"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.

Nayiga, Susan, MacPherson, Eleanor E, Mankhomwa, John, Nasuwa, Fortunata, Pongolani, Raymond, Kabuleta, Rita, Kesby, Mike, Dacombe, Russell, Hilton, Shona, Grace, Delia, Feasey, Nicholas ORCID: https://orcid.org/0000-0003-4041-1405 and Chandler, Clare I R (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, Vol 17, Issue 1, p. 2322839.

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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:	Article
Uncontrolled Keywords:	NOT_LSTM
Subjects:	QW Microbiology and Immunology > QW 45 Microbial drug resistance. General or not elsewhere classified. WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Administration and Organization > WA 540 National and state health administration
Faculty: Department:	Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI):	https://doi.org/10.1080/16549716.2024.2322839
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	14 Mar 2024 15:34
Last Modified:	01 Nov 2024 10:07
URI:	https://archive.lstmed.ac.uk/id/eprint/24193

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