Qualitative study of antibiotic prescription patterns and associated drivers in Sudan, Guinea-Bissau, Central African Republic and Democratic Republic of Congo.
MetadataShow full item record
AbstractObjectives: The objective of this study was to address the knowledge gap regarding antibiotic use in Medecins Sans Frontiéres (MSF) projects located in Africa by exploring antibiotic prescription and consumption habits and their drivers at different healthcare levels. Design: This study used an exploratory study design through thematic analysis of semistructured, in-depth interviews, focus group discussions (FGDs) and field observations in order to understand the main drivers influencing current antibiotics prescription habits and consumption habits of patients in different geographical settings. Setting: The study took place in MSF centres and towns across four countries: Guinea-Bissau, Central African Republic (CAR), Democratic Republic of Congo (DRC) and Sudan. Participants: 384 respondents participated in the study, which includes project staff, prescribers, community members, patients, among other groups. Results: Treatment protocols were physically present in all countries except DRC, but compliance to protocols varied across contexts. A failing health system and barriers to accessing healthcare were perceived as major drivers of overuse and inconsistent prescription practices. Patient demands influenced prescription decisions, and self-medication was commonly reported in the context of failing health systems. Additionally, there was a strong demand for quick cures and communities preferred injections over pills. Patients tended to stop antibiotic treatment once symptoms abated and had major gaps in understanding antibiotic intake instructions and functions. Conclusions: While there were specific findings in each context, the larger trend from these four MSF projects in Africa indicates widespread use of antibiotics based on unclear assumptions, which are often influenced by patient demands. There needs to be a broader focus on the balance between access and excess, especially in such fragile contexts where access to healthcare is a real challenge.
PublisherBMJ Publishing Group
- Perioperative mortality: Analysis of 3 years of operative data across 7 general surgical projects of Médecins Sans Frontières in Democratic Republic of Congo, Central African Republic, and South Sudan.
- Authors: Davies JF, Lenglet A, van Wijhe M, Ariti C
- Issue date: 2016 May
- Delivering HIV care in challenging operating environments: the MSF experience towards differentiated models of care for settings with multiple basic health care needs.
- Authors: Ssonko C, Gonzalez L, Mesic A, da Fonseca MS, Achar J, Safar N, Martin B, Wong S, Casas EC
- Issue date: 2017 Jul 21
- Mental health services for children exposed to armed conflict: Médecins Sans Frontières' experience in the Democratic Republic of Congo, Iraq and the occupied Palestinian territory.
- Authors: Lokuge K, Shah T, Pintaldi G, Thurber K, Martínez-Viciana C, Cristobal M, Palacios L, Dear K, Banks E
- Issue date: 2013 Nov
- Assessing and decomposing inequality of opportunity in access to child health and nutrition in sub-Saharan Africa: evidence from three countries with low human development index.
- Authors: Sanoussi Y, Ahinkorah BO, Banke-Thomas A, Yaya S
- Issue date: 2020 Aug 25
- Diabetes care in a complex humanitarian emergency setting: a qualitative evaluation.
- Authors: Murphy A, Biringanine M, Roberts B, Stringer B, Perel P, Jobanputra K
- Issue date: 2017 Jun 23