Knowledge, perceptions and practices of informal medicine vendors regarding over-the-counter distribution of antibiotics and antibiotic resistance in Nanoro District, Burkina Faso: An exploratory qualitative study

Objectives This study aimed to understand the knowledge possessed by informal medicine vendors regarding antibiotics and antibiotic resistance, identify the perceptions held by informal medicine vendors about antibiotics and their uses and examine the practices employed by informal medicine vendors in the sale and distribution of antibiotics. Design Exploratory qualitative study using semi-structured interviews and direct observations. Setting Markets and shops across 11 villages in the Nanoro health district, Burkina Faso. Participants 23 informal medicine vendors, aged between 25 and 55 years and with 8-30 years of experience, were recruited through snowball sampling in the Nanoro health district of Burkina Faso. Results Informal medicine vendors exhibited a limited understanding of antibiotics, often confusing them with other treatments and referring to them using local terminologies based on perceived use and effectiveness. Antibiotics were perceived as universal remedies, supported by therapeutic belief, empirical reasoning and community solidarity, with empirical diagnosis, approximate dosing and informal preparation techniques passed on through imitation. These findings emerged across themes including perceptions, symbolic attributes and sales practices. Conclusion Informal medicine vendors in rural Burkina Faso demonstrated limited understanding of antibiotics and antimicrobial resistance, with practices shaped by local beliefs and empirical experience. These findings underscore the need for context-sensitive interventions that include tailored education and regulatory engagement to improve antibiotic stewardship and mitigate the spread of resistance.