Practice Of Self Medication Among Women Of Child Bearing Age Attending Antenatal Clinic In Our Lady Of Lourdes Hospital Ihiala

Practice Of Self Medication Among Women Of Child Bearing Age Attending Antenatal Clinic In Our Lady Of Lourdes Hospital Ihiala

Abstract

This study focused on the practice of self medication among women of child bearing age attending antenatal clinic in Our Lady Of Lourdes Hospital Ihiala using Our Lady Of Lourdes Hospital Ihiala as case study. The study is was specifically focused on determining the proportion of pregnant women who self-medicate, examining the factors that inform the practice of self-medication and identifying drugs often used in self-medication and most conditions on which self-medication is done. The study adopted the survey research design and randomly enrolled participants in the study. A total of 327 responses were validated from the enrolled participants where all respondent are women of child bearing age attending antenatal clinic in Our Lady Of Lourdes Hospital Ihiala. The study recommended that the Federal Ministry of Health and relevant government agencies create more awareness on the dangers of self medication and also ensure that street medicine vendors and other unauthorized agencies are totally prevented from selling medicines.

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 of 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 self- medication 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 citizens wait for multiple hours before being attended to and many citizens do not have enough time to spare waiting for a doctor to attend to them. The affordability of modern healthcare have prevented Ghanaians from attending hospital and rather opt to buy modern drugs and herbs that are available and capable of curing their ailments. Also, an abundant amount of citizens 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 Ghana use medications for treatment of their ailment without prescription from a physician from the open market. With this accessibility, citizens of Ghana 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).

Medical practitioners around the world advocate that, most people especially pregnant women should rely on hospital and licensed professionals to meet their health needs. However, there are two main barriers preventing Ghanaians from adhering to these recommendations: inaccessibility of professional medical care and the accessibility of Western and indigenous medication (herbal medicine) through pharmacies and herbalist respectively (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 due to 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 when facility user fees was introduced which made people to engage in self-medication in order to avoid paying consultation fees and transportation costs (Gaddah, 2011)

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 practice of self medication among women of child bearing age attending antenatal clinic in our lady of Lourdes Hospital Ihiala.

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 Yard, Iran was 35% (Baghianimoghadam, Mojahed, Baghianimoghadam, Yousefi, & Zolghadr, 2013), 10.5% in Peru (Mini et al., 2012), and 85% in Nigeria (Emmanuel, Achema, Afoi, & Maroof, 2014b). It was revealed in Egypt that the prevalence of self–medication was 86% (Rizk, Abdel-Aziz, Ashmawy, Mahmoud, & Abuzeid, 1993). 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 Wa Municipality 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 self- treatment. 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 chemical drug 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 (GNA, 2010)

Although the practice of self-medication is known in the population especially pregnant women, one cannot tell the prevalence of self-medication and it associated factors that influence it practice, the drugs mostly used and most conditions treated for with self-medication. Thus this study was conducted to determine the practice of self medication among women of child bearing age attending antenatal clinic in our lady of Lourdes Hospital Ihiala.

Self medication also leads to drugs-interactions, wrong treatment for the wrong problem, drug-resentence, insanity and even death. More and more young people are becoming victims of self-medication, may be due to their experimental nature. It is therefore important to study the practice of self medication among women of child bearing age attending antenatal clinic in our lady of Lourdes Hospital Ihiala.

1.3 Purpose of Study

The purpose of the study is to examine the practice of self medication among women of child bearing age attending antenatal clinic in our lady of Lourdes Hospital Ihiala. specifically, the study aims

1. To determine the proportion of pregnant women who self-medicate
2. To examine the factors that inform the practice of self-medication
3. To identify drugs often used in self-medication and most conditions on which self-medication is done.

1.4 Research Questions

The study intends to answer the following questions:

1. What is the proportion of pregnant women that self–medicate?
2. What factors inform pregnant women to self- medicate?
3. What drugs are most use and conditions treated for without physician prescription?

1.5 Research Hypotheses

The following hypothesis was formulated and tested for the study.

• Ho: There are no factors influencing the practice of self medication among women of child bearing age attending antenatal clinic in our lady of lourdes hospital ihiala
• H1: There are factors influencing the practice of self medication among women of child bearing age attending antenatal clinic in our lady of lourdes hospital ihiala

1.6 Significance of the Study

Self–medication practice exposures one to potential harmful effects of medicines and also account for the reasons why people seek for hospital intervention late, thereby complicating ones condition particularly among pregnant women.

Despite all the harmful effects linked with self-medication, pregnant women are still practicing it. The high prevalence of self-medication as seen in most of the studies could largely be due to lack of knowledge on the harmful effects from irrational use of medicine especially among pregnant women. Results of this study will therefore be important in facilitating development strategies that will be used in addressing the prevalence of self-medication by providing baseline information about the current prevalence of self-medication and related factors. This is useful in planning a health education program that can be implemented during antenatal sessions and public enlighten at both local and national level which will help reduce maternal morbidity and mortality as well as abortion in early cyesis and fetal malformation as a result of the tetratogenic effects of unsafe drugs on the fetus.

1.7 Scope of the Study

The study will analyze the practice of self medication among women of child bearing age attending antenatal clinic in our lady of Lourdes Hospital Ihiala. The study is limited to some selected women of child bearing age attending antenatal clinic in the hospital. Hence, the respondents for this study will be obtained from and among women of child bearing age attending antenatal clinic in the study area.

1.8 Limitation 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.

1.9 Operational Definition of Terms

Self Medication:

It is the use of drug without a doctor’s prescription to treat perceived or real malady or to alleviate distress or pain.

Factors:

Things that contribute or lead to the practice of self medication.

Practice:

To perform self medication habitually or usually.

Gender:

Characteristics of the undergraduate being male or female.

Over- The –Counter:

Medicines that are sold directly to consumers without a prescription from a healthcare professional

1.10 Organization of the Study

This research work is organized in five chapters, for easy understanding, as follows.

• Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study.
• Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature.
• Chapter three deals on the research design and methodology adopted in the study.
• Chapter four concentrate on the data collection and analysis and presentation of finding.
• Chapter five gives summary, conclusion, and recommendations made of the study.

Chapter Five

Summary, Conclusion and Recommendations

5.1 Introduction

This chapter summarizes the findings on the practice of self medication among women of child bearing age attending antenatal clinic in Our Lady Of Lourdes Hospital Ihiala using Our Lady Of Lourdes Hospital Ihiala as case study. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was on the practice of self medication among women of child bearing age attending antenatal clinic in Our Lady Of Lourdes Hospital Ihiala using Our Lady Of Lourdes Hospital Ihiala as case study. The study is was specifically focused on determining the proportion of pregnant women who self-medicate, examining the factors that inform the practice of self-medication and identifying drugs often used in self-medication and most conditions on which self-medication is done.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 327 responses were validated from the enrolled participants where all respondent are women of child bearing age attending antenatal clinic in Our Lady Of Lourdes Hospital Ihiala.

5.3 Conclusion

Self-medication is a public health problem that needs urgent attention with prevalence rate of 74%. Easy accesses to non-prescribed medication, perceived illness as minor and cultural norms and beliefs were the main associated factors that had great influence in the practice of self-medication among pregnant women in this study area. Easy accessibility of medicines in the open market by respondents was mainly due to the proliferations and availability of many chemical shops and pharmacy and poor regulations of non-prescribed medications by the Ghana pharmacy council and the community pharmacist. Perceived illness as minor and cultural beliefs and norms of respondents were largely influenced by low level of education of most of the respondents in this study. Backache, headaches, lower abdominal pains, waist pain and malaria, and paracetamol, tramadol, coartem and diclofenac were conditions and drugs often used for self-medication by respondents. These medicines mentioned above are well known by respondents and easy accessible in the open market and are less expensive and therefore respondents were able to afford. Also backache, waist pain, headaches, lower abdominal pain and malaria are the medical conditions most respondents perceived as minor and were mostly treated without seeing a medical practitioner. It is therefore very imperative to embark on educational campaigns and strict legislation measures relating to drugs dispensing from chemical shops and private pharmacies, ensuring constant supply of medications to the government hospital and facilitate access to health services are among the important intervention(s) that may change the behaviour of respondents and protect them from potential dangers of self-medication.

5.3 Recommendations

In line with the findings of this research, the following recommendations are made

1. The Pharmacy Council of Nigeria in collaboration with Nigeria Health Service should ensure that strategies are formulated and policies enforced to prevent chemical sellers, drug peddlers and private pharmacist from supplying drugs to pregnant women without prescription form from physicians or indications of been to the hospital.
2. 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. In addition to the above, the government of Ghana should do more to control the advertisement and sale of herbal medicines.
3. Future research can be done to explore which particular herbal medicines or combinations of herbal medicines are used by pregnant women to treat which specific conditions.
4. Director of Health Service and the Heads of the health facilities should team up to put measures in place to help address the inconveniences such as long waiting time, non-availability of medicines at the health facilities that is making pregnant women to indulge in the practice of self-medication..

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