Human Centered Design

In this blog post, Michael Gaitho, a Gender Expert from LVCT Health with a deep passion for global health and sustainable development, shares his insights into Antimicrobial Resistance (AMR). He reflects on his recent time spent in Uganda, collaborating with colleagues to refine strategies that ensure effective interventions in AMR programming.

AMR is one of the most pressing global health threats, affecting both human and animal health. This multifaceted challenge needs innovative and urgent solutions, yet discussions often remain confined to the realms of pathogens and treatment efficacy.

As always, let’s start with the basics: What is AMR?

AMR occurs when bacteria and other microorganisms develop resistance to antimicrobial drugs, such as antibiotics, rendering these treatments less effective against infections.

All too often, the critical socio-behavioral aspects of antimicrobial consumption (AMC) and antimicrobial use (AMU) are overlooked. This is where the Human-Centered Design approach comes into play, prioritising a deeper understanding of the people behind the data. By exploring disparities based on age, sex, and various social determinants, we can cultivate a more equitable and effective response to AMR.

Getting It Right: Stakeholders Workshop in Uganda

In March 2025, a workshop was held in Uganda, bringing together key stakeholders to review essential AMR documents. The focus was on integrating gender and equity into strategies and refining approaches to ensure effective interventions.

Throughout the week-long event, participants discussed how to incorporate Human-Centered Design principles into AMR programming. The goal was to ensure that interventions address existing inequalities and are tailored to meet the diverse needs of various populations.

Why does a Human-Centered Design approach matter?

Traditional strategies to address AMR have often remained entrenched in the biomedical realm, focusing solely on pathogen surveillance and antibiotic efficacy. Unfortunately, this narrow lens overlooks critical social, economic, and gender-related factors influencing AMU, AMC, and ultimately, AMR outcomes.

The Human-Centered Design approach pivots this paradigm. Focusing in on individual behaviors, needs, and vulnerabilities, creates a richer understanding of how AMR manifests across different groups. This understanding enables better interventions that target inequities.

The approach extends beyond data collection; it’s a call to action. Disaggregating data by age, sex, and other social variables, ensures that no one is left behind in the crucial fight against AMR.

Key elements of Human-Centred Design in AMR programming

A human-centered approach takes into account the lived experiences and constraints of people within their communities, highlighting three key elements:

1. Gender sensitivity: Addressing gender disparities in access to antibiotics and healthcare is crucial. Research indicates that women often face significant barriers to appropriate AMU, influenced by societal norms and healthcare-seeking behaviors.
2. Age considerations: Different age groups, particularly children and the elderly, exhibit unique vulnerabilities to AMR. Understanding these differences is vital as physiological factors and access to healthcare can significantly influence outcomes.
3. Socioeconomic influences: Poverty and limited education exacerbate the misuse of antibiotics, fueling resistance. By understanding the interplay between these factors, we can design interventions that are more effective and sustainable.

By weaving these considerations into the fabric of AMR programming, we take steps toward creating interventions that are not only effective but just and sustainable in Uganda.

One Health and Human-Centered Design: A converging framework

The Human-Centered Design approach aligns seamlessly with the One Health framework, which emphasises the interconnectedness of human, animal, and environmental health.

Discussions led to revisions in animal health surveillance tools to include gender-sensitive and socioeconomic variables. Proposed changes to AMR reporting for cattle, for instance, aim to assess differential antibiotic access between smallholder farmers and commercial producers, an essential step given the significant role of livestock farming in AMR proliferation.

Human health and AMR surveillance

The recent meeting prioritised revising national microbiology data collection tools to incorporate gender and equity considerations. Dr Susan Nabadda Ndidde, Commissioner of Public Health Laboratories, highlighted the necessity of expanding AMR surveillance in private healthcare facilities.

Environmental Considerations in AMR Programming

While the discussions were primarily centered on human and animal health, the impact of environmental factors cannot be overlooked. Contamination through wastewater, agricultural runoff and improper disposal of antibiotics contributes to AMR. The meeting called for localised interventions that address specific community environmental risks.

Stakeholder meeting at Public Health Laboratories

Key outcomes from the stakeholder engagement meeting 

Introduction of the BALANCE Study Protocol 

A major highlight was the introduction of the BALANCE study, a prospective research initiative comparing the health and economic burden of AMR in low- and middle-income countries versus high-income countries. By generating robust demographic, socioeconomic and clinical data, this study will inform targeted antibiotic stewardship programmes. 

Capacity building on gender and equity in AMR 

LVCT Health led an interactive session on integrating gender and equity considerations into AMR programming. Participants were equipped with tools to assess gender disparities in AMU, reinforcing the importance of data disaggregation to enhance intervention effectiveness. 

Revision of data collection tools 

The revision of national microbiology and animal health data collection instruments to include gender and socioeconomic indicators was a significant achievement. This ensures that AMR surveillance aligns with equity-focused global health agendas. 

Community engagement strategies 

The Animal Health Unit emphasized a shift from policy and technical discussions to community awareness initiatives on AMR. This community-centered approach aligns with evidence from previous One Health studies, which highlight the importance of participatory engagement in AMR mitigation.

Next steps

The meeting concluded with actionable commitments: 

• Finalisation and Validation of the AMR report: The AMR/C/U draft report will be reviewed by the National Technical Working Committee (TWC) and is set to be published this year.
• Completion of the AMR Monitoring & Evaluation Plan:  This plan will be aligned with Uganda’s national and international AMR goals to ensure effective tracking of progress.
• Continued stakeholder collaboration: Ongoing engagement with policymakers, practitioners, and researchers will ensure that gender and equity considerations remain central to AMR interventions. 

Conclusion 

Adopting a Human-Centered Design approach in AMR programming reflects a critical shift from pathogen-centric strategies and towards interventions that put people and communities first.  The Uganda stakeholder engagement meeting emphasised the necessity of integrating gender, age and socioeconomic factors into AMR surveillance and mitigation strategies.  Moving forward, incorporating Human-Centered Design principles in AMR research and policy implementation will be essential for achieving equitable and sustainable health outcomes. 

As we address the AMR crisis, we must remember that every case of antimicrobial resistance involves a person; a patient, a farmer, or a child whose life is impacted.  By designing AMR interventions that prioritise people, we can establish a more resilient and health-secure future. 

The meeting was hosted by the Baylor College of Medicine Children’s Foundation Uganda, in collaboration with LVCT Health, the Liverpool School of Tropical Medicine, and the University of St. Andrews, this historic stakeholder engagement meeting took place at the Center of Excellence in Mulago, Kampala.