ArticleGlobal health action2025
Irrational medicine use and its associated factors in conflict-affected areas in Mali: a cross-sectional study.
Article in Global health action, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Systemic challenges in the supply and distribution of medicines in conflict-affected areas of Mali: a qualitative study.Global health action · 2026Article
- Challenges and best practices in essential medicines supply and use in internally displaced persons (IDP) camps: A qualitative study.Exploratory research in clinical and social pharmacy · 2026Article
- Evaluation of Prescription Practices Using WHO/INRUD Indicators and Determinants of Polypharmacy at a Kenyan County Referral Hospital.Advances in pharmacological and pharmaceutical sciences · 2025Article
- Contextual constraints and dilemmas influencing health providers' prescription practices in a conflict-affected area: Qualitative insights from Mopti, Mali.PLOS global public health · 2025Article
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5 authors.
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Abstract
backgroundRational use of essential medicines is a critical step towards prevention and treatment of many illnesses. However, it represents a significant challenge worldwide, and particularly for under-resourced health systems in conflict-affected areas.
objectiveTo assess barriers to rational use of essential medicines at primary healthcare level in conflict-affected areas of Mali.
methodsWe conducted a cross-sectional study in twenty randomly selected community health centres (CHCs) in four health districts, by applying the World Health Organisation and International Network on Rational Use of Drugs core forms for the rational use of medicines. Seven hundred eighty-nine (789) prescriptions were retrospectively selected and analysed; four hundred forty-three (443) patients were interviewed: and health facility-related indicators were collected prospectively from the 20 CHCs.
resultsThe average number of medicines per prescription was 3.89 ± 1.83; out of these, 94.0% were prescribed by generic name, and 91.0% belonged to Mali's National List of Essential Medicines. Overall, 68% of the assessed prescriptions included antibiotics; 58% included injectables; and 75.79% were characterized by polypharmacy, i.e. more than two medicines per prescription. In multivariate analysis, the study area and prescriber's sex were significantly associated with polypharmacy; prescriber's seniority and training were associated with antibiotic overprescription; the study area, prescriber's sex and seniority were associated with overprescription of injectables. Moreover, the average price of prescriptions was high in relation to average local income, likely making these unaffordable for many households.
conclusionExcessive polypharmacy and overprescription of antibiotics and injectables undermine the performance of the local health system and the achievement of intended therapeutic outcomes. Our findings provide a solid basis for more targeted and multidisciplinary research, to further inform relevant stakeholders on how best to mitigate the impact of conflict on the rational use of medicines.
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