Introduction
Though cultural and economic factors are known to influence access to medicines globally, a critical gap remains in understanding how individual preferences and financial means of Sri Lankans shape paediatric healthcare choices. The study details the sociocultural and financial access of pediatric oral anti-infective medicines to 3–5-year-old children with acute non-severe infections in the Ratnapura District, Sri Lanka.

Methods
We conducted nine Focus Group Discussions (FGDs) among primary caregivers of 3–5-year-old children in three selected health-administrative areas represented by urban, rural and estate sectors/geographical regions in the Ratnapura District, Sri Lanka. Using purposive-sampling, the FGDs were conducted among the selected homogenous participants until theoretical saturation was reached. Eight to ten participants participated in each digitally recorded session. Using pragmatic content analysis, two investigators manually analyzed the data to develop themes, supported by included narrations.

Results
Four key themes were identified, namely, the influence of previous experience in the treatment of similar illnesses, the overall cost of seeking treatment, the influence of the close community in seeking treatment and the use of anti-infective medicines for the child for acute illnesses, and the perception among caregivers of the effectiveness of anti-infectives in reducing symptoms of acute mild illnesses. Some parents skipped the consultation with a prescriber and sought anti-infective medicinal drugs directly from the pharmacy and further stated that the overall cost of government institutions for the treatment of “acute non-severe infections” was greater than that of the private sector.

Conclusions
Primary caregivers reported misconceptions about anti-infective pediatric medications, such as antibiotics, and about the treatment of nonserious pediatric infections. Moreover, a variety of sociocultural factors influence the decisions made by caregivers regarding what steps to take during pediatric illnesses. For this reason, policymakers, and legislators must consider sociocultural aspects of the communities to improve access to medications and health services.