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dc.contributor.authorNdaki, Pendo M.
dc.contributor.authorMwanga, Joseph R.
dc.contributor.authorMushi, Martha F.
dc.contributor.authorKonje, Eveline T.
dc.contributor.authorFredricks, Kathryn Jean
dc.contributor.authorKesby, Mike
dc.contributor.authorSandeman, Alison
dc.contributor.authorMugassa, Stella
dc.contributor.authorManyiri, Msilikale W.
dc.contributor.authorLoza, Olga
dc.contributor.authorKeenan, Katherine
dc.contributor.authorMwita, Stanley M.
dc.contributor.authorHolden, Matthew T. G.
dc.contributor.authorMshana, Stephen E.
dc.identifier.citationNdaki , P M , Mwanga , J R , Mushi , M F , Konje , E T , Fredricks , K J , Kesby , M , Sandeman , A , Mugassa , S , Manyiri , M W , Loza , O , Keenan , K , Mwita , S M , Holden , M T G & Mshana , S E 2023 , ' Practices and motives behind antibiotics provision in drug outlets in Tanzania : a qualitative study ' , PLoS ONE , vol. 18 , no. 8 , e0290638 .
dc.identifier.otherRIS: urn:DACE8175A94B899448D57C32C46DB44A
dc.identifier.otherORCID: /0000-0001-7789-870X/work/142063483
dc.identifier.otherORCID: /0000-0002-2529-6966/work/142063872
dc.identifier.otherORCID: /0000-0002-9670-1607/work/142064165
dc.identifier.otherORCID: /0000-0002-4958-2166/work/142064215
dc.identifier.otherORCID: /0009-0005-4229-8129/work/151190570
dc.descriptionFunding: This study was part of the larger 3-country Holistic Approach to Unravel Antibacterial Resistance in East Africa (HATUA) project funded by the National Institute for Health Research, Medical Research Council and the Department of Health and Social Care, Award (MR/S004785/1).en
dc.description.abstractDispensing antibiotics without prescription is among the major factors leading to antimicrobial resistance. Dispensing of antibiotics without prescription has negative impact at the individual and societal level leading to poor patient outcomes, and increased risks of resistant bacteria facilitated by inappropriate choice of antibiotics doses/courses. Antimicrobial resistance is a global public health threat which is projected to cause 10 million deaths by 2050 if no significant actions are taken to address this problem This study explored the practices and motives behind dispensing of antibiotics without prescription among community drug outlets in Tanzania. Finding of this study provides more strategies to antibiotics stewardship intervention. In-depth interviews with 28 drug dispensers were conducted for three months consecutively between November 2019 and January 2020 in 12 community pharmacies and 16 Accredited Drug Dispensing Outlets (ADDOs) in the Mwanza, Kilimanjaro and Mbeya regions of Tanzania. Transcripts were coded and analyzed thematically using NVivo12 software. Majority of dispensers admitted to providing antibiotics without prescriptions, selling incomplete courses of antibiotics and not giving detailed instructions to customers on how to use the drugs. These practices were motivated by several factors including customers’ pressure/customers’ demands, business orientation-financial gain of drug dispensers, and low purchasing power of patients/customers. It is important to address the motives behind the unauthorized dispensing antibiotics. On top of the existing regulation and enforcement, we recommend the government to empower customers with education and purchasing power of drugs which can enhance the dispensers adherence to the dispensing regulations. Furthermore, we recommend ethnographic research to inform antibiotic stewardship interventions going beyond awareness raising, education and advocacy campaigns. This will address structural drivers of AMR such as poverty and inadequate government health services, and the disconnect between public messaging and/or policy and the public itself.
dc.relation.ispartofPLoS ONEen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titlePractices and motives behind antibiotics provision in drug outlets in Tanzania : a qualitative studyen
dc.typeJournal articleen
dc.contributor.sponsorMedical Research Councilen
dc.contributor.institutionUniversity of St Andrews. School of Geography & Sustainable Developmenten
dc.contributor.institutionUniversity of St Andrews. Geographies of Sustainability, Society, Inequalities and Possibilitiesen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Biomedical Sciences Research Complexen
dc.contributor.institutionUniversity of St Andrews. St Andrews Bioinformatics Uniten
dc.contributor.institutionUniversity of St Andrews. Infection and Global Health Divisionen
dc.description.statusPeer revieweden

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