Dear Sophie Jullien,
Thank you so much for your message. It is wonderful to have your contribution as the lead author of the research [ https://www.hifa.org/dgroups-rss/unnecessary-hospitalisations-and-misuse... ]
I note in your complementary paper [ https://pubmed.ncbi.nlm.nih.gov/37141528/ ]: 'Raising awareness and improving health literacy in the Tajik and Romanian communities is needed: patients and caregivers often do not feel adequately cared for if no medication is prescribed by their doctors, pressuring them into prescribing antibiotics. Communities and parents must be informed about the self-limiting nature of many childhood diseases, the harm and side-effects of antibiotics, and their ineffectiveness against viral infections. Also, patients often consider hospital care as superior to PHC and little is known or recognised about the costs, risks, and potential harms of unnecessary hospitalisations and treatments.'
There is an issue here of a lack of understanding and poor availability and use of basic healthcare knowledge, including knowledge about the limitations and potential harm of antibiotics. Worldwide we see patients and families with limited understanding of antibiotics, pressuring health workers to prescribe them where they are at best ineffective and at worst harmful. What can be done to increase understanding, among both families and health workers?
As CHIFA member Massimo Serventi has pointed out, based on long clinical experience in Africa, one of the drivers to overprescribing is financial gain for the health worker and/or their health facility, related to dispensing services being linked to the facility. Is this a major problem in Tajikistan and other countries in the region?
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org
