Antimicrobial resistance (AMR) is a global health issue disproportionately affecting low- and middle-income countries. In Tanzania, multi-drug-resistant bacteria (MDR) are highly prevalent in clinical and community settings, inhibiting effective treatment and recovery from infection. The burden of AMR can be alleviated if antimicrobial stewardship (AMS) programs are coordinated and incorporate local knowledge and systemic factors. AMS includes the education of health providers to optimise antimicrobial use to improve patient outcomes while minimising AMR risks. For programmes to succeed, it is essential to understand not just the awareness of and receptiveness to AMR education, but also the opportunities and challenges facing health professionals. We conducted in-depth interviews (n = 44) with animal and human health providers in rural northern Tanzania in order to understand their experiences around AMR. In doing so, we aimed to assess the contextual factors surrounding their practices that might enable or impede the translation of knowledge into action. Specifically, we explored their motivations, training, understanding of infections and AMR, and constraints in daily practice. While providers were motivated in supporting their communities, clear issues emerged regarding training and understanding of AMR. Community health workers and retail drug dispensers exhibited the most variation in training. Inconsistencies in understandings of AMR and its drivers were apparent. Providers cited the actions of patients and other providers as contributing to AMR, perpetuating narratives of blame. Challenges related to AMR included infrastructural constraints, such as a lack of diagnostic testing. While health and AMR-specific training would be beneficial to address awareness, equally important, if not more critical, is tackling the challenges providers face in turning knowledge into action.

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Challenges of language, accessibility and ethics when conducting digital interviews in the virtual space.

This paper asks two questions: How has the Covid-19 pandemic been experienced by people seeking asylum who are subjected to United Kingdom (UK) State designed-in destitution? And what might be the alternatives to State produced destitution? To answer these questions, we draw on two case studies from Glasgow, a city unique in the UK for its long history of asylum dispersal and its deeply embedded ecology of third-sector support and asylum advocacy work. We argue that to understand the segregatory power of dispersal and tiered welfare provision as forms of violent migration governance, centring the racialised logics at play is imperative. This provides the framework for developing anti-racist approaches to supporting people made homeless through destitution by design. Using case studies, we explore how the UK Government’s use of ‘emergency hotel accommodation’ for people seeking asylum who are already homeless or are at risk of homelessness, are becoming normalised strategies of containment for racialised others and an extension of the distributed violence of dispersal accommodation that long pre-dates the pandemic. We offer an alternative advocacy-led and rights-based approach to secure refuge for people made homeless by the State.