Knowing when but not how! - Mothers' perceptions and use of antibiotics ina rural area of Viet Nam

Given the world-wide focus on how to rationally use antibiotics, national d rug policy programmes have been developed in many countries in order to min imize the environmental antibiotic pressure and thereby hopefully limit inc reasing bacterial resistance. This study investigated perceptions of antibi otics in a health system with weak drug regulation. The study was conducted in two rural communes in Viet Nam, with a drug market characterized by the increased accessibility and consumption of pharmaceuticals. The study focu sed on rural mothers' perceptions and use of antibiotics in the treatment o f acute respiratory infections (ARI) in children 5 years and under. A combi nation of qualitative and quantitative methods were used including key info rmant interviews, focus group discussions, and interviews with mothers and drug vendors. The study demonstrated that using a combination of qualitative and quantita tive methods gives a better understanding of the prevailing perceptions and use of antibiotics in communities. The results showed that the mothers recognized well the signs of severe ARI and that antibiotics were reserved for more severe illness episodes, where penicillin V and ampicillin were first drugs of choice. However, the mothe rs' perceptions and use of antibiotics reflects indigenization of antibioti cs into traditional Vietnamese thinking and medical practice. This resulted in self-medication and a respect for antibiotics from the mothers point of view. A first step towards the rational use of antibiotics is already taken where mothers, as the health decisionmaker, know when to initiate antibiotic tre atment and try to limit unnecessary use of antibiotics. The next step is to develop a well-functioning health education programme in order to promote the correct use of antibiotics for a successful clinical outcome. This requ ires acknowledgement of the mothers' culture based behaviour.