Nayiga, S. et al. (2024) "Arming half-baked people with weapons!" Information enclaving among professionals and the need for a care-centred model for antibiotic use information in Uganda, Tanzania and Malawi. Global Health Action, 17(1), 2322839. (doi: 10.1080/16549716.2024.2322839) (PMID:38441912) (PMCID:PMC10916894)
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Abstract
Background: The overuse of antimicrobial medicines is a global health concern, including as a major driver of antimicrobial resistance. In many low- and middle-income countries, a substantial proportion of antibiotics are purchased over-the-counter without a prescription. But while antibiotics are widely available, information on when and how to use them is not. Objective: We aimed to understand the acceptability among experts and professionals of sharing information on antibiotic use with end users – patients, carers and farmers – in Uganda, Tanzania and Malawi. Methods: Building on extended periods of fieldwork amongst end-users and antibiotic providers in the three countries, we conducted two workshops in each, with a total of 44 medical and veterinary professionals, policy makers and drug regulators, in December 2021. We carried out extensive documentary and literature reviews to characterise antibiotic information systems in each setting. Results: Participants reported that the general public had been provided information on medicine use in all three countries by national drug authorities, health care providers and in package inserts. Participants expressed concern over the danger of sharing detailed information on antibiotic use, particularly that end-users are not equipped to determine appropriate use of medicines. Sharing of general instructions to encourage professionally-prescribed practices was preferred. Conclusions: Without good access to prescribers, the tension between enclaving and sharing of knowledge presents an equity issue. Transitioning to a client care-centred model that begins with the needs of the patient, carer or farmer will require sharing unbiased antibiotic information at the point of care.
| Item Type: | Articles |
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| Additional Information: | Funding: This study was funded by the Liverpool School of Tropical Medicine as part of the Enabling Optimal Antimicrobial Use in East Africa project with support from the EPSRC, Engineering and Physical Sciences Research Council [WD4 RBPS04394]. The previous empirical research that informed this study was funded under the AMIS, DRUM, HATUA and SNAP-AMR projects. The AMIS study was funded under the Antimicrobials In Society (AMIS) grant awarded by the Economic and Social Research Council (ESRC) on behalf of the Antimicrobial Resistance Cross Council Initiative supported by the seven Research Councils UK (RCUK) in partnership with other funders [ES/P008100/1]. The DRUM Project was funded by the AMR Cross-Council Initiative through a grant from the Medical Research Council [MR/S004793/1]. HATUA was funded by the UK Research and Innovation (UKRI) through a grant from the Medical Research Council [MR/S004785/1]. SNAP-AMR was funded by the UK Research and Innovation (UKRI) through a grant from the Medical Research Council [MR/S004815/1]. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | MACPHERSON, Dr ELEANOR and Hilton, Professor Shona |
| Authors: | Nayiga, S., MacPherson, E., Mankhomwa, J., Nasuwa, F., Pongolani, R., Kabuleta, R., Kesby, M., Dacombe, R., Hilton, S., Grace, D., Feasey, N., and Chandler, C. I. R. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU College of Social Sciences |
| Journal Name: | Global Health Action |
| Publisher: | Taylor and Francis |
| ISSN: | 1654-9716 |
| ISSN (Online): | 1654-9880 |
| Published Online: | 05 March 2024 |
| Copyright Holders: | Copyright © 2024 The Author(s). |
| First Published: | First published in Global Health Action 17(1):2322839 |
| Publisher Policy: | Reproduced under a Creative Commons license |
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