Co-creating antimicrobial resistance (AMR) literacy in Zimbabwean higher education institutions: A participatory, qualitative study following the one health approach

Antimicrobial resistance (AMR) is a global health challenge that encompasses social, economic, and ecological risks, and the relationship between human, animal, and environmental health is emerging as a key factor. Addressing AMR means developing capacities across health sectors, with training of health practitioners through higher education institutions (HEIs) essential for strengthening one's health literacy. This paper explores how Zimbabwean University lecturers and students co-create an understanding of AMR, contributing to the development of AMR literacy. A participatory qualitative study using research workshops was conducted at two Zimbabwean HEIs, engaging 60 interdisciplinary participants in vignette-based discussions of AMR. Using thematic analysis, three key themes were identified: (1) reflective engagement with antimicrobial use impacting environmental, human, and animal health; (2) preventive actions to protect environmental, human, and animal health; and (3) holistic health promotion grounded in social and ecological care. AMR literacy is outlined as interdisciplinary and context-dependent, encompassing biomedical understanding, critical ethical reflections, and pluralistic reasoning, enabling context-relevant approaches and decision-making. This study contributes to global health research by highlighting the potential of participatory and contextually sensitive educational approaches to address AMR. Operationalising AMR literacy could support cross-sectoral collaboration among health practitioners, strengthening global health efforts to address sustainable health challenges.