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INVESTIGATING RATIONAL ANTIBIOTIC PRESCRIBING IN PUBLIC HEALTH CARE FACILITIES OF ZANZIBAR TANZANIA

  1. 1Mzumbe University - Dar es Salaam Campus

Abstract

This study aims at assessing the rational antibiotic medicines prescribing in public health care facilities in Zanzibar, Tanzania. The study employed a descriptive and cross-sectional study with a quantitative approach in collecting and analysing data. The study targeted all 30 health care facilities in the western urban region of Zanzibar together with all prescribers and prescriptions prescribed during the study period. Prescriptions were selected by using probability systematic sampling techniques from selected public health facilities.

The study found that, 3,455 (99.9%) recorded prescription encounters had a documented diagnosis, indicating comprehensive record-keeping. On average, 1.1 (SD= {+/-}0.3) antibiotics were prescribed per prescription encounter, with 2,277 (65.9%) prescribed generic names. Injectable antibiotics were recorded in 166 (4.8%) of prescriptions, while 2,270 (65.7%) of prescriptions adhered to the Zanzibar Standard Treatment Guidelines (STG). The overall mean knowledge score among prescribers was 6.1 (SD = 0.89). 24.3% of prescribers had low knowledge ([≤]5 points), 41.4%had medium knowledge (6 points), and 34.3%had high knowledge ([≥]7 points). A majority of prescribers (90%) reported that they always adhere to the Zanzibar Standard Treatment Guidelines (ZSTG) and Zanzibar Essential Medicines List (ZEML) when prescribing antibiotics. 1.4% of prescribers acknowledged that they sometimes prescribe antibiotics even when unnecessary. Regarding antibiotic selection, 45.7% of prescribers prescribe only generic antibiotics. The study also found that Beta-Lactam antibiotics were the most prescribed, with 98.6% of prescribers confirming their frequent use. According to the results, most of the prescribing indicators in these health facilities did not meet the WHOs standard requirements, thus irrational (poor rational prescribing).

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BibTeX
@misc{swalehe2026investigating,
  title = {{INVESTIGATING RATIONAL ANTIBIOTIC PRESCRIBING IN PUBLIC HEALTH CARE FACILITIES OF ZANZIBAR TANZANIA}},
  author = {O. Swalehe and M. Salum},
  howpublished = {medRxiv},
  year = {2026},
  month = sep,
  doi = {10.64898/2026.09.09.26362003},
  url = {https://www.medrxiv.org/content/10.64898/2026.09.09.26362003v1},
  note = {CC BY},
}
RIS
TY  - UNPB
TI  - INVESTIGATING RATIONAL ANTIBIOTIC PRESCRIBING IN PUBLIC HEALTH CARE FACILITIES OF ZANZIBAR TANZANIA
AU  - O. Swalehe
AU  - M. Salum
PY  - 2026
DA  - 2026/09/09
PB  - medRxiv
DO  - 10.64898/2026.09.09.26362003
UR  - https://www.medrxiv.org/content/10.64898/2026.09.09.26362003v1
AB  - This study aims at assessing the rational antibiotic medicines prescribing in public health care facilities in Zanzibar, Tanzania. The study employed a descriptive and cross-sectional study with a quantitative approach in collecting and analysing data. The study targeted all 30 health care facilities in the western urban region of Zanzibar together with all prescribers and prescriptions prescribed during the study period. Prescriptions were selected by using probability systematic sampling techniques from selected public health facilities.  The study found that, 3,455 (99.9%) recorded prescription encounters had a documented diagnosis, indicating comprehensive record-keeping. On average, 1.1 (SD= {+/-}0.3) antibiotics were prescribed per prescription encounter, with 2,277 (65.9%) prescribed generic names. Injectable antibiotics were recorded in 166 (4.8%) of prescriptions, while 2,270 (65.7%) of prescriptions adhered to the Zanzibar Standard Treatment Guidelines (STG). The overall mean knowledge score among prescribers was 6.1 (SD = 0.89). 24.3% of prescribers had low knowledge ([≤]5 points), 41.4%had medium knowledge (6 points), and 34.3%had high knowledge ([≥]7 points). A majority of prescribers (90%) reported that they always adhere to the Zanzibar Standard Treatment Guidelines (ZSTG) and Zanzibar Essential Medicines List (ZEML) when prescribing antibiotics. 1.4% of prescribers acknowledged that they sometimes prescribe antibiotics even when unnecessary. Regarding antibiotic selection, 45.7% of prescribers prescribe only generic antibiotics. The study also found that Beta-Lactam antibiotics were the most prescribed, with 98.6% of prescribers confirming their frequent use. According to the results, most of the prescribing indicators in these health facilities did not meet the WHOs standard requirements, thus irrational (poor rational prescribing).
ER  -