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Pathways to antibiotics in Bangladesh_ A qualitative study investigating how and when households access medicine including antibiotics for humans or animals when they are ill.pdf (459.76 kB)

Pathways to antibiotics in Bangladesh: a qualitative study investigating how and when households access medicine including antibiotics for humans or animals when they are ill

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posted on 2023-06-09, 20:09 authored by Patricia Jane Lucas, Mohammad Rofi Uddin, Nirnita Khisa, S M Salim Akter, Leanne Unicomb, Papreen NaharPapreen Nahar, Mohammad Aminul Islam, Fosiul Alam Nizame, Emily K Rousham
Background To understand how to reduce antibiotic use, greater knowledge is needed about the complexities of access in countries with loose regulation or enforcement. This study aimed to explore how households in Bangladesh were accessing antimicrobials for themselves and their domestic animals. Methods In-depth interviews were conducted with 48 households in one urban and one rural area. Households were purposively sampled from two lower income strata, prioritising those with under 5-year olds, older adults, household animals and minority groups. Households where someone was currently ill with a suspected infection (13 households) were invited for a follow-up interview. Framework analysis was used to explore access to healthcare and medicines. Findings People accessed medicines for themselves through five pathways: drugs shops, private clinics, government/charitable hospitals, community/family planning clinics, and specialised/private hospitals. Drug shops provided direct access to medicines for common, less serious and acute illnesses. For persistent or serious illnesses, the healthcare pathway may include contacts with several of these settings, but often relied on medicines provided by drug shops. In the 13 households with an unwell family member, most received at least one course of antibiotics for this illness. Multiple and incomplete dosing were common even when prescribed by a qualified doctor. Antibiotics were identified by their high cost compared to other medicines. Cost was a reported barrier to purchasing full courses of antibiotics. Few households in the urban area kept household animals. In this rural area, government animal health workers provided most care for large household animals (cows), but drug shops were also important. Conclusions In Bangladesh, unregulated drug shops provide an essential route to medicines including those prescribed in the formal sector. Wherever licensed suppliers are scarce and expensive, regulations which prohibit this supply risk removing access entirely for many people.

History

Publication status

  • Published

File Version

  • Published version

Journal

PLOS ONE

ISSN

1932-6203

Publisher

Public Library of Science

Issue

11

Volume

14

Article number

a0225270

Department affiliated with

  • BSMS Publications

Research groups affiliated with

  • Brighton and Sussex Centre for Global Health Research Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2020-01-08

First Open Access (FOA) Date

2020-01-08

First Compliant Deposit (FCD) Date

2020-01-08

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