Introduction Antimicrobial resistance is still not given enough attention and the public is insufficiently aware of its existence, leading to behaviour, which propagates the rise of antimicrobial resistance (AMR). One of the objectives of Tanzania's national action plan on antimicrobial resistance is to improve awareness and understanding of antimicrobial use and resistance through effective communication, education and training. This task will need involvement of many stakeholders and sectors. Objectives To assess the knowledge, attitudes and practices toward antimicrobial use and resistance among students in three secondary schools in Dodoma city. Methods For this interventional pre-post comparative study, data were collected before and after training on antimicrobial use and resistance. Secondary school students from Mkonze, Merriwa and Kiwanja cha Ndege secondary school who are members of AMR school clubs participated. Training included classroom teaching and arts and crafts. We used quantitative and qualitative data collection methods by using self-administered paper-based structured coded questionnaires delivered to the students with the supervision of school guardians. Analysis was done through Excel and SPSS. Results Three aspects were investigated: awareness of ways to reduce AMR; knowledge that antibiotics cannot be used to treat flu and factors that contribute to AMR. Before the training knowledge of these was below 37%. Three months after the training knowledge had increased to above 90%. Conclusions Training of secondary school students significantly improved awareness, knowledge and attitude regarding antimicrobial use and antimicrobial resistance. AMR school clubs are an effective vehicle to raise awareness and mitigate the AMR crisis. Focus on students will lead to wider awareness in the community.

Introduction One of the strategic objectives of the AMR national action plan is to improve public awareness and understanding of AMR. Changing people's behaviour is not easy and the older a person is, the more they are set in their ways. Schoolchildren are in their formative years, which is the right time to impart knowledge and best practices that will guide their behaviour in life. Importantly, students have links with families and communities and are future leaders. Roll Back Antimicrobial resistance Initiative (RBA Initiative) has been pioneering the use of youth as agents of change to increase AMR awareness, promote positive behavioural change and thus reduce treatment failure. Objectives The main objective was to equip young people (schoolchildren) with knowledge and skills to understand antimicrobial use and resistance and ability to pass the knowledge to their families, other students and community at large. Methods Through AMR clubs, RBA Initiative used different methodologies to engage and educate schoolchildren on AMR. These included classroom teaching, arts and crafts like songs, skits, drama, traditional dances and storytelling and fun videos. Further motivation for active participation was encouraged through competition. The content of the training included topics such as behaviour that fuels AMR, hand hygiene and sanitation, the impact of fake drugs and the One Health approach. Results In 2020, the project build the capacity of 160 students. Subsequently, these trained students have reached over 1000 fellow secondary school students, over 3000 primary school pupils and over 800 community members including family members with key AMR messages. Conclusions If engaged and empowered, young people are able to increase community knowledge and awareness regarding AMR as agents of change, contributing to the national action plan on AMR.