The Effect Of Self Medication Among Pregnant Women

Project and Seminar Material for Nursing (Science)

The Effect Of Self Medication Among Pregnant Women (Charles)


Abstract


This study was carried out to examine the effect of self medication among pregnant women in selected PHC in Mbaise.The study was carried out to determine the prevalence of self-medication among pregnant women, examine the factors that inform the practice of self-medication among pregnant women, ascertain the drugs that are most often used in self-medicating among pregnant women and investigate the level of awareness and knowledge of pregnant women about the possible side effects of self-medication.The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of all the pregnant women in the selected PHC in Mbaise. In determining the sample size, the researcher conveniently selected 41 respondents and 35 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables and mean scores. While the hypotheses were tested using chi-square statistical tool.The result of the findings reveals that the prevalence of self-medication among pregnant women is high.The study also revealed that the factors that inform the practice of self-medication among pregnant women includes: socio-demographic factors, health facility related factors, nonprescribed drug related factors, psychological factors and cultural factors.Therefore, it is recommended that the Ministry of Health and the Nigeria Health Service, in collaboration with WHO must embark on an educational program to educate the public in general and pregnant women specifically of the dangers of self-medicating with herbal drugs, especially since they are perceived by users as safe, even though they can actually have detrimental effects on the pregnant mother and the foetus.To mention but a few.


Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

Chapter One:

Introduction

  • 1.1 Background of the Study
  • 1.2 Statement of the Problem
  • 1.3 Objective of the Study
  • 1.4 Research Questions
  • 1.5 Research Hypothesis
  • 1.6 Significance of the Study
  • 1.7 Scope of the Study
  • 1.8 Limitation of the Study
  • 1.9 Definition of Terms
  • 1.10 Organisations of the Study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Review

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the Study
  • 3.3 Sample Size Determination
  • 3.4 Sample Size Selection Technique and Procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of Data Collection
  • 3.7 Method of Data Analysis
  • 3.8 Validity of the Study
  • 3.9 Reliability of the Study
  • 3.10 Ethical Consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions
  • 4.4 Test of Hypotheses

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE

Chapter One


Introduction

1.1 Background to the Study

Globally, self–medication has become a public health problem due to its prevalence and harmful effects. It is been practiced in both developing and developed countries (Hanafy, Sallam, Kharboush, & Wahdan, 2016). The extent of self-medication and the reasons for practicing it may vary from country to country. The prevalence of selfmedication in Nepal was 59%, in Bambi 54%, in Mexico 34% and in Ethiopia 26.2% (Befekadu, Dhekama, & Mohammed, 2014) . In developing countries, both modern drugs and traditional medicines are commonly used for self-medication. It was also noted that, medication that can only be obtained upon physician prescription, could easily be obtained without prescriptions for self medication in developing countries like Ghana and Ethiopia. Beside, self-medication has been made known as common health behaviour in other developing countries like Nigeria and Zambia (Yusuff & Omarusehe, 2011).

The proportion of people who self-medicate is motivated by a lot of reasons that may vary from place to place. In all however, self–medication in the advanced countries may be due to the increasing de-regulation of previously restricted drugs. The reasons had been that different types of drugs are now available over the counter for the management of all kind of different health challenges (Lettre, 2011). Again, this claims concerning the various factors influencing the practice of self-medication was mentioned in a similar study (Novignon, Mussa, Msonda, & Nonvignon, 2011). Moreover, self-medication in the developing countries may be due to different types of factors including high cost involve in seeking professional care in hospitals,poverty, long waiting hours in the hospitals to seek health care, lack of regulations and availability of drugs outside health facility and regulated environment (Babatunde et al., 2016).

In Nigeria, there are many reasons why patients opt out of seeking modern medical care such as long waiting time, unaffordability and the distance of healthcare facility (Bonti, 2017). The long waiting lines are caused by minimal staff in healthcare facilities; some pregnant women wait for multiple hours before being attended to and many citizen do not have enough time to spare waiting for a doctor to attend to them. The affordability of modern healthcare have prevented Nigerians from attending hospital and rather opt to buy modern drugs and herbs that are available and capable of curing their ailments. Also, an abundant amountof citizen do not have transportation to the closest facility because of the limited amount of public transportation coming in and out of their town. There is easy accessibility of non-prescribed drugs and herbs as many people in Nigeria use medications for treatment of their ailment without prescription from a physician from the open market. With this accessibility, citizen of Nigeria do not want to go to the hospital to spend long hours to see a doctor, find transportation to different towns, and this help to deal with the expenses of visiting a healthcare facility (Bonti, 2017).

People practice self-medication in order to ensure they continue to be in good health as good health is a necessity. Although self-medication has been adopted and is being practiced globally, people are not limiting themselves to over the counter drugs only, or if they are, they are not using them appropriately (Vidyavati, 2016). The practice of self-medication has gotten to a serious situation, as people use available drugs they believe, have medicinal content without knowledge on their harmful effect in connection with those specific medicines; thus, poor knowledge on the negative effect of self-medication is adding significantly to the practice of self-medication. As a result, people have developed serious harmful effects from the drugs and has also led to delay in asking for medical care at the hospital, thereby worsening their conditions (Afolabi, 2012). Secoli, (2017) stressed on the need to use Over the Counter (OTC) drugs responsibly, as irrational use of drugs predispose one to harmful implications. This is a problem in most developing countries where level of education is low, as well as poor exposure to medical information, lead to abuse of medicines (Novignon et al., 2011). Self-medication is not only limited to a particular group of people but rather all manner of people including race, age, occupational status, gender, culture, and other such groups (Afolabi, 2008). Nonetheless, the practice of self-medication is very common among people living in areas with high incidence of infectious disease (Akanbi, Odaibo, Afolabi, & Ademowo, 2004). Self–medication practice with specific medication like antibiotics, has been reported to be highly prevalent in both developed and developing countries, with the exclusion of a few developed countries (Donkor, Tetteh-Quarcoo, Nartey, & Agyeman, 2012).

The harmful consequences of self-medication are of different kinds and may include treatment failure, prolonged hospitalization, drug toxicity, increase in treatment cost and high mobility. Self–medication is more dangerous in the developing countries dueto lack of basic knowledge about the pharmacological properties of these drugs and how these drugs affects those who self–medicate (Abasiubong, Bassey, & John Akpan Udobang, Oluyinka Samuel Akinbami, Sunday Bassey Udoh, 2012).

The increasing rate of self-medication among pregnant women is not different from the general population as many pregnant women are engaged in the practice without due diligence, as a results of limited knowledge on the harmful effects on their health and foetus. The harmful effects of self-medication on the unborn child and the mother is a potential threat to their life and health which has become a global problem that needs urgent attention. In most sub-Saharan African countries such as Ghana where the health system is not efficient, the probability that women will self-medicate is high. In many developing countries, there is growing evidence that, self-medication among pregnant women is a common practice (Abasiubong et al., 2012). Pregnant women do not know which drug is safe to them and the unborn baby as many drugs are considered contraindicated in pregnancy. Controlling self-medication among pregnant women could go a long way to decrease incidence of drug related abortion, congenital malformation and maternal and child mortality related to drug misuse. The harmful effects of self-medication are serious when the individual self-medicating is a pregnant woman (Abasiubong et al., 2012). Self–medication can impose a serious hazardous effects to the unborn baby and the mother mostly in the first trimester where pregnant women self–medicate due to early morning illness. Some of hazardous effects includes: impediment in the normal growth of the baby, deficiency or problem in the development of reproductive organs, urinary retention, undescended testis and other problems (Abasiubong et al., 2012). Similar with other developing countries, self–medication is a serious health concern in Ghana since 1985 whenfacility user fees was introduced which made people to engage in self-medication in order to avoid paying consultation fees and transportation costs (Gaddah, 2011).


1.2 Statement of the Problem

Globally, self–medication has become a public health problem due to its prevalence and harmful effects. The prevalence of self–medication among pregnant women in Nigeria 85% (Emmanuel, Achema, Afoi, & Maroof, 2014b). Also 68.9% of pregnant women were found to have practiced self-medication in a study conducted in Ghana (Agyei-Boateng, 2015).

The situation of self-medication practice in Nigeria among pregnant women is a major problem and has become dangerous as many pregnant women do not longer seek health care services from qualify health professional at health facilities as they prefer to buy drugs and herbal medicine from chemical shops and herbalist for selftreatment. This account for late reporting to the hospital with a worse condition or complications as a result of self-treatment of condition with the wrong drug which could not treat the underlying condition or it might be due to complication as a result of the side effect of the drug taken. Moreover, these drugs are bought from chemicaldrug sellers, drug peddlers and herbalist who have very little knowledge about drugs functions, side effects and the appropriate conditions these medications are supposed to treat. This predisposes many pregnant women and the foetus to harmful effects such as abortion, foetal malformation, maternal morbidity and finally maternal death (NIG, 2010)

Although, practice of self-medication is known among pregnant women, one cannot tell the prevalence of self-medication and its associated factors, the drugs mostly used and most conditions treated for with self-medication. Thus for this reason this study investigated the effect of self medication among pregnant women.


1.3 Objectives of the Study

The overall aim of this study is to critically examine the effect of self medication among pregnant women. Hence, the study will be channeled to the following specific objectives;

  1. Determine the prevalence of self-medication among pregnant women.
  2. Examine the factors that inform the practice of self-medication among pregnant women.
  3. Ascertain the drugs that are most often used in self-medicating among pregnant women.
  4. Investigate the level of awareness and knowledge of pregnant women about the possible side effects of self-medication.

1.4 Research Question

This study will be guided by the following questions;

  1. What is the prevalence of self-medication among pregnant women?
  2. What are the factors that inform the practice of self-medication among pregnant women?
  3. What are the drugs that are most often used in self-medicating among pregnant women?
  4. Does self medication have any significant effect on pregnant women?
  5. What is the level of awareness and knowledge of pregnant women about the possible side effects of self-medication?

1.5 Research Hypothesis

  • Ho: Self medication has no significant effect on pregnant women.
  • Ha: Self medication has a significant effect on pregnant women.

1.6 Significance of the Study

This study will be immensely valuable and useful to mostly pregnant in Nigeria as it will educate and enlighten them on the effect of self medication so as to aid them in being meticulous not to be victims. The recommendations proffered in this study will as well be of great help to mothers in general. Lastly this study will add to the body of literature which has existed in this aspect of intellectual studies, thereby making it available and useful to students, researchers and other intellectuals.


1.7 Scope of the Study

Determine the prevalence of self-medication among pregnant women, examine the factors that inform the practice of self-medication among pregnant women, ascertain the drugs that are most often used in self-medicating among pregnant women and investigate the level of awareness and knowledge of pregnant women about the possible side effects of self-medication.


1.8 Limitations of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

Moreover, the case study method utilized in the study posed some challenges to the investigator including the possibility of biases and poor judgment of issues. However, the investigator relied on respect for the general principles of procedures, justice, fairness, objectivity in observation and recording, and weighing of evidence to overcome the challenges.


1.9 Definition of Terms

Pregnancy:

Pregnancy is the term used to describe the period in which a fetus develops inside a woman’s womb or uterus.

Self-medication:

It is taking drugs, herbs or home remedies on one’s own initiative or on the advice of another person, without consulting a doctor.


1.10 Organization of the Study

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, abnd selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.


Chapter Five


Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the effect of self medication among pregnant women in selected PHC in Mbaise. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was to examine the effect of self medication among pregnant women in selected PHC in Mbaise. The study is was specifically carried out determine the prevalence of self-medication among pregnant women, examine the factors that inform the practice of self-medication among pregnant women, ascertain the drugs that are most often used in self-medicating among pregnant women and investigate the level of awareness and knowledge of pregnant women about the possible side effects of self-medication.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 35 responses were validated from the enrolled participants where all respondent wereall the pregnant women in the selected PHC in Mbaise.


5.3 Conclusions

Based on the findings of this study, the researcher concluded that;

  1. The prevalence of self-medication among pregnant women is high.
  2. The factors that inform the practice of self-medication among pregnant women includes: socio-demographic factors, health facility related factors, nonprescribed drug related factors, psychological factors and cultural factors.
  3. The drugs that are most often used in self-medicating among pregnant women includes: paracetamol, tramadol, coartem, diclofenac and antibotics
  4. Self medication has a significant effect on pregnant women
  5. The level of awareness and knowledge of pregnant women about the possible side effects of self-medication is low.

5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered.

  1. The Ministry of Health and the Nigeria Health Service, in collaboration with WHO must embark on an educational program to educate the public in general and pregnant women specifically of the dangers of self-medicating with herbal drugs, especially since they are perceived by users as safe, even though they can actually have detrimental effects on the pregnant mother and the foetus.
  2. Since some pregnant women were self-employed and private business owners, this research recommends that public health facilities provide appointment based health access services for pregnant but self-employed women. Whenthis is done, pregnant women will not have to resort to self-medication simply because they are reluctant to suffer the inconvenience of attending the hospital and leaving their businesses unattended for much of the day.
  3. This research recommends that health education and promotion educational programs must educate the public of the fact that several perceived „non-serious‟ diseases could be symptoms of much more serious underlying conditions which can only be revealed and treated in a hospital. This will change the attitude of people regarding self-medication for perceived non-serious diseases.
  4. The government of Nigeria should do more to control the advertisement and sale of herbal medicines in public places. According to the WHO (2010), when these are done in combination, they will be effective in improving the adequate use of medicines among pregnant women. Emphasis should be placed on the combined education of all stakeholders, the provision of adequate health care, and the control of drug sale. These approaches are less likely to be successful when used individually (WHO, 2010).
  5. Lastly, since family members and relatives have been revealed as important sources of self-medicated drugs and drug information, health education and health promotion programs should, in addition to targeting pregnant women in hospitals, target other stakeholder groups including mothers, relatives and respected people in the community.

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