Innovative approaches to AMR education: evaluating the impact of gamification on empowering ASHA workers’ knowledge and engagement in Mysuru, India

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Abstract
Antimicrobial resistance (AMR) poses a major threat to public health, especially in LMICs. Accredited Social Health Activists (ASHAs) are key community health workers in India who can be empowered to promote rational antibiotic use. To compare the effectiveness of gamified versus conventional teaching methods in improving AMR-related knowledge among ASHAs in Mysuru, south India. A prospective interventional study was conducted among 73 ASHAs during World Antimicrobial Awareness Week 2024. Group A (n = 31) received gamified training using interactive games, and Group B (n = 42) received conventional teaching through lectures and board-based instruction. Knowledge was assessed using a 25-item questionnaire before and after the intervention. Data were analysed via Wilcoxon signed-rank and Mann–Whitney U tests. Knowledge improved in both groups, but gains were markedly higher with gamification. The mean post-test score reached 86.08% in gamified training versus 54.48% for conventional teaching (p < 0.001; effect size r = 0.75). Gamified training consistently outperformed conventional methods across all infection domains, leading to predominantly good-to-excellent knowledge levels. Gamified interventions substantially enhanced ASHAs’ knowledge compared to conventional teaching, offering a scalable and low-cost strategy to strengthen antimicrobial stewardship in community settings. Long-term studies are needed to assess retention and behavior change.

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