Acceptability of laws and regulations restricting over-the-counter selling of antibiotics among community pharmacists in Kinondoni municipal, Dar es salaam

Abstract

ABSTRACT Introduction: The world is faced with a major problem of antimicrobial resistance. Over-the counter (OTC) selling of antibiotics is one of the factors fueling the irrational use of antibiotics due to easy access. Despite present laws and regulations restricts, over-the-counter selling of antibiotics is still common in community pharmacies. There were no comprehensive information on the acceptability of implementation of these laws and regulations from community pharmacist perspectives in Tanzania. Objective: This study aimed to comprehensively explore the acceptability of laws and regulations restricting over-the-counter selling of antibiotics from the perspectives of community pharmacists in Dar es Salaam. Materials and method: An explorative case study design focusing on community pharmacists was conducted in Kinondoni municipality. A total of 15 in depth interviews with community pharmacists and 5 key informant interviews with inspectors from the Pharmacy council of Tanzania were conducted. Carefully prepared and pre-tested interview guides were used to collect data on affective attitudes, perception of burden and self-efficacy of community pharmacists on laws and regulations restricting OTC selling of antibiotics. A thematic analysis approach was used to analyze data. Findings: Attitudes and perception towards laws, professional and moral values, perception of burden, professional confidence and autonomy in dispensing were identified as key areas associated with decision to comply and acceptance of laws and regulations. Findings revealed that community pharmacists understand the importance of these regulations in preventing misuse and professional misconduct. Despite this, deliberate non-compliance occurred, driven by factors such as customer demand, business pressures, and moral dilemmas. Community pharmacists reported a positive attitude towards compliance, appreciating the professional safeguards the laws provide. However, the acceptance of these regulations was mixed, with most pharmacists noting negative business impacts. Conflicts arose between adherence to regulations vi and personal morals, especially when customers were in urgent need or unable to afford prescriptions. Conclusion: Overall, the study highlights the need for increased awareness efforts, to balancing professional values, business viability, and public health. This study highlights requirements of collaborative efforts in addressing economic pressure, burden viewed by community pharmacists and therefore enhancing adherence to restriction and promoting responsible antibiotic use. Recommendations: There is a need for regulators to consider economic realities associated with adherence which will ensure professional conduct and business sustainability of community pharmacies while protecting public health. Furthermore, deliberate efforts by the Pharmacy Council of Tanzania along with other regulators, should be made to increase awareness on rational use of antibiotics at community level combined with improving accessibility and quality of health services to reduce customer demand in community pharmacies.