Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study
Globally, Antibiotic resistance is a major public health concern, with antibiotic use contributing significantly. Targeting informal healthcare providers (IHCPs) is important to achieve universal health coverage and effective antibiotic stewardship in resource-constrained settings. We, therefore, ai...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Antibiotics |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2079-6382/11/4/459 |
| _version_ | 1827621970674450432 |
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| author | Shweta Khare Ashish Pathak Cecilia Stålsby Lundborg Vishal Diwan Salla Atkins |
| author_facet | Shweta Khare Ashish Pathak Cecilia Stålsby Lundborg Vishal Diwan Salla Atkins |
| author_sort | Shweta Khare |
| collection | DOAJ |
| description | Globally, Antibiotic resistance is a major public health concern, with antibiotic use contributing significantly. Targeting informal healthcare providers (IHCPs) is important to achieve universal health coverage and effective antibiotic stewardship in resource-constrained settings. We, therefore, aimed to analyse the internal and external drivers that influence IHCPs’ prescribing behaviour for common illnesses in children under five, with an emphasis on antibiotic use in rural areas of India. A total of 48 IHCPs participated in focus group discussions. Thematic framework analysis with an inductive approach was used, and findings were collated in the theoretical framework based on knowledge, attitude, and practice model which depicted that the decisions made by IHCPs while prescribing antibiotics are complex and influenced by a variety of external and internal drivers. IHCPs’ internal drivers included the misconception that it is impossible to treat a patient without antibiotics and that antibiotics increase the effectiveness of other drugs and cure patients faster in order to retain them. Formal healthcare providers were the IHCPs’ sources of information, which influences their antibiotic prescribing. We found when it comes to seeking healthcare in rural areas, the factors that influence their choice include ‘rapid cure’, ‘cost of treatment’, ‘distance’ and ‘24 h availability’, instead of qualification, which may create pressure for IHCPs to provide a quick fix. Targeted and coordinated efforts at all levels will be needed to change the antibiotic prescribing practices of IHCPs with a focus on behaviour change and to help resolve misconceptions about antibiotics. |
| first_indexed | 2024-03-09T11:14:42Z |
| format | Article |
| id | doaj.art-2e3315668d7b4d648d422021f98a8827 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T11:14:42Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-2e3315668d7b4d648d422021f98a88272023-12-01T00:32:11ZengMDPI AGAntibiotics2079-63822022-03-0111445910.3390/antibiotics11040459Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative StudyShweta Khare0Ashish Pathak1Cecilia Stålsby Lundborg2Vishal Diwan3Salla Atkins4Health Systems and Policy (HSP): Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, SwedenHealth Systems and Policy (HSP): Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, SwedenHealth Systems and Policy (HSP): Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, SwedenHealth Systems and Policy (HSP): Medicines, Focusing Antibiotics, Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, SwedenSocial Medicine, Infectious Diseases and Migration (SIM), Department of Global Public Health, Karolinska Institutet, Tomtebodavagen 18A, 171 77 Stockholm, SwedenGlobally, Antibiotic resistance is a major public health concern, with antibiotic use contributing significantly. Targeting informal healthcare providers (IHCPs) is important to achieve universal health coverage and effective antibiotic stewardship in resource-constrained settings. We, therefore, aimed to analyse the internal and external drivers that influence IHCPs’ prescribing behaviour for common illnesses in children under five, with an emphasis on antibiotic use in rural areas of India. A total of 48 IHCPs participated in focus group discussions. Thematic framework analysis with an inductive approach was used, and findings were collated in the theoretical framework based on knowledge, attitude, and practice model which depicted that the decisions made by IHCPs while prescribing antibiotics are complex and influenced by a variety of external and internal drivers. IHCPs’ internal drivers included the misconception that it is impossible to treat a patient without antibiotics and that antibiotics increase the effectiveness of other drugs and cure patients faster in order to retain them. Formal healthcare providers were the IHCPs’ sources of information, which influences their antibiotic prescribing. We found when it comes to seeking healthcare in rural areas, the factors that influence their choice include ‘rapid cure’, ‘cost of treatment’, ‘distance’ and ‘24 h availability’, instead of qualification, which may create pressure for IHCPs to provide a quick fix. Targeted and coordinated efforts at all levels will be needed to change the antibiotic prescribing practices of IHCPs with a focus on behaviour change and to help resolve misconceptions about antibiotics.https://www.mdpi.com/2079-6382/11/4/459healthcare providersinfectious diseasescaregiverschildprescriptionantibiotics |
| spellingShingle | Shweta Khare Ashish Pathak Cecilia Stålsby Lundborg Vishal Diwan Salla Atkins Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study Antibiotics healthcare providers infectious diseases caregivers child prescription antibiotics |
| title | Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study |
| title_full | Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study |
| title_fullStr | Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study |
| title_full_unstemmed | Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study |
| title_short | Understanding Internal and External Drivers Influencing the Prescribing Behaviour of Informal Healthcare Providers with Emphasis on Antibiotics in Rural India: A Qualitative Study |
| title_sort | understanding internal and external drivers influencing the prescribing behaviour of informal healthcare providers with emphasis on antibiotics in rural india a qualitative study |
| topic | healthcare providers infectious diseases caregivers child prescription antibiotics |
| url | https://www.mdpi.com/2079-6382/11/4/459 |
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