“Antibiotics heal all diseases”; the factors influencing the pratices of self-medication with antibiotics in Maputo City, Mozambique

Background Antibiotic consumption is the primary driver of antimicrobial resistance (AMR). The non-prescribed use for self-perceived diseases is one of the chief contributing factors to the unwise use of antibiotics as it paves the way to the development, growth, and spread of AMR. We aimed at describing the underlying factors influencing self-medication with antibiotics (SMA) in Maputo city, Mozambique. Methodology A qualitative cross sectional study was conducted between October 2018 and March 2019 with 32 participants. Using purposeful sampling, participants were recruited and interviewed after purchasing antibiotics without prescriptions from nine pharmacies in Maputo city. Out of 32 participants, 20 enrolled for individual in-depth interviews and 12 for focus group discussions that were audio-recorded, transcribed, coded, and analyzed using latent content analysis. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist by (Tong et al. Int J Qual Health Care 19:349–357, 2007 ) was performed. Results The participants declared recurrent practices of SMA to treat self-perceived illnesses. The private pharmacies were the main platform to access the non-prescribed antibiotics (NPA). The main factors driving the pratices of SMA were the easy availability of antibiotics, previous experience with antibiotics, easy access to pharmacist’s advice, long wait to access health care facilities, perceived poor quality of assistance at health care facilities, considering minor illness that do not need to seek professional health care, influencing role of the people from the social circle, cultural beliefs on the healing power of antibiotics, and time and financial constraints. Conclusion The practices of SMA are influenced by various factors that flow from the health care system, to the participant’s health-seeking behavior. These are reinforced by the public’s cultural belief that “antibiotics heal all diseases,” which determines the social representations of medicines shape the attitudes and behaviors of SMA. The culturally rooted behavior, the social representations of the health care system, and the therapeutic itineraries the public adopt are to be considered as having an ever-present effect on all different stages of the disease and healing process. Understanding the phenomenon of SMA to better address the promotion of rational use of antibiotics is urgently needed in Mozambique.