‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in Vietnam
Antimicrobial resistance is a major global and national health challenge, accelerated by ‘irrational’ antibiotic use. In response, Vietnam has been implementing a public health plan of antimicrobial stewardship since 2013 to reduce antibiotic sales in community pharmacies, although it has had limite...
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| Format: | Article |
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Taylor & Francis Group
2024-12-01
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| Series: | Critical Public Health |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/09581596.2024.2303421 |
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| author | Duy Trinh Hoang Shannon McKinn Dorothy Drabarek Thao Thu Trieu Van Thuy Pham Yen Ngoc Pham Thai Hung Cao Hung Mai Tran Greg J. Fox Thu-Anh Nguyen Sarah Bernays |
| author_facet | Duy Trinh Hoang Shannon McKinn Dorothy Drabarek Thao Thu Trieu Van Thuy Pham Yen Ngoc Pham Thai Hung Cao Hung Mai Tran Greg J. Fox Thu-Anh Nguyen Sarah Bernays |
| author_sort | Duy Trinh Hoang |
| collection | DOAJ |
| description | Antimicrobial resistance is a major global and national health challenge, accelerated by ‘irrational’ antibiotic use. In response, Vietnam has been implementing a public health plan of antimicrobial stewardship since 2013 to reduce antibiotic sales in community pharmacies, although it has had limited effect. Given that private pharmacies are increasingly the entry point to access healthcare, reflective of the inhibited accessibility of primary healthcare, understanding how the positioning of community pharmacists shapes the delivery of antimicrobial stewardship plans warrant further investigation. This qualitative analysis draws on data from 24 in-depth interviews with licensed community pharmacists in Vietnam. Interviewees described being constrained in rationing the sale of antibiotics by tensions within their professional role, in which the delivery of antimicrobial stewardship within their public health commitments rubs up against commercial and social obligations to their livelihoods and communities respectively. The concept of ‘resistance’ provides insight into what obstructs the integration of national antimicrobial stewardship guidance and policy, hindering the transformation of local practices concerning antibiotic sales at the community level. Findings reveal opportunities to recast community pharmacists as ‘productive anchors’ who can facilitate the appropriate use of antibiotics and strengthen links to primary care within the local context. Structural changes are needed, however, so that people do not use antibiotics as a proxy for health care. Improving the accessibility of primary healthcare would also curtail the reliance on community pharmacists’ to dispense antibiotics as a local mechanism of financial protection and social care within community. |
| format | Article |
| id | doaj-art-7c28cb7b08f549189d9e551047a88140 |
| institution | Kabale University |
| issn | 0958-1596 1469-3682 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Critical Public Health |
| spelling | doaj-art-7c28cb7b08f549189d9e551047a881402024-12-17T07:39:38ZengTaylor & Francis GroupCritical Public Health0958-15961469-36822024-12-0134111410.1080/09581596.2024.2303421‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in VietnamDuy Trinh Hoang0Shannon McKinn1Dorothy Drabarek2Thao Thu Trieu3Van Thuy Pham4Yen Ngoc Pham5Thai Hung Cao6Hung Mai Tran7Greg J. Fox8Thu-Anh Nguyen9Sarah Bernays10Qualiative research, Woolcock Institute of Medical Research, Ha Noi, Viet NamSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, AustraliaSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, AustraliaQualiative research, Woolcock Institute of Medical Research, Ha Noi, Viet NamDepartment of Clinical Pharmacology, Hanoi University of Pharmacy, Ha Noi, Viet NamQualiative research, Woolcock Institute of Medical Research, Ha Noi, Viet NamDepartment of Medical Service Administration, Ministry of Health, Ha Noi, Viet NamDepartment of Planning and International Cooperation, National Institute of Hygiene and Epidemiology, Ha Noi, Viet NamQualiative research, Woolcock Institute of Medical Research, Ha Noi, Viet NamQualiative research, Woolcock Institute of Medical Research, Ha Noi, Viet NamSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, AustraliaAntimicrobial resistance is a major global and national health challenge, accelerated by ‘irrational’ antibiotic use. In response, Vietnam has been implementing a public health plan of antimicrobial stewardship since 2013 to reduce antibiotic sales in community pharmacies, although it has had limited effect. Given that private pharmacies are increasingly the entry point to access healthcare, reflective of the inhibited accessibility of primary healthcare, understanding how the positioning of community pharmacists shapes the delivery of antimicrobial stewardship plans warrant further investigation. This qualitative analysis draws on data from 24 in-depth interviews with licensed community pharmacists in Vietnam. Interviewees described being constrained in rationing the sale of antibiotics by tensions within their professional role, in which the delivery of antimicrobial stewardship within their public health commitments rubs up against commercial and social obligations to their livelihoods and communities respectively. The concept of ‘resistance’ provides insight into what obstructs the integration of national antimicrobial stewardship guidance and policy, hindering the transformation of local practices concerning antibiotic sales at the community level. Findings reveal opportunities to recast community pharmacists as ‘productive anchors’ who can facilitate the appropriate use of antibiotics and strengthen links to primary care within the local context. Structural changes are needed, however, so that people do not use antibiotics as a proxy for health care. Improving the accessibility of primary healthcare would also curtail the reliance on community pharmacists’ to dispense antibiotics as a local mechanism of financial protection and social care within community.https://www.tandfonline.com/doi/10.1080/09581596.2024.2303421Antimicrobial resistance (ARM)antibioticsantimicrobial stewardship (AMS)Vietnamcommunity pharmacists |
| spellingShingle | Duy Trinh Hoang Shannon McKinn Dorothy Drabarek Thao Thu Trieu Van Thuy Pham Yen Ngoc Pham Thai Hung Cao Hung Mai Tran Greg J. Fox Thu-Anh Nguyen Sarah Bernays ‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in Vietnam Critical Public Health Antimicrobial resistance (ARM) antibiotics antimicrobial stewardship (AMS) Vietnam community pharmacists |
| title | ‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in Vietnam |
| title_full | ‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in Vietnam |
| title_fullStr | ‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in Vietnam |
| title_full_unstemmed | ‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in Vietnam |
| title_short | ‘When I tried to explain, they shouted back at me!’: exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in Vietnam |
| title_sort | when i tried to explain they shouted back at me exploring how community pharmacists navigate tensions implementing antimicrobial stewardship in vietnam |
| topic | Antimicrobial resistance (ARM) antibiotics antimicrobial stewardship (AMS) Vietnam community pharmacists |
| url | https://www.tandfonline.com/doi/10.1080/09581596.2024.2303421 |
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