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Social factors influencing the acquisition of antibiotics without prescription in Kerala State, south India

Author

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  • Saradamma, Rema Devi
  • Higginbotham, Nick
  • Nichter, Mark

Abstract

We investigated the magnitude of self-medication with antibiotics in a peri-urban area of Southern Kerala State, India and factors influencing this practice. First, a random sample of 400 households was surveyed in one primary health centre area near Trivandrum. We found 69.3% (95% CI=64.8-73.8) of households had at least one person using a pharmaceutical product during the two-week recall period; antibiotics formed almost 11% of the medicines consumed. Next, pharmacy based interview and observation data were collected from 405 antibiotic purchasers sampled from 11 out of the 12 private pharmacies in the area. Seventy-three of these 405 customers purchased antibiotics without a prescription (18%; 95% CI=14.3-21.7). By combining the household survey and pharmacy observations, we estimate that almost half of 1% (0.41%; 95% CI=0.24-1.16) of the population, or four people per 1000, is engaged in self-medication using antibiotics in Kerala in any two-week period. Our data show that people least likely to follow this practice are from higher income families, having more education and higher status occupations and receiving the benefits of medical insurance. Conversely, logistic regression analysis indicated that risk of buying antibiotics without a script was associated with education at secondary level or below, the perception that it is expensive to consult a doctor and low satisfaction with medical practitioners. Keralites' self-medication patterns are interpreted broadly using social, cultural, historical and economic perspectives. Solutions to the problem of antibiotic misuse are suggested, proceeding on several fronts: among practitioners, suppliers and marketeers of medicines, and among the population of pharmaceutical consumers themselves.

Suggested Citation

  • Saradamma, Rema Devi & Higginbotham, Nick & Nichter, Mark, 2000. "Social factors influencing the acquisition of antibiotics without prescription in Kerala State, south India," Social Science & Medicine, Elsevier, vol. 50(6), pages 891-903, March.
  • Handle: RePEc:eee:socmed:v:50:y:2000:i:6:p:891-903
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    Citations

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    Cited by:

    1. Faden, Laura & Vialle-Valentin, Catherine & Ross-Degnan, Dennis & Wagner, Anita, 2011. "Active pharmaceutical management strategies of health insurance systems to improve cost-effective use of medicines in low- and middle-income countries: A systematic review of current evidence," Health Policy, Elsevier, vol. 100(2), pages 134-143.
    2. Schensul, Stephen L. & Mekki-Berrada, Abdelwahed & Nastasi, Bonnie & Saggurti, Niranjan & Verma, Ravi K., 2006. "Healing traditions and men's sexual health in Mumbai, India: The realities of practiced medicine in urban poor communities," Social Science & Medicine, Elsevier, vol. 62(11), pages 2774-2785, June.
    3. Lina Cheaito & Sophie Azizi & Nadine Saleh & Pascale Salameh, 2014. "Assessment of self-medication in population buying antibiotics in pharmacies: a pilot study from Beirut and its suburbs," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(2), pages 319-327, April.
    4. Das, Jishnu & Sanchez-Paramo, Carolina, 2003. "Short but not sweet - new evidence on short duration morbidities from India," Policy Research Working Paper Series 2971, The World Bank.

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