SELF MEDICATION AND ITS ASSOCIATED FACTORS AMONG PREGNANT WOMEN ATTENDING ANTENATAL CLINIC

1.1 Introduction

Self-medication is defined as the use of manufactured or homemade drugs without medical prescriptions seeking to treat symptoms or self-diagnosed health conditions (WHO, 2000). In many developing countries where drugs are not well-regulated analgesics, anti-malarial, antibiotics, and cough syrups drugs are prone to self-medication of which analgesics are the most commonly used preparations (Afolabi, 2008; Fox, 2001). Self-medication is a universal challenge that requires attention because of the potential threat not only to the pregnant women but also to unborn child. Data on self-medication practice and predictors among pregnant women is lacking in Nigeria. Information on the effects of this practice to the pregnant woman and the foetus globally is also scanty.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

According to World Health Organization, self-medication is the treatment of self-diagnosed disorders or symptoms by use of medicines or intermittent or continued use of medicines prescribed by physicians for chronic or recurring diseases (WHO, 2000). It is one of the basic components of self-care and includes taking of drugs, herbs or home remedies (Jambo et al., 2018) by one’s own initiative, or by the advice of another person, without consulting a doctor (Hernandez-Juyol et al., 2002).

Self medication carries serious risk of drug interactions, poly pharmacy, misdiagnosis, excessive drug dosage use, prolonged drug use, incorrect drug choice, rare but severe adverse events, dependence or abuse and increased antimicrobial resistance (Hughes et al., 2001; Awad et al., 2005; Organization, 2000).

Self-medication is common in African countries including Nigeria (Basco et al., 2004; Grigoryan et al., 2006; Mangesho et al., 2007;Nsimba et al., 2005;Awad et al., 2006; Shankar et al., 2002). Many studies have addressed the use drugs after prescriptions/directions from physicians; however data on self-medication during pregnancy is scanty. Herbal drugs are commonly used in self-medication in developing countries (Awad et al., 2006; Shankar et al., 2002; Moussally et al., 2011). The wide use of herbal drugs in pregnancy is also observed in developed countries (Moussally et al., 2011) Norway being an example (36%) (Nordeng et al., 2004).

Although some of the drugs are intended for self-medication and are of established efficacy and safety, they have serious insinuation, especially in some groups like children, elders, pregnant and lactating mothers due to inappropriate use and lack of knowledge about their side effects and interactions (Murray et al., 2003; WHO, 2001). Pregnancy is a special physiological condition when drug treatment presents needs for a special concern. Inappropriate use of medications during pregnancy may result in serious structural as well as functional adverse effects on the health of the mother and the development of the child. Even though it is not a direct cause of maternal and child mortality, it could lead to abortion and subsequently death (Benjamin, 2003; Koren et al., 2006; Nakhai-Pour et al., 2011).

Therefore, in Comprehensive Health Centre Kola Alagbado, Lagos State where the research was carried out, the activities that was conducted is to know the self medication and its associated factors among pregnant women attending antenatal clinic.

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1.3 Statement of Problems

Investigation revealed the use of self-medication by pregnant women with medicine and/or herb can disturb the development of the embryo or fetus and may cause serious structural and functional adverse effects, including low birth weight, premature birth, feeding problems, respiratory problems, malformations, developmental fetal toxicity, and other potential harm to the fetus (Abasiubong et al., 2012;Emmanuel et al., 2014;Beza, 2018;Mohammed et al., 2013;Banzal et al., 2017) and mother (Abasiubong et al., 2012; Gebremedhin et al., 2014;Joseph et al., 2017).

In addition, the increased practice of self-medication will exacerbates the danger of drug interaction and adverse event and results in irrational use of drugs (Befekadu et al., 2014). Thus, it is appropriate to evaluate and know the drugs that are consumed during pregnancy (Banzal et al., 2017).

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1.4 Aim and Objectives of Study

The aim of the study is to examine the effect of self medication on pregnant women attending antenatal clinic in Comprehensive Health Centre Kola Alagbado, Lagos State In achieving this aim, the following specific objectives were laid out as follows:

1. To evaluate the prevalence of self-medication and predictors of self medication among pregnant women in the study area.
2. To investigate the factors instigating the self medication among pregnant women in the study area.
3. To determine the pattern of self-medication and contributing factors among pregnant women attending the antenatal care (ANC) clinic in the study area.
4. To suggest an effective program for the control and monitoring of self-medication among pregnant women in the study area.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Are there factors instigating the self medication among pregnant women in the study area?
• What is the prevalence of self-medication and predictors of self medication among pregnant women in the study area?
• What are the pattern of self-medication and contributing factors among pregnant women attending the antenatal care (ANC) clinic in the study area?
• Are there effective program for the control and monitoring of self-medication among pregnant women in the study area?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There are no significant factors instigating the self medication among pregnant women in the study area
• H1: There are significant factors instigating the self medication among pregnant women in the study area

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1.7 Significance of Study

The study will be of immense importance to evaluate self-medication among pregnant women considering the above barriers in provision of antenatal care services to this population in Nigeria. Close monitoring of drug use during pregnancy is of paramount importance towards protecting the pregnant woman and the unborn foetus.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

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1.8 Scope of Study

The study focuses on the self medication and its associated factors among pregnant women attending antenatal clinic in Comprehensive Health Centre Kola Alagbado, Lagos State.

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1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

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1.10 Operational Definition of Terms

Attitude: The way one behaves towards somebody or something that shows how you think or feel.

Knowledge: To have information about something because you have experience or because you have learned it or be told.

Macrosomia: Large babies weighing more than 40kg at birth especially in diabetic mothers.

Mortality: The number of death in a particular situation or period of time.

Perception: To notice something in a particular way or hold a view about something.

Placenta previa: This is a condition in which the placenta of a fetus lies where the presenting part of the fetus is supposed to come out (the cervical OS).