"I can make more from selling medicine when breaking the rules" - understanding the antibiotic supply network in a rural community in Viet Nam
"I can make more from selling medicine when breaking the rules" - understanding the antibiotic supply network in a rural community in Viet Nam
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DOI：
10.1186/s12889-019-7812-z
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发表时间：
2019-11-26
影响因子：
4.5
通讯作者：
Wertheim, Heiman
中科院分区：
文献类型：
--
作者：
Hong Hanh Nguyen;Dang Phuc Ho;Wertheim, Heiman
背景资料：与许多其他低收入和中等收入国家一样，越南的制药业也经历了重大增长，拥有大量药房和药店，过去十年人均药品支出不断增加。尽管已引入监管框架来控制处方药（包括抗生素）的分配和使用，但据报道，合规性非常低，特别是在越南的农村地区。这种定性研究的目的是了解抗生素的获取和使用的做法，在社区从供应商和消费者的角度来看，以支持识别和开发未来的interventions.Methods：这种定性研究的一部分，社区抗生素的获取和使用（ABACUS）在六个低收入国家的项目。重点是河内首都的Ba Vi区，我们在那里与毒品供应商进行了16次深入访谈（IDI），与社区成员进行了16次IDI和6次焦点小组讨论（FGD）。根据研究区域所有非正式和正式抗生素购买或分发点的地图对药物供应商进行抽样。社区成员是通过当地网络和与外地合作者的关系确定的。所有IDIs和FGD的录音，转录和分析使用content analysis.Results：我们确定了大量的抗生素供应商在当地的监管要求的广泛侵犯。注意到供应商和消费者在毒品交易中建立了互惠关系，消费者信任供应商提供的知识和服务。此外，抗生素的使用已成为一种习惯性的选择，在大多数疾病的条件下，驱动的供应商和consumers.Conclusions：本研究提出了一个分析的做法，抗生素的访问和使用在越南农村环境。它强调了社区中抗生素供应商和消费者之间的互动，并确定了可能的干预目标。
Background: As in many other low and middle income countries (LIMCs), Vietnam has experienced a major growth in the pharmaceutical industry, with large numbers of pharmacies and drug stores, and increasing drug expenditure per capita over the past decade. Despite regulatory frameworks that have been introduced to control the dispensing and use of prescription-only drugs, including antibiotics, compliance has been reported to be strikingly low particularly in rural parts of Vietnam. This qualitative study aimed to understand antibiotic access and use practices in the community from both supplier and consumer perspectives in order to support the identification and development of future interventions.Methods: This qualitative study was part of a project on community antibiotic access and use (ABACUS) in six LMICs. The focus was Ba Vi district of Hanoi capital city, where we conducted 16 indepth interviews (IDIs) with drug suppliers, and 16 IDIs and 6 focus group discussions (FGDs) with community members. Drug suppliers were sampled based on mapping of all informal and formal antibiotic purchase or dispensing points in the study area. Community members were identified through local networks and relationships with the field collaborators. All IDIs and FGDs were audio-taped, transcribed and analysed using content analysis.Results: We identified a large number of antibiotic suppliers in the locality with widespread infringements of regulatory requirements. Established reciprocal relationships between suppliers and consumers in drug transactions were noted, as was the consumers' trust in the knowledge and services provided by the suppliers. In addition, antibiotic use has become a habitual choice in most illness conditions, driven by both suppliers and consumers.Conclusions: This study presents an analysis of the practices of antibiotic access and use in a rural Vietnamese setting. It highlights the interactions between antibiotic suppliers and consumers in the community and identifies possible targets for interventions.