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Abstract Background Inappropriate use of antibiotics is a major contributing factor to the emergence of antimicrobial resistance globally, including in Sudan. Objectives The project aimed to develop a theory-driven behaviour change strategy addressing both prescribers and patients based on factors that are driving antibiotic use in primary healthcare settings in Gezira state in Sudan. Methods The strategy was designed based on the Theoretical Domains Framework (TDF) to identify behavioural domains and the Behaviour Change Wheel (BCW) to select appropriate intervention functions. The process included (1) a formative qualitative research study and (2) a knowledge co-production workshop that utilized the results of the qualitative study to design a salient, appropriate, and credible behaviour change strategy. Results The TDF domains related to prescribers that emerged from the study included knowledge, skills, and intention. The selected BCW intervention functions included education, training, modelling, and persuasion. The main TDF domains related to patients included social influences and intention. The selected BCW intervention functions included enablement and education. Conclusion Using the TDF and BCW intervention functions, the study identified behavioural domains that influence antibiotic prescription and consumption in rural primary healthcare settings in Gezira state in Sudan and appropriate intervention functions to modify these behaviours. Knowledge co-production ensured that the evidence-based strategy was acceptable and practical in the local context.

Globally, frontline health care providers are among the most affected population group by the COVID-19 pandemic. Knowing the factors contributing to the transmission of COVID-19 infection among frontline health care providers is essential for implementing tailored control measures and protecting this vital population group. This study aimed to estimate the proportion and to identify factors associated with COVID-19 infection among medical doctors in Sudan. A web-based survey was used to collect data from medical doctors who were working in Sudan during the study period. Data were analyzed using SPSS® version 25; Descriptive analysis in terms of means (SD) for continuous variables, frequencies, and percentages with 95% CI for the categorical variable was conducted. Chi-square test and binary logistic regression for associations between the outcome variables (risk of exposure to COVID-19 infection and ever tested positive for COVID-19 infection) and independent variables (socio-demographic and infection control standards) were also performed. Out of 352 valid responses, 13.6% had tested positive for COVID-19 infection at least once during the pandemic. More than one-third have identified colleagues as the main sources of infection compared to 21% of patients (p-value < 0.04). Doctors who received training on COVID-19 were 60% less likely to have positive tests for COVID-19 (p-value