Self-medication under Uncertainty: Consumer Beliefs about Drug Quality in Burkina Faso

In many countries, access to affordable, quality-assured, and effective medicine is constrained by inadequate regulation, poor supply chain management, and weak gatekeeping, resulting in the proliferation of substandard or falsified (SF) products. In the absence of access to quality health care and with drugs available over-the-counter (OTC, without prescription), consumers often resort to self-medication to a range of health problems. Self-medication is associated with an overuse of antibiotics, which in turn is a driver of the spread of antimicrobial resistant (AMR) bacteria. In this study, we aim to better understand self-medication with antibiotics in a low-income setting. The study is conducted in Ouagadougou, the capital of Burkina Faso. It covers 400 households across six randomly selected neighborhoods (arrondissements). We conduct experiments on the extent to which consumers are aware of the risk of poor-quality antibiotics in the market, the extent to which they are able to infer quality, and the extent to which decisions regarding self-medication are influenced by the probability of low-quality quality drugs circulating in the market. We complement our study with data from laboratory testing of antibiotics.