Prevalence of Self-medication and its Associated Factors among Pregnant Women Attending Antenatal Care at Nekemte Referral Hospital, Oromia Regional State, West Ethiopia
Received Date: Feb 04, 2019 / Accepted Date: Mar 22, 2019 / Published Date: Mar 28, 2019
Background: Self-medication is one element of self-care in which individuals to treat self-recognized illnesses or symptoms did the selection and use of medicines. Pregnant women’s practice self-medication to treat a number of medical conditions. However, self-medication in pregnant women’s leads to potential drug adverse reaction. Higher risks were reported if women were in their first trimesters of pregnancy.
Objectives: The objective of this study is to assess the prevalence of self-medication and its associated factors among pregnant women attending antenatal care at Nekemte Referral Hospital.
Methodology: A Hospital based cross-sectional study was conducted among 195 pregnant women attending antenatal care at Nekemte Referral hospital from May to June 2018. Semi-structured interviewer questionnaire was used to collect data from each study subjects. SPSS version 21 software was used to categorize and analyze data. Association is significant at p-value less than 0.05.
Results: In this study, 195 pregnant mothers were participated. The respondents’ age range from 21 to 45 years and their mean age was 30.4+3.45 years. Self-medication practice among pregnant women was 21.5% with the most common self-medicated drugs were paracetamol 19 (45.2%) and amoxicillin 12 (28.6%). Respondents aged between 20 to 30 years (AOR=0.108, 95% CI: 0.012-0.952) and 31 to 40 years (AOR= 0.078, 95% CI: 0.009-0.698) were less likely to practice self-medication than those above 40 years old respondent. Farmer pregnant women were less likely (AOR=0.881, 95% CI: 0.006-1.099) to use self-medication than students.
Conclusion: The prevalence of self-medication was 21.5% among respondents. Pregnant women with age group of 31 to 40 years and farmers had less likely to practice self-medication.
Keywords: Antenatal care; Pregnant; Self-medication; Women
ANC: Antenatal Care; NRH: Nekemte Referral Hospital
Self-medication is one element of self-care in which individuals to treat self-recognized illnesses or symptoms did the selection and use of medicines . It was practiced throughout the world and among different age group individuals even though the magnitude shows a discrepancy [2-6]. It was mostly common in developing countries and consumer vulnerability to risks of self-medication in developing country related to low literacy levels in the common population, affordability of medicines and lack of accessibility to primary healthcare . In Ethiopia research’s revels that the prevalence of self-medication varied from 12.8% to 77.1% . Therefore, the use of prescription-only medications including antimicrobial agents without medical consult has become alarmingly high in Ethiopia .
Medications provide therapeutic benefits through curing a disease, slowing its evolution, or alleviating its symptoms. But medications also carry the risks of adverse drug reactions, which can span from minor symptoms to severe events such as anaphylaxis or organ failure . Also self-medication will come with potential health related hazards including emergence of antimicrobial resistance .
Pregnant women’s practice self-medication to treat a number of medical condition [2,3,11,12]. The most common reasons reported by pregnant women to practice self-medication were disease not serious, prior experience about the drug, economical cost and easy access to the drug without prescription [12,13]. However, self-medication in pregnant women’s leads to potential drug adverse effects likes congenital birth defects, a miscarriage, and allergic disease. Higher risk was reported if women were in their first trimesters of pregnancy .
Medications use during pregnancy normally based on evaluation of their harm to the mother and fetus. In most cases, the first choice for treatment of a condition during pregnancy differs from treatment in non-pregnant women. Hence, the choice of drugs must take into account the fetus and may direct therapy to non-standard regimens . Therefore, assessment of medication use during pregnancy is important for clinical, educational, economical, and public health. By taking into consideration the potential effects of self-medication, this study aimed to assess prevalence of self-medication and associated factors to help health care providers in educating and counseling pregnant women about the consequence of self-medication use.
Study area and study period
The study was conducted in Nekemte Referral Hospital antenatal care (ANC) clinic from May to June 2018. The Hospital was found in Nekemte Town, Oromia region, West Ethiopia at 331 km from Addis Ababa.
A Hospital based cross-sectional study was conducted.
All pregnant women who attend antenatal care clinic at Nekemte Referral Hospital during the study period were the study population.
Inclusion and exclusion criteria
All Pregnant women who attend antenatal care clinic at NRH during study period and willing to participate in the study were included in the study. Nevertheless, pregnant women who were critically ill, mentally ill, and unable to hear and speak were excluded from study.
Sample size determination and sampling technique
The sample size was determined using the single population proportion formula considering prevalence of self-medicine use; 26.6% (p=0.266) (11) with a margin of error of 5% (d=0.05) and a 95% confidence interval. Substituting this value in the formula yields 301 pregnant women.
Where: n= sample size
p= Prevalence of self-medication among pregnant women
d= Margin of sampling error tolerated
Zα/2= Critical value for normal distribution at 95% confidence level which equals to 1.96 (z value at α =0.05).
Since the total pregnant women, attending ANC at NRH was less than 10,000, which was 553; reduction formula was applied as follow:
Where; Nf = final sample size
n = Calculated sample size (301)
N = Source of population (553)
Therefore, 195 pregnant women were recruited consecutively and interviewed. During the study period, 203 pregnant women were comes to the hospital. Only 195 pregnant women were fully participated whereas five pregnant women were critically ill and three of them were not voluntary to participate in the study.
Dependent variables: Self-medication
Independent variables: Age, marital status, number of children, occupation, monthly income, place of residence, distance from health center.
Data collection instrument and procedure
Data about socio-demographic, medical history, and self-medication practice of the pregnant women was collected from participants by semi-structured interview questionnaire items. The questionnaire was prepared in English language after reviewing literatures. Then translated to Afan Oromo language and back translated to English to ensure consistency of meaning. Before the beginning of the actual data collection, the questionnaire was pretested on 5% pregnant women attending NRH antenatal care who were later excluded from the study and a slightly modification was made on questionnaire
Ethical clearance was obtained from Wollega University, College of Health Sciences Ethical Review Committee. A formal letter was written to the NRH. Then permission was given from NRH in order to conduct the study. Written informed consent was obtained from study participants prior to data collection.
Data processing and analysis
Data was coded, entered, and analyzed by using SPSS version 21 software. Statistical significance was considered when p-value is less than 0.05. Univariable and multivariable logistic regression analysis was used to determine factors associated with self-medication practice.
Socio demographic characteristics of study participants
In this study, 195 pregnant mothers were participated. The respondents mean age was 30.4+ 3.45 years, which range from 21 to 45 years. Ninety-eight (50.3%) of the respondents were between the ages of 21-30 years. Urban residents’ account 159 (81. 5%) of respondents. There is no smoking history among all respondents. Majority of the respondents were married, which account 187 (95%). In addition, seventy-three (37.4%) had completed diploma/degree. Government employees were 54 (27.7%) of participants. One hundred thirty five (69.2%) respondent get greater than 3000 Ethiopian birr per month. One hundred thirty two (67.7%) of respondents have less than 5-kilometer distances from health facility and 52 (26.2%) of respondents has two children previously born. Majority of pregnant women 179 (91.8%) had planned pregnancy, in 29 (14.9%) respondents history of adverse pregnancy outcome occurred and 101 (51.8%) participants were currently at second trimester pregnancy (Table 1).
|Variables||Number (n)||Percent (%)|
|Age in years|
|Monthly in come|
|Place of residence|
|Distance from health facility|
|Number of children previously born|
|Timing of first ANC visit|
|Number of ANC visit
|Pregnancy planning status
|History of adverse pregnancy outcome
Table 1: Socio-demographic characteristics of pregnant women attending antenatal care at Nekemte Referral Hospital, 2018.
Self-medication practice among pregnant women was 42 (21.5%) during current pregnancy (Figure 1). The most common self-medicated drugs were paracetamol 19 (45.2%) and amoxicillin 12 (28.6%) (Figure 2). This drugs were used for headache 13 (31%) and diarrhea 11 (26.2%) management (Figure 3).
Twenty-four (57.1%) of pregnant women obtain information about self-medication practice from druggist/pharmacist. The mentioned reason for using self-medication was; prior experience to the drug 19 (45.2%) and better knowledge about the disease and treatment 16 (38.1%). Forty one (98%) of respondent access to self-medication at community pharmacy and drug store. Only three (7.1%) of respondent who used self-medication knows the side effect of the drug they used (Table 2).
|Reason for self-medication||Number||Percent (%)|
|Better knowledge about the disease and the treatment||16||38.1|
|Had prior experience to the drug||19||45.2|
|Source of information|
|From where do you get the drug|
|Community pharmacy and drug store||41||97.6|
|What do you know about drugs that you have used|
|How to take||19||45.2|
Table 2: Characteristics of self-medication among pregnant women attending antenatal care at Nekemte Referral Hospital, 2018.
Factors associated with self -medication
Age group and occupational status were found to have a significant association in multivariate logistic regression analysis. Respondents aged between 20 to 30 years (AOR=0.108, 95% CI: 0.012-0.952) and 31 to 40 years (AOR= 0.078, 95% CI: 0.009-0.698) were less likely to practice self-medication than those above 40 years old respondent. Farmer pregnant women were less likely (AOR=0.881, 95% CI: 0.006- 1.099) to use self-medication than those who were students.
There is no significant association between self-medication use and monthly income, place of residence, education status, marital status, distance from health facility, number of children previously born, timing of first ANC and Number of ANC visit both in the univariate and in multivariate logistic regression analysis (Table 3).
|Variables||Self-medication use||COR||AOR 95%CI|
|20-30||21||77||0.136 (0.017,1.059)||0.057||0.108 (0.012-0.952)||0.045*|
|31-40||20||49||0.091 (0.012,0.714)||0.023||0.078 (0.009-0.698)||0.023*|
|Illiterate||7||27||1.456 (0.548,3.869)||0.452||1.419 (0.445-4.520)||0.554|
|Primary||4||21||1.981 (0.605,6.490)||0.259||1.727 (0.431-6.928)||0.440|
|Secondary||4||21||1.981 (0.605,6.490)||0.259||1.017 (0.235-4.400)||0.982|
|College& above||7||31||1.671 (0.635,4.400)||0.299||2.920 (0.498-17.119)||0.235|
|Govt. employee||14||40||0.989 (0.374,2.614)||0.982||0.277 (0.049,1.560)||0.146|
|Self-employee||14||49||1.212 (0.463,3.174)||0.696||0.293 (0.058,1.488)||0.139|
|Farmer||1||11||3.808 (0.429,3.783)||0.230||0.881 (0.006,1.099)||0.040*|
|House wife Student||4
|<1000||1||10||3.107 (0.383.25.207)||0.289||6.993 (0.089,2.059)||0.985|
|1001-2000||2||12||1.864 (0.396,8.770)||0.431||0.585 (0.112,3.063)||0.525|
|2001-3000||7||28||1.243 (0.496,3.113)||0.643||0.866 (0.331,2.264)||0.769|
|Urban||33||126||1.273 (0.546,2.966)||0.576||0.429 (0.089,2.059)||0.290|
|Distance from health facility|
|<5 km||30||102||1.133 (0.481,2.671)||0.775||1.751 (0.436,7.035)||0.430|
|5-10 km||3||24||2.667 (0.646,11.006)||0.175||0.579 (0.192,3.756)||0.542|
|Number of children|
|No||10||31||1.033 (0.322,3.319)||0.956||0.503 (0.128,1.975)||0.325|
|One||10||27||0.900 (0.278,2.914)||0.860||0.759 (0.192,3.009)||0.695|
|Two||9||42||1.556 (0.482,5.019)||0.460||0.466 (0.119,1.820)||0.272|
|Three||7||35||1.667 (0.487,5.700)||0.416||0.308 (0.073,1.294)||0.108|
Table 3: Factors associated with self-medication among pregnant women attending antenatal care at Nekemte Referral Hospital, 2018.
The present study assessed self-medication and its associated factors among pregnant women Attending Antenatal Care at Nekemte Referral Hospital. The prevalence of self-medication practice in our study was 21.5%, which was lower than study done in Congo, Tanzania and Iran [2,3,16]. This discrepancy might be because of sample size difference since data for this study was lower, differences in regulatory compliance and knowledge of medications. Also the finding of this result is lower than a study conducted in Harar, Ethiopia . The main reason for this difference is that in our study self-medication to modern medicine was assessed whereas self-medication to both conventional and herbal medicines was assessed in Harar study.
On the contrary the finding of this study is higher than a study done in Bangladesh . This is due to the weak pharmaceutical regulatory system in case of Ethiopia since any one can buy any medicine without a prescription from the retail outlets without prescription, differences in knowledge of medications and sample size. However, the current findings of self-medication practice was in line with a studies conducted in the Iran, Bahir Dar Ethiopia and Addis Ababa Ethiopia [11,18,19].
In 17.5% of pregnancies, at least one drug associated with a teratogenic mechanism was in use during first trimester. The teratogenic total exposure trend increase in the second and third trimesters . In current, study the most common self-medicine used were paracetamol 19 (45.2%) and amoxicillin 12 (28.6%). This study is in line with a study done in Brazzaville, Congo and Ethiopia [2,21]. The most common indication for use were headache 13 (31%) and diarrhea 11 (26.2%).
Pregnant women use self-medication because of safe treatment, availability of drugs, emergency usage, knowledge about drugs, advice from traditional healers, non-serious illness and lack of faith in doctor’s practice [2,17]. Similarly, our study indicated the reasons why pregnant women practiced self-medication. Accordingly easy access to medicines from pharmacies or drug shops without prescription, time saving, have prior experience to the drug, better knowledge about the disease and the treatment were responsible to self-medication in Nekemte Referral Hospital.
In the present study, respondents aged between 20 to 30 years and 31 to 40 years were less likely to practice self-medication than those above 40 years old respondent. The low rate of self-medication in the age group younger than 40 years could be because this group of pregnant mothers had less experience of diseases and using medications than older pregnant mothers. Farmer pregnant women were less likely to use self-medication than those who were students. The low practice of selfmedication in farmers’ pregnant mothers might be fear of side effect and poor communication with pharmacies to purchase drug.
Generally, this study has the following strength: The study determined the prevalence of self-medication practices among pregnant women and identified factors associated to self-medication practices.
Limitation of the Study
This study has the following limitations: First data was gathered through interview questionnaire; therefore, recall bias may influence the results. Some patients may prefer telling stories about their positive side. Second, the study subjects were recruited consecutively that might affect the finding.
The prevalence of self-medication use among pregnant women attending ANC at Nekemte Referral hospital was found to be 42 (21.5%). The most common indication for use was headache 13 (31%) and diarrhea 11 (26.2%). Paracetamol (45.2%) and amoxicillin (28.6%) were found to be the most self-medicated drug among the pregnant women. Pregnant women with age group of 20 to 30 years, 31 to 40 years, and farmer were less likely to practice self-medication. However, in this study, herbal medicine use was not addressed and further prospective longitudinal study will be required to clarify their use in pregnant women.
We were thankful for the co-operation of all pregnant mothers who participated in this study for their sincere response and precious time.
Availability of data and materials
The data used during current study are available from the corresponding author up on reasonable request.
The authors declare that they have no competing interests.
BGB conceived and designed the study; extracted, analyzed and interpreted the data. GBW and BGL supervised the whole research, guided the conception and design of the study, and assisted with analysis, interpretation of data and drafted the manuscript. All authors read and approved the final manuscript.
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Citation: Wakjira GB, Boru BG, Labata BG (2019) Prevalence of Self-medication and its Associated Factors among Pregnant Women Attending Antenatal Care at Nekemte Referral Hospital, Oromia Regional State, West Ethiopia. J Bioanal Biomed 11: 160-165. DOI: 10.4172/1948-593X.1000228
Copyright: © 2019 Wakjira GB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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