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April 14, 2026Medical Anthropology0 citations

“Making One’s Own Doctor” :“ Épicerie medicine ” and the Informal Circulation of Antibiotics in Northern Madagascar

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MBMingyuan Zhang BetancourtUniversity of Oslo

Key Points

  • The aim is to investigate the informal circulation of antibiotics and patterns of use in northern Madagascar.
  • Examine the role of small grocery kiosks in providing antibiotics
  • Analyze local healthcare coverage and health practices
  • Discuss implications for antimicrobial resistance
  • Informal antibiotic circulation leads to unregulated usage.
  • Improvised health solutions stem from inadequate healthcare coverage.
  • Local patterns of use reflect urgent health needs despite long-term AMR threats.

Abstract

People in Madagascar often resort to small grocery kiosks (épicerie) for various Western medicines including antibiotics - they call the practice "magnano docteur tegna" ("making one's own doctor"). Creating an unregulated antibiotic market, the practice is detrimental to the fight against antimicrobial resistance (AMR). This article explores the informal circulation of antibiotics in northern Madagascar and the local patterns of antibiotic use. I argue that the lack of healthcare coverage is the key reason for improvised health solutions. There is a discrepancy between the long-term threat of AMR and the most urgent need of people living in precarity.

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Cite This Study

Mingyuan Zhang Betancourt (2026) studied this question.

synapsesocial.com/papers/69ddd8eee195c95cdefd66fahttps://doi.org/10.1080/01459740.2026.2656931
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