Comprehensive Summary
This study explores how medical doctors in Nigeria perceive antibiotic self-medication by pregnant women, and what emotional tones (sentiments) they express about this issue. The researchers interviewed 25 obstetrics & gynecology physicians from three tertiary hospitals, using semi-structured interviews, then analyzed the transcripts thematically, and also applied sentiment analysis (using a pretrained model) to classify lines of text as positive, negative, or neutral. They identified seven main themes, divided into doctor views on antibiotic treatment (e.g. prescribing practices, side effects, easy access to antibiotics), patient behaviours (use of herbal medicines, motivations, family/friend influence), and clinical practice guideline issues (lack of specific policies for self-medication). In the sentiment analysis, they found that around 77.7% of statements were labelled neutral, around 12% negative, and 10.3% positive; this neutral majority was significantly above what would be expected by chance. In the discussion, the authors highlight that though doctors are aware self-medication is common and pose risks (especially via herbal medicines and non-prescribed antibiotics), many felt there was insufficient urgency or policy clarity, and expressed the need for tailored guidelines and tools for detection and monitoring.
Outcomes and Implications
This work is important because self-medication (including over-the-counter antibiotics and herbal treatments) during pregnancy carries risks for both mother and fetus (e.g. birth defects, interactions, toxicity), and because physicians’ attitudes and local policies shape how such practices are addressed. Clinically, it suggests gaps: doctors lack specific, locally relevant guidelines for managing or preventing self-medication, and routine detection is weak (often reliant on patient history, which may be under-disclosed). The findings imply that to improve maternal and neonatal safety in LMICs, there is need for development and implementation of context-appropriate policies, training for providers, and affordable point-of-care tools for detecting self-medication. While some recommendations could be enacted in the short to medium term (training, guideline development), others (e.g. monitoring tools, regulatory changes) may take longer, particularly given resource constraints and cultural practices; the authors emphasize that incorporating physician concerns and sentiments will help in crafting more acceptable and effective interventions.