design and Architecture combating drug resistant infection (IDAPPS) project at University of Reading, there was an opportunity to explore how this approach could be taken to an international community.

A collaboration between the University of Reading, the University of Rwanda, the Rwanda Community Pharmacists Union (RCPU), the Commonwealth Pharmacists Association (CPA), Design Science and Isomeric was formed to explore how a design led approach to develop a campaign would change behaviours and attitudes towards AMR in Rwanda.

Pharmacy and health care access in Rwanda

Several workshops in Kigali Rwanda were held to better understand how just over 800 registered pharmacists serve a population of approximately 12.5million and dispense AMR advice. The broader insights of how doctors and community health workers support the community was imperative to ensure any campaign woudl bridge the gap and provide continuity of health care. The project team included designers, behavioural change consultants and pharmacists.

Workshops in Rwanda

The workshops were designed to engage with pharmacist, pharmacy users and other stakeholders. New models that fuelled creativity were introduced at the workshops led by designers and pharmacists. The co-design workshops were practical and interactive and the team came away with many ideas to progress within the context and constraints that were discussed.

Pilot study and pharmacist training

Initial pharmacy materials and a training plan were implemented, during this first phase, across several pharmacies reaching different populations.

Training pharmacists on the campaign materials

The next phase…

Following the success of the pilot phase the project team are developing the materials for a bigger launch reaching a wider population. Analysis of pilot data, other research in Rwanda and a final workshop in the UK has led to more collaborations and new ideas.

Collaborations

Working with organisations in different contexts and environments has led to many successful projects and partnerships.


The Commonwealth Pharmacists Association (CPA) aims to advance health for the public benefit by developing the knowledge and skills of the pharmacy profession and creating opportunities for education, training and mentorship. By supporting quality improvement projects, including health promotion, the CPA are a voice of advocacy and representation that aim to advance the health of the people of the Commonwealth.


The Mucopolysaccharide Society (MPS) provides support across the UK to families affected by rare, life-limiting genetic conditions. These genetic conditions cause a range of complex difficulties and we provide vital support to the whole family for as long as they need it.


Rare Disease Research Partners (RDRP) support research and access to treatment for people living with rare conditions. RDRP provide clinical trial support services, deliver managed access programmes, curate evidence to understand the benefits of treatments, conduct research, develop medical communications, and offer expert advice in all aspects of rare diseases


Caroline Teng is an experienced designer working with research-based healthcare communication consultants. Caroline received the Chancellor’s Award in 2017 at University of Reading where she graduated with First Class honours in Graphic Communication.

Caroline also has a BA (hons) in English Literature with Distinction from the University of Toronto and was awarded the Ruth J. Norton book prize in 2015. Caroline has international experience working for freelance clients based in Toronto, Singapore, Hong Kong, New York and London with work ranging from food businesses to academic medical papers. Further work can be viewed here InstagramDribble, or Behance.


The Rwanda Community Pharmacists Union (RCPU) is the National body representing Community pharmacists and pharmacy technicians, founded in 2016. Through their District organisations and individual members, they represent over 260 pharmacists and pharmacy technicians.

RCPU is a non-governmental organisation that has been in official relations with the Rwanda National Pharmacy Council since 2016. Through their partnerships and extensive National pharmacy and pharmaceutical network, they support the development of the pharmacy profession, through practice and emerging scientific innovations, in order to meet the national’s health care needs and expectations.


Professor Sue Walker is the Director of Collections and Archives and teaches undergraduate and postgraduate students in design practice and lecture on the theory and history of typography and graphic communication in the Department of Typography & Graphic Communication.

Professor Walker is the Director of the AHRC-funded Design Star Doctoral Training Centre, based at Reading, working with colleagues at Brighton, Goldsmiths, Loughborough and the Open University.


Professor Egide Kayitare is the Head of Department of Pharmacy of the University of Rwanda, Member of bureau of Rwanda Pharmacy Council and Member of Rwanda National Ethic Committee.


Dune Technical Healthcare Consulting optimises healthcare by navigating healthcare systems with a deep understanding of the relationships between the system and healthcare professionals, medical evidence, technology and guidelines and the pharmaceutical industry.


Quality Improvement Clinic (QIC) is a healthcare consultancy company whose values are reflected in its vision:

Better Me, Better Service, Better Care™.

QIC works with organisations, teams and individuals to improve the services they provide and the care they give to their patients.


Design Science create design solutions that bring knowledge to life through design in science, healthcare and education. Their outcomes are aimed at improving understanding and awareness by both lay audiences and subject specialists.


Innovative pharmacy solution to antimicrobial resistance

Antimicrobial resistance (AMR)

The overuse and misuse of antibiotics has led to a growing number of antibiotic resistant bacteria in humans.  Antibiotics are life saving medicines and changing attitudes and behaviours in AMR is fundamental in preserving the value they bring to our lives. The pharmacy environment provides an excellent opportunity to improve the knowledge and understanding of antimicrobial resistance.

Changing attitudes and behaviour in AMR

The Arts and Humanities Research Council (AHRC) funded Information Design and Architecture combating drug resistant infection (IDAPPS). IDDAPS is an inter-disciplinary project bringing together academics and practitioners in graphic and information design, architecture, ergonomics and human factors and pharmacy to consider how to ‘improve the knowledge and understanding of antimicrobial resistance’.

Designing persuasive pharmacy space

Design Science and partners developed the winning Beat Bad Bugs (BBB) campaign for IDAPPS. The BBB team are life-size characters each offering a perspective on antibiotic usage. This innovative approach also included various materials to support the pharmacy team at Day Lewis Reading branch.

The approach has been developed and tailored for pharmacies in other countries.

TaP-MS: Treatment Priorities and Expectations of people with Multiple Sclerosis

Multiple sclerosis (MS) is a chronic disease attacking the central nervous system (brain and spinal cord) affecting over 2.3million people worldwide, it is 2-3 times more common in women than in men, and people are usually diagnosed between 20 and 50 years of age. Presently, there is no cure for MS, however disease modifying treatments (DMTs) effectively delay disability for people living with MS.

There is extensive information about how people with MS interact with their neurologists and the MS symptoms that they find most distressing. Fatigue is a widespread concern for patients, the significance of which is not always fully understood by those providing medical care and or social support. There is also evidence that the use of medicines may be delayed or impaired because of fears about factors such as drug side effects and or a lack of belief in their benefits.

Why do treatment priorities of peple with MS matter?

There is evidence that the use of medicines may be delayed or impaired because of fears about factors such as drug side effects and or a lack of belief in their benefits. Patients both prioritise and expect treatments that support them in becoming more independent. therfore it is crucial to communicate MS therapeutic advances with patients and instil trust in bio-pharmaceutical innovation, regardless of cultural disparities in attitudes to healthcare. Not much is known about how best such problems can be addressed and the priorities that people with MS have for future treatment improvements.

How was the TaP-MS research conducted?

The aims of he research where to to explore MS patient understandings, beliefs and preferences, to address the gap in present knowledge on expectations and priorities for people with MS and to improve care standards and health outcomes for people with MS globally.

Methodology overview

What did this research achieve?

The main recomenations of the research where

  • Understanding concerns about treatment trade-off and how these interplay with individual disease-specific, as well as contextual factors
  • Removing barriers to disease comprehension becasue patient perceptions and priorities around the disease and treatment may not accurately be reflected in communications using concepts such as brain health
  • Look for a holistic approach when supporting people with MS by providing psychological support

The full report is available to download

iSAID: Sources of Additional Information in Diabetes

Information about diabetes is readily available including online, in print, through healthcare professionals and the wider family and friends circle. Yet despite there being more medicines and information than ever before about managing diabetes, the number of people worldwide with type 2 diabetes in 2017 was nearly 425 million with an increase estimated to around 629 million by 2045 (International Diabetes Federation Diabetes Atlas 8th edition 2017).

Managing diabetes is complex and involves many healthcare professionals and with rapidly growing technology to monitor and manage diabetes, adherence in type 2 diabetes is poor with approximately 7 out of 10 people behaving non-adherently.  

Why do sources of additional information matter?

Increasing adherence to medicine is more than just giving people information. Although providing the right information at the right time is important, who shares that information and how it’s shared are factors that impact and influence people about how they feel about their medicines and their condition.

How was the iSAID research conducted?

The research was focused on gathering insights through via focus group discussions, interviews and social media listening. Using behavioural science and established adherence models and frameworks the data was thematically analysed.

What did this research achieve?

The insights gathered were very interesting and informed how a larger programme was developed. Read the report for key findings.