Addressing Antimicrobial Resistance (AMR) and Self-medication Practice (SMP) in Developing Countries: A Field Experiment in Bangladesh
The World Health Organization (WHO) identifies antimicrobial resistance (AMR) as a gradually unfolding pandemic. In third-world countries, insufficient knowledge and awareness about the detrimental health impacts of antibiotics are widespread. Studies have indicated that in Bangladesh, numerous selectively chosen drugs have become ineffective due to antimicrobial resistance. In rural areas, village doctors, or "quacks", who often lack awareness about the harmful effects of antibiotics, are the predominant healthcare providers and a major source of antibiotic prescription. The logistical and financial challenges of accessing government hospitals or registered doctors lead individuals to purchase medicines from local shops without professional advice. Consequently, the routine over-the-counter purchase of commonly prescribed antibiotics persists in an effort to expedite recovery. Overall, addressing the AMR problem is significantly hampered by the general public's knowledge constraints and unawareness about the negative health impacts of antibiotics. This study introduces an innovative information intervention aiming to limit unnecessary antibiotic consumption by influencing the medication behavior of the populace in Bangladesh.
We formed a partnership with a Bangladeshi NGO and initiated a program focused on women's health and nutrition, targeting approximately 820 households across 38 villages in the Dinajpur District of Bangladesh. The program commenced in February 2023. In early October 2023, we conducted a baseline survey on the medication behaviors of the household members. Starting from November, households in the treatment group will receive information and have their transportation costs to local government facilities covered. Concurrently, a subgroup will receive boxes in which to store self-purchased medicines and any medications not prescribed by an MBBS doctor. These boxes serve as a visual reminder that consuming medicines from them may eventually render them ineffective. The setup facilitates our randomized experiment.
Funding Authority: Center for Social and Economic Behavior(C-SEB), University of Cologne.[Partial]
Ethical Approval: Ethics committee of the Faculty of Management, Economics and Social Sciences, University of Cologne.
RCT Registration No: Registered at AEA RCT Registry. RCT ID: AEARCTR-0011418
Local Partner: EHHD Foundation