Antimicrobial stewardship in animal health: Experience-based co-design framework to capture progress and accelerate improvement

Abstract Antimicrobial stewardship (AMS) is essential for mitigating antimicrobial resistance (AMR) in animal health, but implementing national initiatives is challenging due to diverse influencing factors and the need for context-specific approaches. An Animal AMS Practice Group, comprising individuals with lived experience overseeing AMS in various animal health contexts, was engaged and through an experience-based co-design approach created a comprehensive AMS Framework that captures progress and supports tangible improvements in AMS practices in each context. The Framework supported a cross-sectoral pilot assessment that helped users identify progress, areas for improvement and contextualise antimicrobial usage and AMR data, while also motivating further AMS efforts. Despite common barriers to the sharing of sensitive data, participants willingly shared AMS results for comparison and publication. The process demonstrated that co-design coupled with peer learning and expert support is essential to creating AMS tools that are relatable to users. Several participants incorporated the Framework into routine practice, with some using it to drive sector-level AMS action. The resulting Framework offers an adaptable, scalable entry point for AMS efforts and a platform for setting meaningful improvement goals. It supports broader opportunities for national-level AMS assessments and strategy development.