Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study

Enid Kawala Kagoya; Kathleen Van Royen; Paul Waako; Paul Van Royen; Jacob Stanley Iramiot; Samuel Baker Obakiro; Tomislav Kostyanev; Sibyl Anthierens

doi:10.1016/j.jgar.2021.02.019

Experiences and views of healthcare professionals on the prescription of antibiotics in Eastern Uganda: A qualitative study

J Glob Antimicrob Resist. 2021 Jun:25:66-71. doi: 10.1016/j.jgar.2021.02.019. Epub 2021 Mar 2.

Authors

Enid Kawala Kagoya¹, Kathleen Van Royen², Paul Waako³, Paul Van Royen⁴, Jacob Stanley Iramiot⁵, Samuel Baker Obakiro³, Tomislav Kostyanev⁶, Sibyl Anthierens⁴

Affiliations

¹ Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Uganda. Electronic address: enidkawala@gmail.com.
² Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Department of Communication Studies, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium.
³ Department of Pharmacology and Therapeutics, Faculty of Health Sciences, Busitema University, Uganda.
⁴ Department of Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
⁵ Department of Microbiology and Immunology, Faculty of Health Sciences, Busitema University, Uganda.
⁶ Vaccine and Infectious Disease Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.

PMID: 33667701
DOI: 10.1016/j.jgar.2021.02.019

Abstract

Objectives: This study aimed to explore the experiences and views of healthcare professionals on antibiotic prescription in Eastern Uganda.

Methods: This was an exploratory qualitative study using semi-structured interviews. Participants included 16 healthcare professionals from Mbale and Soroti Regional Referral Hospitals. Additionally, two workshops were held (one in each hospital) with a total of 56 healthcare professionals to discuss the findings. Thematic analysis was used to analyse the data.

Results: Healthcare professionals' prescriptions are influenced by (i) healthcare workers' perceptions and practices, (ii) patients' perceptions and beliefs, and (iii) contextual factors. Healthcare workers' prescriptions depend on the presence of bacterial infection and the severity of the condition, the availability and cost of medication, previous experience with antibiotic prescribing, patient characteristics, and trial and error. They also have limited knowledge and share little information on the use of antibiotics with patients. Patient factors included demand for a particular antibiotic, inability to afford expensive drugs, and limited knowledge about antibiotic use and resistance. Contextual factors that contributed to antibiotic prescribing were an overburdened healthcare system, the influence of pharmaceutical companies and pharmacies, the use of (treatment) guidelines, and difficulties with laboratory services.

Conclusion: This study showed that healthcare professionals are aware of the problem of antibiotic resistance but do not feel ownership of the problem. Instead, they rather blame the overburdened system, local drug shops, pharmacies, drug representatives and patients. There is a need for a multisectoral and holistic approach toward fighting antibiotic resistance.

Keywords: Antibiotic prescribing; Antimicrobial resistance; Healthcare professionals; Perceptions; Qualitative study; Uganda.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents* / therapeutic use
Delivery of Health Care
Health Knowledge, Attitudes, Practice*
Health Personnel
Humans
Uganda

Substances

Anti-Bacterial Agents