Drug use and self-medication among children with respiratory illness or diarrhea in a rural district in Vietnam: a qualitative study

Thi Hoan Le^1,2, Ellinor Ottosson³, Thi Kim Chuc Nguyen⁴, Bao Giang Kim⁵, Peter Allebeck^1
1Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden; ²Department of Environmental Health, Hanoi Medical University, Hanoi, Vietnam; ³Department of Medicine, Gothenburg University, Gothenburg, Sweden; ⁴Department of Family Medicine, Hanoi Medical University, Hanoi, Vietnam; ⁵Department of Health Education, Hanoi Medical University, Hanoi, Vietnam

Aims: To explore the knowledge, attitudes, and behaviors of parents in their use of drugs for respiratory illness or diarrhea among children under 5 years of age, and to understand factors influencing self-medication.
Methods: A qualitative study was conducted, using in-depth interviews with two drug sellers and three health care providers, and four focus-group discussions with mothers of children under 5 years of age. Verbatim transcriptions were analyzed, and emerging themes and categories identified, using content analysis.
Results: Use of a number of different drugs was reported, including broad-spectrum antibiotics and corticosteroids. There was poor awareness of side-effects, antibiotic resistance, and drug efficacy. Factors influencing self-medication were perceptions of the illness in the child, waiting time, and convenience, the attitudes of public health medical staff, insufficient drug supply in public health facilities, and poor control of prescribed drugs on the market.
Conclusion: Misuse and misconceptions regarding drug use gave rise to considerable problems. Mothers' knowledge and attitudes to illness and health care services played an important role in determining the nature of self-medication. Financial barriers were not the only obstacle to adequate treatment. Health services should be more accessible and responsive to the needs of the population.

Keywords: health services, parental attitudes, education