This study is conducted by The Maldives National University in collaboration with the Maldives Food and Drug Authority, Ministry of Health and supported by World Health Organisation.
Antimicrobial resistance (AMR) represents a growing public health challenge globally and poses a significant threat to the effective prevention and treatment of infectious diseases. In response, the Maldives has committed to addressing AMR through the implementation of its National Action Plan on Antimicrobial Resistance. However, evidence on public knowledge, attitudes, and practices related to antibiotic use has been limited. This national Knowledge, Attitudes, and Practices (KAP) survey was conducted to generate baseline evidence to inform policy development, programme prioritisation, and monitoring of progress under the national AMR response.
A national Knowledge, Attitudes and Practices (KAP) survey on antimicrobial resistance (AMR) was conducted between July and October 2025 among 1,713 adults across urban and non-urban areas of the Maldives. Using a questionnaire adapted from the World Health Organization’s AMR public awareness survey, the study assessed public knowledge and attitudes towards antibiotics and AMR, as well as antibiotic-use practices.
The findings showed that while attitudes towards responsible antibiotic use were generally favourable, important gaps remain in both knowledge and antibiotic-use practices. Misconceptions about the use of antibiotics for viral infections were common, and understanding of how antimicrobial resistance develops and spreads was limited. Antibiotic-use practices emerged as the weakest area, with nearly half of respondents demonstrating poor practices, including incomplete treatment courses and inappropriate responses to missed doses.
Education was the most consistent sociodemographic factor associated with knowledge, attitudes, and practices. The study also identified important equity considerations, with foreign nationals more likely to report poor antibiotic-use practices, highlighting the need to address potential language, healthcare access, and communication barriers.
The findings demonstrate that improving knowledge alone may not be sufficient to change antibiotic-use behaviour. Tackling AMR will require a combination of targeted public education, behaviour-focused antimicrobial stewardship, effective healthcare and pharmacy communication, regulatory enforcement, and inclusive multilingual interventions. The survey provides an important national baseline to support implementation and monitoring of the National Action Plan on Antimicrobial Resistance and future AMR initiatives within a One Health framework.
