Caring Under Constraints; A qualitative case study on health-seeking behaviour and the role of antibiotics among parents and caregivers in response to childhood illness in Nậm Ty, Vietnam

Sammanfattning

This qualitative case study explores the health-seeking behaviours (HSB) of parents and caregivers responding to childhood illness in Nậm Ty, a remote, rural commune in Vietnam’s northern highlands, focusing particularly on the role of antibiotics. Recognising antibiotic resistance (ABR) as a major global health threat that disproportionately affects vulnerable communities in low-and middle-income countries (LMICs), the study uses HSB as its analytical lens and the Social Ecological Model (SEM) as a structural framework to explore how contextual factors interplay to shape behaviour. Drawing on Traditional Knowledge and the Principle of Subsidiarity, it centers participants' perspectives and experiences. Empirical data were gathered through 24 semi-structured interviews, participant observations, and a Participatory Rural Appraisal (PRA) matrix-ranking exercise with ten caregivers. Findings reveal diverse, pragmatic HSB navigating traditional medicine, formal healthcare, and biomedicine, often based on perceived severity, past experience, and cultural beliefs. Limited trust in the communal health station (CHS) due to perceived resource constraints and frequent referrals drive many to private and informal suppliers. National policies on prescription-only antibiotics and ABR awareness campaigns are not meaningfully trickled down to the community level. The study concluded that HSB and antibiotic use (ABU) are complex, non-linear processes shaped by factors across all SEM levels. Effective interventions tackling ABR must be context-sensitive, culturally informed, engage communities, and address systemic constraints, rather than solely focusing on individual behaviour.