From coping to structural abandonment: Reframing self-medication in Yemen's protracted conflict

Area of Science:

• Public Health
• Health Systems Research
• Conflict Studies

Background:

• Protracted conflict in Yemen has severely disrupted the healthcare system.
• This has reshaped healthcare access and utilization patterns.
• Previous studies viewed self-medication as coping; this commentary re-examines it in systemic collapse.

Purpose of the Study:

• To analyze self-directed care practices in Yemen within the context of systemic health collapse.
• To argue that these practices stem from enduring structural conditions, not just episodic constraints.
• To highlight the role of psychological distress and limited mental health services.

Main Methods:

• Structural analysis of healthcare access barriers in conflict settings.
• Re-examination of self-medication and informal antibiotic use.
• Integration of psychological distress factors in health-seeking behavior.

Main Results:

• Self-directed care in Yemen is driven by structural issues: destroyed infrastructure, depleted workforce, and disrupted supply chains.
• Physical, financial, and sociocultural barriers normalize informal care, including self-prescription.
• Lack of mental health services exacerbates reliance on self-directed care.

Conclusions:

• Self-medication in Yemen is a consequence of structural determinants, not individual choice.
• Behavior-focused interventions are insufficient; structural factors must be addressed.
• Understanding health system collapse requires analyzing enduring structural conditions in conflict zones.