Why are antibiotics overprescribed? (8) Overprescription and poverty (3)

23 June, 2022

Dear Massimo, cc CHIFA

Thank you for your observations. You write:

"In countries where PEM (Protein Energy Malnutrition) both moderate and severe is widespread, mothers perceive that their children are not malnourished but sick. In fact diarrhoea, vomit and loss of appetite are often present, prompting them to jump from a clinic to another in search of pharmaceutical remedies that are prescribed as syrups of hematinics/probiotics/multivitamins and of course antibiotics. The maigre budget of the family is therefore spent for drugs instead of food, nutritious local food that would save the life of that child and his brothers-sisters."

What you describe is largely related to a lack of basic healthcare inforamtion among mothers (and the general population). Malnutrition is perceived by (some) mothers as a medical condition that requires drugs rather than nutritious food. This results in clinical consultations whereby the child ends up with an ineffective medicine and the mother ends up even less able to buy food. The mother expects a medicine and the health worker provides it (whether to meet the mother's demands or because they incorrectly think it may help or because they want to make a profit).

There is an important and tragic story here. Can you and others say a bit more, based on your long experience on the front line? Can you share examples, case studies, publications?

How can this story be improved? How can we edge towards a world where mothers (and health workers) have the information and knowledge they need to make better decisions about the care of a child with malnutrition?

Best wishes, Neil

Join CHIFA (child health and rights): http://www.hifa.org/joinchifa

Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org

Working in official relations with WHO