DISADVANTAGES OF SELF MEDICATION USING ANTIBIOTICS

ABSTRACT

The concept of self-medication which encourages an individual to look after minor illnesses with simple and effective medicines has been adopted worldwide. Although self-medication has been reported to have several benefits, it has also been associated with many risks. Self- medication among poorly informed segments of the population may result in a waste of household and government resources. Regardless of the growing research attention in self- medication, little information has been available about perspectives and practices of self- medication especially in developing countries. In Nigeria, particularly the study site, little information is available on the subject. The purpose of this study was to explore the perspectives and practices of self-medication.

A qualitative case study design was used. A total number of 63 participants participated in the study, four (4) focus group discussions, six (6) key informant interviews and 22 in-depth interviews were conducted during data collection. The study incorporated free listing and pile sorts in focus group discussions and In-depth interviews. Key informant interviews were also conducted with relevant individuals. Purposive sampling using maximum variation was used to select study participants. Data was analysed using grounded theory to see how emerging issues were related. From the information recorded in each interview and discussion, major themes and sub-themes were identified.

The findings of the study revealed that the study participants did not follow a specific dosage or timeframe when self-medicating. Both health workers and the general population follow the same pattern when self-medicating. However, health workers perceived self-medication as being risk while the general population viewed it as being of benefit to them. The results also showed that diseases that are seen to be relatively minor and common, self-medication would be preferred. On the other hand, if the disease was thought to be severe, unfamiliar or injuries, the patient would much more likely go to the health centre for treatment.

In conclusion, self-medication practices are influenced among others by income, distance to health facility, condition of the disease and disease severity. People don‟t have a specific dosage and duration to follow when self-medicating. The perceived benefits of self- medication are likely to result in it being a common health seeking behaviour.

CHAPTER ONE

INTRODUCTION

1.1. Background Information

The concept of self-medication which encourages an individual to look after minor illnesses with simple and effective medicines has been adopted worldwide (Awad, 2005) cited by (Afolabi, 2009). It is the most common form of health care practiced in most parts of the world (Ocan et al., 2015). The practice of self-medication is common in both developed and developing countries (Fuentes et al., 2008) and may even be more common than the use of prescribed medication (Lam et al., 1989). Self-medication is far from being a completely safe practice, in particular in the case of non-responsible self-medication (Gholap and Mohite, 2013). There are potential risks to self-medication practices such as wrong self-diagnosis, delays in seeking treatment, infrequent but severe adverse reactions, dangerous drug interactions, incorrect dosage, incorrect choice of therapy, masking of a severe disease and risk of dependence and abuse and unnecessary out of pocket expenditure (Kumar et al., 2016).

Self-medication is a global phenomenon and a concern for health authorities worldwide. For example, there is much public and professional concern about the irrational use of drugs (Filho et al., 2004). The prevalence rates are high all over the world; up to 68% in European countries, while it is much higher in the developing countries with rates as high as 92% (Zafar et al, 2008). For example, in the United Kingdom on the average 50% of health care takes place within the realm of self-medication. The government encourages self- reliance, while agencies like the World Health Organisation (WHO) promote individual family and community participation in primary health care (Cutting, 1989).

However, self-medication has a number of limitations. Various studies have shown that self- medication may lead to delay in seeking care which results in increased treatment cost, prolonged hospitalization periods and increase in morbidity due to delay in the diagnosis of underlying conditions and appropriate treatment (Donkor et al., 2012). Self-medication is defined as the use of medicinal products by the consumer to treat self-recognized disorders or symptoms, or the intermittent or continued use of a medication prescribed by a physician for chronic or recurring diseases or symptoms. In practice, it also includes use of the medication of family members, especially where the treatment of children or the elderly is involved (WHO, 2000).

A number of factors have contributed to self-medication, poor investigative capability compounded by a limited knowledge of suitable management result in the increase of self- medication and low rate of health care utilization (Bexell et al., 1996). Many patients resort to the practice of self- medication instead of contacting professional health care workers because of long waiting periods in hospitals, minor sicknesses, to save money and time, lack of accessibility, shortage of doctors, or a feeling that their illness is beyond the knowledge of western trained doctors (Afolabi, 2009). The practice of self-medication cuts across culture, gender, health and social status, race, occupation or any other social, medical or demographic factors (ibid).

Generally, it is accepted that self-medication has an important role in the care of minor illness (WHO, 1986). In fact, the role of self-care was emphasized by the World Health Organization (WHO) in 1978 in its “Health for all by the year 2000” initiative, which was implemented in many countries of the world. Studies indicate that the use of self-medication is influenced by several personal, organizational and environmental factors (Sawalha, 2008, Versteegen et al., 2007 and Worku et al., 2003). Self-medication has positive benefits in terms of time saving and giving quick relief to pain.

Nigerian Context

In the quest to ensure that essential drugs and medical supplies are always available at health facility level and that there is rational use of drugs, the Nigerian Ministry of Health developed and adopted the National Drug Policy in 1999. Whose vision is to provide equity of access to all Nigerians to good, quality, safe and efficacious medicines which are affordable and rationally used as close to the family as possible (MOH, 1999). In addition, in order to strengthen drug availability and usage, the Ministry of Health undertook a number of activities such as development of the essential drug list, establishment of the Nigeria logistic management information system as well as the establishment of the Pharmaceutical Regulatory Authority in 2004 through an act of parliament. However shortages and inappropriate clinical usage of drugs and medical supplies still remain a major problem (MOH, 2005).

The consequences of self-medication practices are increasingly being recognized around the world (Abay and Amelo, 2010). In Nigeria, Diop et al., (1998) argued that, the prevalence of self-medication using Antibiotics in Nigeria is high (36%) and a lot of money is being spent by households on self-medication. A survey by Living Conditions Monitoring Survey (LCMS) (2012) reported that the prevalence of self-medication using Antibiotics in Nigeria is at 31%, this did not include those who self-medicated and later made consultation. However, reviewed literature indicates that there is little information on the practice of self-medication using Antibiotics in Nigeria. A detailed search of literature on the research topic did not yield any data on the practice in Yaba.

Despite some studies being conducted on this topic, self-medication has not received much attention (Alghanim, 2009). For example, in Nigeria studies were done on self-medication of uncomplicated malaria (Mulenga and Kawimbe, 2015), Self-Care practices and experiences of people living with HIV not receiving Antiretroviral therapy (ART) Musheke et al., 2013) and Household health seeking behaviour (Diop et al., 1998). Data on the perspectives of and practices of self-medication using Antibiotics in Nigeria are necessary to help with the planning of interventions to improve the self-use of medicines in the country.

In this study, self-medication was defined as, obtaining and consuming drugs without the advice of a physician for diagnosis, prescription or surveillance of treatment. It may include the use of herbs (Awad et al., 2005), acquiring medicines without a prescription, resubmitting old prescriptions to purchase medicines, sharing medicines with relatives or members of one's social circle or using leftover medicines stored at home (Zafar et al., 2008).

Health Seeking Behaviour

A study by Abby et al. (2016) showed that self-medication is due to varying factors. In public health research, theories and models on health-seeking behaviour help explain the underlying motivations for often multifaceted and complex people‟s healthy seeking decisions (Berry, 2004). In particular the health belief model (HBM) is widely applied to explain health- seeking behaviour (Metta, 2014). The HBM and findings from various studies shows that self-medication is influenced by a number of factors. The HBM centers on four concepts, perceived susceptibility to disease, the perceived severity of the disease, perceived benefits of the treatment actions and perceived barriers to adopting proposed measures. The model posits that, what triggers individuals‟ decisions regarding health seeking behaviour are general health motivations including internal cues (i.e. symptoms) and external cues (i.e. interpersonal interactions and media communications (Berry, 2004). In this study, the model will be used to verify the findings of the study and broaden understanding of the perspectives and practices of self-medication. As the model is helps to explain and predict health-related behaviours, particularly in regard to the uptake of health services.

Regardless of the growing research attention in self-medication, little information has been available about perspectives and practices of self-medication especially in developing countries (Afolabi, 2009). It was therefore the aim of this study to add to available literature on self-medication using Antibiotics in the country. The outcomes of this study will also add to evidence based information to the body of knowledge, regarding perspectives and practices of self- medication in Yaba and will be useful in guiding health promotion and education programs in health and related sectors. It could also provide for replication and basis for future research.

1.2. Statement of the Problem

Self-medication is a global phenomenon and a concern for health authorities at global level. The prevalence of self-medication is high in Nigeria at 19.7% (LCMS, 2015). Moreover, a lot of money is spent by households on self-medication (Diop, seshamani and Mulenga, 1998).

Self-medication among poorly informed segments of the population may result in a waste of household resources and, eventually, a drain on public resources if illnesses are treated late after ineffective self-medication. Although self-medication has been reported to have several benefits, it has also been associated with many risks that may include misdiagnosis, delays in seeking medical advice when needed, incorrect dosages, masking severe diseases, and maladministration among others (Ruiz, 2010).

Regardless of the growing research attention in self-medication, little information has been available about perspectives and practices of self-medication especially in developing countries (Afolabi, 2009). Particularly in Nigeria, reviewed literature indicates that there is little information on the practice of self-medication using Antibiotics in Nigeria. A detailed search of literature on the research topic did not yield any data on the practice in Yaba.

1.3. Objectives

General Objective

To explore the perspectives and common practices of self-medication using Antibiotics in Yaba and generate knowledge for action.

Specific Objective

1. To explore illnesses for which self-medication is used and reasons for not consulting a physician.

2. To identify common sources of medications used as well as the source of the information.

3. To define what informs or guides individuals regarding the self-medication process and duration during the course of a particular illness.

4. To identify peoples‟ perspectives of the benefits and limitations of self-medication

1.4. Research question

1. How is self-medication practiced among men and women above the age of 18 in Yaba?

2. What are the perspectives of self-medication among women and men above the age of 18 in Yaba?

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Item Type: Project Material  |  Size: 40 pages  |  Chapters: 1-5

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