Assessing the Factors Influencing Awareness of The One Health Approach to Antimicrobial Resistance A Case Study Among Senior High School Students in The Lower Manya Krobo Municipality, Eastern Region of Ghana

Abstract

Background: Antimicrobial resistance (AMR) remains one of the most critical global public health threats, with growing concern over its spread across human, animal, and environmental domains. The One Health Approach (OHA) emphasizes the interconnectedness of these sectors in addressing AMR. However, awareness of OHA among young people, who represent future health stewards, remains poorly documented in Ghana. This study assessed the factors influencing awareness of AMR and the One Health Approach among Senior High School (SHS) students in the Lower Manya Krobo Municipality, Eastern Region of Ghana. Methodology: A cross-sectional study was conducted among 394 science students randomly selected from four Senior High Schools in the municipality. The study adopted a quantitative cross-sectional design, targeting SHS students aged 15–19 years. A multistage stratified random sampling approach was used to select 394 participants. Data was collected using a structured, self-administered questionnaire adapted from validated tools, focusing on students’ knowledge of antibiotics and AMR, misconceptions, and information sources. Data was entered using KoboCollect and analyzed with SPSS V2.0. Descriptive statistics summarized demographic characteristics and awareness levels, while Chi-square tests and multivariate logistic regression identified associations between socio-demographic factors and awareness levels. Statistical significance was set at p < 0.05. Results: The findings revealed that awareness of AMR was moderate, with 66% of respondents demonstrating moderate to good knowledge, while 34% had poor awareness. In contrast, awareness of the One Health Approach was strikingly low (16.3%). Male students were more likely to have good AMR awareness compared to females (AOR = 2.24, p = 0.006). Socioeconomic status and religion were also significant predictors, with students from higher-income backgrounds and Christian faiths demonstrating better awareness (p < 0.05). No significant associations were found for age, ethnicity, or location. Although AMR knowledge was positively associated with awareness of the One Health Approach, the relationship was not statistically significant (p = 0.209), indicating limited translation of AMR knowledge into holistic understanding. Conclusion: The study highlights moderate awareness of AMR but poor understanding of the One Health framework among SHS science students. Gender, religion, and socioeconomic status significantly influenced AMR awareness, while One Health understanding remained uniformly low across demographic groups. These findings underscore the urgent need to integrate AMR and One Health education into the Senior High School science curriculum. Strengthening teacher capacity and leveraging digital platforms identified as key information sources could enhance sustained youth engagement. Collaboration among the Ghana Education Service (GES), the District Health Directorate, and NGOs is recommended to promote One Health literacy as part of Ghana’s broader National Action Plan on Antimicrobial Resistance.