| Daniel Valia, Juste Stéphane Kouanda, Brecht Ingelbeen, Karim Derra, Bérenger Kaboré, François Kiemdé, Toussaint Rouamba, Eli Rouamba, Franck Sovi Hien, Linda Campbell, Marie Meudec, Annie Robert, Halidou Tinto, Marianne A. B. Sande, Hector Rodriguez Villalobos Healthcare seeking outside healthcare facilities and antibiotic dispensing patterns in rural Burkina Faso: A mixed methods study Journal Article In: Tropical medicine & international health : TM & IH, vol. 28, iss. 5, pp. 391-400, 2023, ISSN: 1365-3156. @article{Valia2023,
title = {Healthcare seeking outside healthcare facilities and antibiotic dispensing patterns in rural Burkina Faso: A mixed methods study},
author = {Daniel Valia and Juste St\'{e}phane Kouanda and Brecht Ingelbeen and Karim Derra and B\'{e}renger Kabor\'{e} and Fran\c{c}ois Kiemd\'{e} and Toussaint Rouamba and Eli Rouamba and Franck Sovi Hien and Linda Campbell and Marie Meudec and Annie Robert and Halidou Tinto and Marianne A. B. Sande and Hector Rodriguez Villalobos},
url = {https://pubmed.ncbi.nlm.nih.gov/36871194/},
doi = {10.1111/TMI.13868},
issn = {1365-3156},
year = {2023},
date = {2023-01-01},
journal = {Tropical medicine \& international health : TM \& IH},
volume = {28},
issue = {5},
pages = {391-400},
publisher = {Trop Med Int Health},
abstract = {Objective: Optimising antibiotic use is important to limit increasing antibiotic resistance. In rural Burkina Faso, over-the-counter dispensing of antibiotics in community pharmacies and non-licensed medicine retail outlets facilitates self-medication. We investigated its extent, reasons and dispensing patterns. Methods: In an exploratory mixed-method design conducted between October 2020 and December 2021, this study first explored illness perceptions, the range of healthcare providers in communities, antibiotics knowledge and reasons for seeking healthcare outside healthcare facilities. Second, frequencies of illness and healthcare utilisation in the last 3 months were quantitatively measured. Results: Participants distinguished between natural and magico-religious illnesses, according to origins. For illnesses considered to be ‘natural’, healthcare was mainly sought at healthcare facilities, private pharmacies and informal drug outlets. For illnesses considered as magico-religious, traditional healers were mainly visited. Antibiotics were perceived in the community as medicines similar to painkillers. Healthcare-seeking outside healthcare facilities was reported by 660/1973 (33.5%) participants reporting symptoms, including 315 (47.7%) to informal vendors. Healthcare seeking outside facilities was less common for 0\textendash4-year-olds (58/534, 10.9% vs. 379/850, 44.1% for ≥5-year-olds) and decreased with improving socio-economic status (108/237, 45.6% in the lowest quintile; 96/418, 23.0% in the highest). Reported reasons included financial limitation, and also proximity to informal drug vendors, long waiting times at healthcare facilities, and health professionals' non-empathetic attitudes towards their patients. Conclusion: This study highlights the need to facilitate and promote access to healthcare facilities through universal health insurance and patient-centred care including reducing patients' waiting time. Furthermore, community-level antibiotic stewardship programmes should include community pharmacies and informal vendors.},
keywords = {Anti-Bacterial Agents* / therapeutic use, Attitude of Health Personnel, Burkina Faso, Child, Daniel Valia, doi:10.1111/tmi.13868, Hector Rodriguez Villalobos, Humans, Juste St\'{e}phane Kouanda, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Patient Acceptance of Health Care*, pmid:36871194, Preschool, PubMed Abstract, Research Support, Self Medication},
pubstate = {published},
tppubtype = {article}
}
Objective: Optimising antibiotic use is important to limit increasing antibiotic resistance. In rural Burkina Faso, over-the-counter dispensing of antibiotics in community pharmacies and non-licensed medicine retail outlets facilitates self-medication. We investigated its extent, reasons and dispensing patterns. Methods: In an exploratory mixed-method design conducted between October 2020 and December 2021, this study first explored illness perceptions, the range of healthcare providers in communities, antibiotics knowledge and reasons for seeking healthcare outside healthcare facilities. Second, frequencies of illness and healthcare utilisation in the last 3 months were quantitatively measured. Results: Participants distinguished between natural and magico-religious illnesses, according to origins. For illnesses considered to be ‘natural’, healthcare was mainly sought at healthcare facilities, private pharmacies and informal drug outlets. For illnesses considered as magico-religious, traditional healers were mainly visited. Antibiotics were perceived in the community as medicines similar to painkillers. Healthcare-seeking outside healthcare facilities was reported by 660/1973 (33.5%) participants reporting symptoms, including 315 (47.7%) to informal vendors. Healthcare seeking outside facilities was less common for 0–4-year-olds (58/534, 10.9% vs. 379/850, 44.1% for ≥5-year-olds) and decreased with improving socio-economic status (108/237, 45.6% in the lowest quintile; 96/418, 23.0% in the highest). Reported reasons included financial limitation, and also proximity to informal drug vendors, long waiting times at healthcare facilities, and health professionals' non-empathetic attitudes towards their patients. Conclusion: This study highlights the need to facilitate and promote access to healthcare facilities through universal health insurance and patient-centred care including reducing patients' waiting time. Furthermore, community-level antibiotic stewardship programmes should include community pharmacies and informal vendors. |
