Informal over-the-counter supply of antibiotics in Ghana - A qualitative analysis of practices in community pharmacies

Sep 29, 2026

Exploratory qualitative research examines the informal over-the-counter supply of antibiotics within community pharmacies across Ghana. Despite established regulatory frameworks for antibiotic access and supply, weak enforcement has enabled non-prescription access and frequent self-medication. Semi-structured interviews with randomly recruited pharmacy practitioners across rural, peri-urban, and urban communities were analyzed thematically using NVivo. Findings identify economic incentives, sales targets, and customer social pressure as key drivers, alongside limited public education and restricted awareness of national antimicrobial policies. Policy-relevant community-tailored strategies are recommended.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Background

Objective

Method

Results

Conclusion

Exploratory Research in Clinical and Social Pharmacy 21 (2026) 100696 Contents lists available at ScienceDirect Exploratory Research in Clinical and Social Pharmacy journal [homepage:](homepage: www.elsevier.com/locate/rcsop)[ www.elsevier.com/locate/rcsop](homepage: www.elsevier.com/locate/rcsop) | Informal over-the-counter supply of antibiotics in Ghana: A qualitative analysis of practices in community pharmacies
Radolf Ansbert Norteya,*,1, Irene Akwo Kretchyb,2, Mercy Naa Aduele Opare-Addoa
a Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Private Mail Bag, University Post Office, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
b Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, P.O. Box LG 43, Legon, Accra, Ghana | | | --- | --- | | A R T I C L E I N F O
Keywords: Antibiotics
Regulations Supply Pharmacy Policy Resistance Ghana | A B S T R A C T
Background: Antibiotics are among the most widely prescribed medicines and fall within a well-defined framework for access and supply. Despite existing regulatory systems for antibiotic control, weak regulatory enforcement has led to non-prescription access from community drug retail outlets and widespread selfmedication with antibiotics.
Objective: To explore the factors associated with the over-the-counter supply of antibiotics within community pharmacies across Ghana.
Method: The exploratory qualitative study employed semi-structured interviews. The study population consisted of pharmacy practitioners randomly recruited from the medicine retail outlets situated in rural, peri-urban, and urban communities in Ghana. The interview questions were organised within the framework of the theory of planned behaviour and investigated participants’ attitudes, social norms, and perceived control over antibiotic use. The data was transcribed, coded, and thematically analysed using NVivo version 10.
Results: Twenty-three pharmacy practitioners (i.e., pharmacists, pharmacy technicians, and medicine counter assistants) participated in the study. Participants described how economic incentives, sales targets, and the perceived social status of customers often pressured them to supply antibiotics without prescriptions, especially in an environment where regulatory oversight was viewed as weak or absent. Many noted that customers felt increasingly entitled to request antibiotics, drawing confidence from online health information and limited public education. Although the participants knew about antibiotics and antimicrobial resistance, their awareness of existing national antimicrobial policies was limited.
Conclusion: The over-the-counter supply of antibiotics in Ghana is fuelled by various factors that differ slightly along the lines of community urbanisation and development. Policy makers must take full cognisance of these factors and adopt community-tailored strategies that target medicine retailers. | 1. Background Antibiotics are generally classified as prescription medicines and fall within a well-defined framework for access and supply.1 Around the world, antibiotics remain among the most frequently prescribed medications.2 The increasing rate of antibiotic consumption has been attributed to multiple factors, including economic growth and an unwarranted ease of access.3 This situation has been linked to the increasing rate of antimicrobial resistance (AMR), which is a major public health concern worldwide.4–6 To effectively combat antimicrobial resistance, it is essential to address both global and industry-wide strategies as well as the specific practices contributing to the problem. Although the emergence of AMRis multifactorial and a natural phenomenon, the misuse and overuse of antibiotics play significant roles in accelerating this process of resistance.7 This inappropriate use of antibiotics is typically associated with Abbreviations: AMR, An

FAQs

What was the study’s objective in Ghana?

To explore factors associated with the over-the-counter supply of antibiotics within community pharmacies across Ghana.

How was data collected and analyzed?

Through exploratory qualitative semi-structured interviews with pharmacy practitioners from rural, peri-urban, and urban medicine retail outlets, followed by transcription, coding, and thematic analysis using NVivo version 10.

What factors drove practitioners to supply antibiotics without prescriptions?

Economic incentives, sales targets, and perceived social pressure from customers, particularly where regulatory oversight was viewed as weak or absent.

Sep 29, 2026

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