ArticleBMJ global health2019
Invisible medicine sellers and their use of antibiotics: a qualitative study in Cambodia.
Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Physicians', pharmacists', and nurses' education of patients about antibiotic use and antimicrobial resistance in primary care settings: a qualitative systematic literature review.Frontiers in antibiotics · 2024Pooled it
- Barriers and facilitators of implementing interventions to improve appropriate antibiotic use in low- and middle-income countries: a systematic review based on the Consolidated Framework for Implementation Research.Implementation science : IS · 2022Pooled it
- Improving antibiotic use through behaviour change: a systematic review of interventions evaluated in low- and middle-income countries.Health policy and planning · 2021Pooled it
- Antibiotic dispensing practices and determinants among informal healthcare providers in low- and middle-income countries: a mixed-methods scoping review.BMJ global health · 2026Article
- Expectations Shaped Elsewhere: Refugee Experiences of Healthcare in Aotearoa New Zealand.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Strengthening healthcare systems to prevent antimicrobial resistance in LMICs: it is time to act.Journal of global health · 2026Article
- They don't want to close Roxy: a qualitative account on the perceived efforts by Ivory Coast to end the informal market for medicines.Health policy OPEN · 2025Article
- Burden of multi-drug-resistant organisms in a tertiary healthcare institute in North India: Implications for regional public health.World journal of experimental medicine · 2025Article
- Challenges and opportunities for AMR research in the ASEAN following the One Health approach.One health (Amsterdam, Netherlands) · 2025Article
- Patterns and factors associated with healthcare utilisation in Cambodia: a cross-sectional study based on the World Health Survey Plus 2023.BMJ public health · 2025Article
- Identification, mapping, and self-reported practice patterns of village doctors in Sitakunda subdistrict, Bangladesh.Journal of global health · 2024Article
- Drug providers' perspectives on antibiotic misuse practices in eastern Ethiopia: a qualitative study.BMJ open · 2024Article
- Inappropriate antibiotic access practices at the community level in Eastern Ethiopia.Scientific reports · 2024Article
- Multidrug-Resistant Sepsis: A Critical Healthcare Challenge.Antibiotics (Basel, Switzerland) · 2024Review
- Understanding networks in rural Cambodian farming communities and how they influence antibiotic use: A mixed methods study.PLOS global public health · 2023Article
- Crossover-Use of Human Antibiotics in Livestock in Agricultural Communities: A Qualitative Cross-Country Comparison between Uganda, Tanzania and India.Antibiotics (Basel, Switzerland) · 2022Article
- Perspectives on the Ethics of Antibiotic Overuse and on the Implementation of (New) Antibiotics.Infectious diseases and therapy · 2022Article
- How conflicts of interest hinder effective regulation of healthcare: an analysis of antimicrobial use regulation in Cambodia, Indonesia and Pakistan.BMJ global health · 2022Article
- Availability, Prices and Affordability of Antibiotics Stocked by Informal Providers in Rural India: A Cross-Sectional Survey.Antibiotics (Basel, Switzerland) · 2022Article
- Global antibiotic consumption and usage in humans, 2000-18: a spatial modelling study.The Lancet. Planetary health · 2021Article
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12 authors.
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Abstract
backgroundGlobal attention to antimicrobial resistance has increased interest in tackling the widespread inappropriate dispensing of antibiotics by informal, for-profit healthcare providers (HCPs). We provide new evidence on an understudied group of informal HCPs: invisible medicine sellers (IMS) who operate without any marked facility. We investigated factors that influence community decisions on which HCPs to purchase medicines from, focusing on reasons for using IMS, and compared different HCPs' knowledge of antibiotic use.
methodsWe conducted community focus group discussions (FGDs) in seven purposively selected villages representing high and low informal HCPs use in two peri-urban districts in Phnom Penh, Cambodia. Using information from the FGDs to identify HCPs that sell medicines, we interviewed 35 participants: 21 HCPs (including five IMS) and 14 key informants, including government HCPs and village leaders. We adopted an interpretative approach and conducted a thematic analysis.
resultsCommunity members typically knew of several formal and informal HCPs selling medicines nearby, and IMS were common, as were doctors that sell medicines covertly. Two factors were most salient in influencing the choice of HCP for medicine purchasing. The first was trust in the effectiveness of medicines provided, judged by the speed of symptomatic relief. This pushed HCPs to provide several medicines, including antibiotics, at the first consultation. The second was the convenience offered by IMS and other informal HCPs: supplying medicines when other facilities are closed, accepting delayed payments, providing incomplete courses of medication and selling human antibiotics for animal use.
conclusionThis first study focusing on IMS indicates that it is important, but challenging, for public health agencies to engage with them to reduce inappropriate use of antibiotics. Although public health facilities must fill some gaps that informal HCPs are currently addressing, such as access to medicines at night, reducing demand for unnecessary antibiotics is also critical.
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