Poor and non-poor gaps in antibiotic misuse in Indonesia: A Blinder-Oaxaca decomposition analysis

Problem considered

Antibiotic misuse is a significant public health concern. Moreover, the gap between poor and non-poor groups in Indonesia remains understudied. Identifying the factors contributing to this disparity is key for effective intervention strategies. This study aims to quantify the contributing factors explaining the gap in antibiotic misuse between the poor and the non-poor in Indonesia.

Methods

We used data from the 2023 Indonesia Health Survey, which included 446,605 individuals aged 15 years and older in Indonesia. The main effect was antibiotic misuse—buying medications without a prescription from practitioners. Poor and non-poor gaps in antibiotic misuse determinants were examined using Blinder–Oaxaca decomposition, which separates differences between groups into those explained by observed factors and those unexplained by them.

Results

The gap of antibiotic misuse between poor and non-poor groups was 6.0 percentage points (p < 0.001). The between-group differences in the predictors of study participants (endowments) contributed 0.051 (85.0 %) to the gap, whereas the between-group differences in effects of the predictors (coefficients) contributed 0.009 (15.0 %) towards the gap. The predictors that contributed most towards the gap due to endowments (explained component) were household economic status, knowledge of antibiotic use, antibiotic procurement source, region, and insurance ownership, and due to coefficients were place of residence, insurance ownership, drug literacy, knowledge of antibiotic use, and region.

Conclusion

Endowments like economic status and antibiotic knowledge explain much of the antibiotic usage discrepancy between poor and non-poor groups. Economic, health education, and healthcare interventions may narrow this gap.