Experiences of antibiotic use and healthcare access among migrants to the UK: a qualitative study

Abstract Background In recent years, migration to and within Europe has increased. Human mobility has been hypothesised as a contributing factor towards antimicrobial resistance (AMR). However, there is limited evidence to explain how migration contributes towards antibiotic resistance. More qualita...

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Main Authors: Luisa Silva, Amani Al-Oraibi, Shajwan Nanakali, Mayuri Gogoi, Osama Hassan, Isra Al-Sharabi, Pankhuri Sahare, Manish Pareek, Irtiza Qureshi, Laura B. Nellums
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22384-1
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author Luisa Silva
Amani Al-Oraibi
Shajwan Nanakali
Mayuri Gogoi
Osama Hassan
Isra Al-Sharabi
Pankhuri Sahare
Manish Pareek
Irtiza Qureshi
Laura B. Nellums
author_facet Luisa Silva
Amani Al-Oraibi
Shajwan Nanakali
Mayuri Gogoi
Osama Hassan
Isra Al-Sharabi
Pankhuri Sahare
Manish Pareek
Irtiza Qureshi
Laura B. Nellums
author_sort Luisa Silva
collection DOAJ
description Abstract Background In recent years, migration to and within Europe has increased. Human mobility has been hypothesised as a contributing factor towards antimicrobial resistance (AMR). However, there is limited evidence to explain how migration contributes towards antibiotic resistance. More qualitative research regarding migrants’ perspectives of antibiotic use is needed to understand this complex interaction. The aim of this study was to explore experiences of antibiotic use and healthcare access among migrants in the UK, and how this might influence the risk of AMR. Methods Adult migrants were purposively recruited through community organisations, collaborators, online platforms and snowball sampling representing different migrant statuses, countries of origin and ethnicities. Semi-structured interviews were conducted online, by phone or face-to-face, in participants’ preferred languages, between March and July 2022 exploring antibiotic use and healthcare access. Data were analysed thematically and the study was informed by a Project Advisory Committee, with members from Doctors of the World and professionals who were previously refugees or asylum seekers. Results Twenty-seven migrants (17 males and 10 females), aged 21–60, from 17 different countries were interviewed. Four main themes were generated: 1) Uncharted territory: navigating a new healthcare system (sub-themes (a) access to care during journey, (b) difficult access to healthcare in the UK and (c) comparison between different healthcare systems); 2) Preserving the sense of agency and decision-making around antibiotic use, 3) Self-perpetuating cycle (sub-themes - (a) co-infections; (b) using alarming symptoms or “red-flags” and (c) taking antibiotics due to previous similar symptoms or persisting symptoms), and 4) The fragile state of the patient-doctor relationship. Conclusions These findings give useful insight into barriers faced by migrants when trying to access healthcare services both en route and after arriving in the UK, as well as their attitudes and behaviours in relation to antibiotics. Results also shed light on the complexity of factors contributing to health-seeking behaviour and antibiotic use, and how these may vary depending on previous experiences. We discuss implications for future research and practice, and how current policies may need to evolve to better support and reduce possible risk factors for AMR in migrant communities.
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spelling doaj-art-fa5fd6f2b7f4459ca9b6fc559f50e7d62025-08-20T03:07:54ZengBMCBMC Public Health1471-24582025-05-0125111110.1186/s12889-025-22384-1Experiences of antibiotic use and healthcare access among migrants to the UK: a qualitative studyLuisa Silva0Amani Al-Oraibi1Shajwan Nanakali2Mayuri Gogoi3Osama Hassan4Isra Al-Sharabi5Pankhuri Sahare6Manish Pareek7Irtiza Qureshi8Laura B. Nellums9Lifeorgdivision and Population Health, School of Medicine, University of NottinghamLifeorgdivision and Population Health, School of Medicine, University of NottinghamLifeorgdivision and Population Health, School of Medicine, University of NottinghamDepartment of Respiratory Sciences, University of LeicesterLifeorgdivision and Population Health, School of Medicine, University of NottinghamDoctors of the WorldLifeorgdivision and Population Health, School of Medicine, University of NottinghamDepartment of Respiratory Sciences, University of LeicesterLifeorgdivision and Population Health, School of Medicine, University of NottinghamLifeorgdivision and Population Health, School of Medicine, University of NottinghamAbstract Background In recent years, migration to and within Europe has increased. Human mobility has been hypothesised as a contributing factor towards antimicrobial resistance (AMR). However, there is limited evidence to explain how migration contributes towards antibiotic resistance. More qualitative research regarding migrants’ perspectives of antibiotic use is needed to understand this complex interaction. The aim of this study was to explore experiences of antibiotic use and healthcare access among migrants in the UK, and how this might influence the risk of AMR. Methods Adult migrants were purposively recruited through community organisations, collaborators, online platforms and snowball sampling representing different migrant statuses, countries of origin and ethnicities. Semi-structured interviews were conducted online, by phone or face-to-face, in participants’ preferred languages, between March and July 2022 exploring antibiotic use and healthcare access. Data were analysed thematically and the study was informed by a Project Advisory Committee, with members from Doctors of the World and professionals who were previously refugees or asylum seekers. Results Twenty-seven migrants (17 males and 10 females), aged 21–60, from 17 different countries were interviewed. Four main themes were generated: 1) Uncharted territory: navigating a new healthcare system (sub-themes (a) access to care during journey, (b) difficult access to healthcare in the UK and (c) comparison between different healthcare systems); 2) Preserving the sense of agency and decision-making around antibiotic use, 3) Self-perpetuating cycle (sub-themes - (a) co-infections; (b) using alarming symptoms or “red-flags” and (c) taking antibiotics due to previous similar symptoms or persisting symptoms), and 4) The fragile state of the patient-doctor relationship. Conclusions These findings give useful insight into barriers faced by migrants when trying to access healthcare services both en route and after arriving in the UK, as well as their attitudes and behaviours in relation to antibiotics. Results also shed light on the complexity of factors contributing to health-seeking behaviour and antibiotic use, and how these may vary depending on previous experiences. We discuss implications for future research and practice, and how current policies may need to evolve to better support and reduce possible risk factors for AMR in migrant communities.https://doi.org/10.1186/s12889-025-22384-1Migrant healthGlobal healthAntibiotic knowledgeAntibiotic useAntimicrobial resistanceQualitative research
spellingShingle Luisa Silva
Amani Al-Oraibi
Shajwan Nanakali
Mayuri Gogoi
Osama Hassan
Isra Al-Sharabi
Pankhuri Sahare
Manish Pareek
Irtiza Qureshi
Laura B. Nellums
Experiences of antibiotic use and healthcare access among migrants to the UK: a qualitative study
BMC Public Health
Migrant health
Global health
Antibiotic knowledge
Antibiotic use
Antimicrobial resistance
Qualitative research
title Experiences of antibiotic use and healthcare access among migrants to the UK: a qualitative study
title_full Experiences of antibiotic use and healthcare access among migrants to the UK: a qualitative study
title_fullStr Experiences of antibiotic use and healthcare access among migrants to the UK: a qualitative study
title_full_unstemmed Experiences of antibiotic use and healthcare access among migrants to the UK: a qualitative study
title_short Experiences of antibiotic use and healthcare access among migrants to the UK: a qualitative study
title_sort experiences of antibiotic use and healthcare access among migrants to the uk a qualitative study
topic Migrant health
Global health
Antibiotic knowledge
Antibiotic use
Antimicrobial resistance
Qualitative research
url https://doi.org/10.1186/s12889-025-22384-1
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