Understanding antimicrobial use in subsistence farmers in Chikwawa District Malawi, implications for public awareness campaigns

• DOI: 10.1371/journal.pgph.0000314
• Publication Date: 2022-06-08T17:25:17Z
• Authors: Eleanor E. MacPhe...; Joanna Reynolds; Esnart Sanudi; Alexander Nkaombe; John Mankhomwa; Justin Dixon; Clare I. R. Chandler
• Keywords: Scarcity

Drug resistant infections are increasing across the world and urgent action is required to preserve current classes of antibiotics. Antibiotic use practices in low-and-middle-income countries have gained international attention, especially as antibiotics often accessed beyond formal health system. Public awareness campaigns popularity, conceptualising antimicrobial resistance (AMR) a problem excess, precipitated by irrational behaviour. Insufficient attention has been paid people’s lived experiences accessing medicines low-income contexts. In Chikwawa District, Malawi, place extreme scarcity, our study aimed understand care medicine households dependent on subsistence farming. Adopting an anthropological approach, we undertook interviews (100), ethnographic fieldwork (six-month period) key informant (33) with range participants two villages rural Chikwawa. The most frequently used drugs were cotrimoxazole amoxicillin, not considered be critical importance human health. Participants recognised that keeping, sharing, buying informally was “right thing.” However, they described using other these ways due conditions precarity, costs limitations seeking public sector, inevitability future illness. Our findings emphasise need contexts scarcity equip policy actors interventions address AMR through strengthening systems, rather than foreground overuse dangers sector.