Governance to address health systems pitfalls of antibiotics overuse in low- and middle-income countries

Excerpt

Over the last decades, health systems, including those in low- and middle-income countries (LMICs), experienced a sharp trend of increased use of antibiotics (Laxminarayan et al. 2013). The surge in antimicrobial drugs consumption in LMICs is a result of both patient factors like culture, lack of health education, awareness or income and health systems factors like increasing availability of drugs on public, private, legal and illegal markets, inefficient regulation of prescription practices and incentive schemes that favour over-prescription (Radyowijati and Haak 2003). Each problem exacerbates the other, forming a vicious feedback loop. Whilst health benefits and risks associated with overuse of antibiotics (like antimicrobial resistance) are well documented (Laxminarayan et al. 2013), we often fail to consider the role of the health system. …