Annals of African Medicine
Vol. 7, No.3; 2008:120 – 127
ORIGINAL ARTICLE
Page | 120
FACTORS INFLUENCING THE PATTERN OF
SELF-MEDICATION IN AN ADULT NIGERIAN
POPULATION
A. O. Afolabi
Department of Dental Services, Federal Medical Centre, Owo, Ondo State, Nigeria
Reprint requests to: Dr. Afolabi Adedapo Olanrewaju, Department of Dental Services, Federal Medical Center,
P. M. B. 1053, Owo, Ondo State, Nigeria. E-mail: dapoyemi99@yahoo.com
Tel.: +234-8066217682, +234-8056341953
Abstract
Background: Despite the growing research interest in self-medication, little information has been
available about its major determinants especially in developing countries. This informed the conduct of
this study to determine the major factors that influence the pattern of self medication in a population
of market women in Ifako-Ijaiye area of Lagos, Nigeria.
Methods: Interviewer administered pretested semistructured questionnaire was used to collect data
from 205 market women selected by multistage sampling technique.
Results: The patent medicine dealers were the commonest source of information on medications
(31.4%) and where they were obtained (52.2%). The exceptions were the educated (62.5%)
respondents who obtained theirs from hospitals and pharmacies. Trade and generic names (61.1%)
were common means of drug recognition especially among the educated respondents (P < .05).
Education of the respondents was the major factor influencing the practice of self-medication though
the pattern was descriptively associated with the marital status and educational level of the
respondents (P < .05). Benefits of the practice includes in the order: curing of ailments (58.0%), saving
time and money (32.0%) and independence of care (7.0%).
Conclusion: Literacy and public health education were the major factors influencing the pattern of self-
medication among market women. Recommendations on the role of education of market women,
patent medicine dealers and the importance of community pharmacy were suggested.
Key Words: Factors; pattern; self-medication; market women; Nigeria
Résumé
Contexte: Malgré l’intérêt croissant de la recherche sur l’automédication, peu de connaissances sont
disponibles sur les déterminants majeurs notamment dans les pays en voie de développement. Cela est
à l’origine de cette étude ayant pour but de déterminer les facteurs majeurs influençant le motif de
l’automédication dans une population de femmes au marche dans la zone de Ifako-Ijaiye a Lagos au
Nigeria.
Méthode: Un questionnaire semi structuré a été utilise par des enquêteurs pour collecter les données
de 205 femmes au marche sélectionnées par une méthode d’échantillonnage stratifié.
Résultats: Les vendeurs de médicaments agréés étaient la source usuelle d’informations sur les
médicaments (31,4%) et le lieu ont-elles étaient obtenues (52,2%). Les exceptions concernaient les
participantes instruites (62,5%) qui s’informaient auprès des hôpitaux et pharmacies. Les noms de
marque et les génériques (61,1%) étaient des moyens habituels d’identification des produits en
particulier pour les participantes instruites (p<0,05). L’instruction des participantes était le facteur
Self -medication in adults. Afolabi O. A.
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121
majeur influençant la pratique de l’automédication bien que le motif soit descriptive associe avec le
statut marital et le niveau d’instruction des participantes (p<0,05). Les bénéfices de la pratique
comportent par ordre décroissant les soins pour maladies (58,0%), le gain de temps et d’argent (32,0%)
et le non dépendance de soins (7,0%).
Conclusion: La littérature et l’éducation a la sante publique étaient les principaux facteurs influençant le
motif d’automédication parmi des femmes au marche. Les recommandations sur le rôle de l’instruction
des femmes au marche, les vendeurs de médicaments agréés et l’importance des pharmacies
communautaire a été souligne.
Mots clés: Facteurs, Motif, automédication, femmes au marche, Nigeria
Introduction
The concept of self-medication which encourages an
individual to look after minor ailments with simple
and effective remedies has been adopted
worldwide.
1-3
People hold the view that medicine
should be used in the event of any sickness or
discomfort.
4
In the United Kingdom where on the
average 50% of health care takes place within the
realm of self-medication, the government
encourages self reliance,
5,6
while agencies like the
World Health Organization (WHO) promote individual
family and community participation in primary health
care.
7
Poor diagnostic ability compounded by a
limited knowledge of appropriate management result
in the increase of self-medication and low rate of
health care utilization.
8
This shows that the practice
cuts across culture, gender, health and social status,
race, occupation or any other sociomedical or
demographic factors.
Many resort to the practice instead of contacting
professional health care workers because of long
waiting periods in hospitals,
3
minor ailments,
9,10
cost,
11-13
to save money and time,
14
lack of
accessibility,
11,15,16
shortage of doctors, or a feeling
that their ailment is beyond the knowledge of
western trained doctors.
17
Individuals sometimes self administer
medications through drug identification. Trade
names were common means of identification and
less frequently by generic name, action, color, shape
and common usage names.
18
Sources of drug
information could be from the sales clerk in the
chemist shop,
19
print media, family and friends,
20
pharmacists, general medicine dealers, general and
private medical practitioners
21
and among individuals
who interact frequently with the public like
hairdressers, salespeople and bank officials. Among
the young ones, sources of drug knowledge include
family members especially the mother (for
therapeutic purposes), peer groups and the illegal
market (for addiction purposes).
22
Individual self-care in illness is shaped in the
social environment - a major determinant of the type
and amount of health care services used.
23
The
sociodemographic determinants are age, gender,
occupation, educational level, marital status, religion,
place of residence, race, income and culture. Despite
the growing research interest in self-medication, little
information has been available about its major
determinants especially in developing countries.
1, 24-26
Studies on factors influencing the pattern of this
practice should be of interest to public health
practitioners due to its possible deleterious effects
especially in societies with high levels of illiteracy.
Market women were chosen because the main
providers of health care in the family are women,
who often diagnose most common illness and treat
them with the materials at hand. This informed the
conduct of this study to determine the major factors
which influence the pattern of self medication in a
population of market women and to make rational
recommendations.
Methodology
Ifako-Ijaiye local government was created on October
1996 out of Agege local government. Inhabited by
over 266 000 people according to 1991 census,
majority of who belong to the Yoruba ethnic group. It
is the most rural local government in metropolitan
Lagos city, with nine known markets scattered within
11 wards. The study population consists of market
women within the local government. Since there was
no available literature showing the prevalence of self-
medication among market women, a pilot study of 40
market women in Pen Cinema area of Agege, Lagos
State, yielded a prevalence of 85%. This was used to
determine the minimum sample size for this study
using the formula
27
:
n = z
2
pq
——
d
2
Where n = minimum sample size z = 1.96 at 95%
confidence interval obtained from standard statistical
table of normal distribution p = estimated prevalence
of non-adherence in a given population (85% or 0.85)
q = precision i.e. prevalence of adherence in a given
population (1 – p or 0.15) d = margin of error (0.025)
n = 196.
With the minimum sample size known, a total of
205 market women were selected, using a multistage
stratified sampling of the markets, stalls and
Self -medication in adults. Afolabi O. A.
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finally market women (assuming a market woman
per stall). Each of the nine markets was given a
number and five were randomly picked: Ojokoro,
Asokobowa, Ayewadun, Araromi and Baale-iju. These
markets were enumerated for the total number of
stalls (total of 475) and the market women selected
by sampling fraction. From each of the selected stalls,
market women were contacted, explanation about
the purpose of the study was given, verbal and
informed consent was granted before administering
the questionnaire by the researcher and three
trained assistants. Market women in this study are
defined as those who sell goods in stalls, either open
or locked-up excluding those who do not have a fixed
location like local drug, wares, and alcoholic or herbal
drink hawkers within the market. Study instrument
was interviewer administered semi-structured
pretested questionnaire with close-ended questions
assessing major sociodemographic variables, how the
medication was used, sources of information on
medication used, where medication was obtained
and benefits derived from self medication.
Data obtained was entered into a micro computer
running the statistical package for social sciences
(SPSS version 12.0.1) soft ware to validate and
analyze entries. Results of major factors influencing
the pattern of self medication consist of generation
of frequency tables and further analysis will explore
statistical relationship between variables using
2
test. The p-value will be set at 0.05.
Results
Of the 205 market women interviewed, with ages
ranging between 15 to 65 years, the mean age was
34.2 years with standard deviation of 10.4 (Table 1).
The modal age was 25-34 years and it accounted for
31.7% of the respondents. The response rate was
about forty percent probably due to the less
attention span of the market women because of
anticipation of the next customer and considering the
study of no financial advantage to them. Almost all
the respondents (95%-98%) surveyed admitted one
form of self medication or the other. Fifty-six point
six percent (56.6%) of the respondents had at least a
secondary school education while 23.9% and 19.5%
had primary and no formal education respectively.
Majority of the respondents (52.2%) were married,
20% were single, 14.2% were separated, 7.3% were
divorced and 6.3% were widowed. Most of the
market women sell foodstuff and vegetables (53.2%),
provisions-milk, tea, sugar (17.6%), cosmetics
(15.1%), clothes and bags (14.1%).
Age and modality of use of medications
(Table 2)
Irrespective of the age group, most (66.0%) of the
respondents used medications combined with each
other rather than singly (34.0%). The prevalence was
highest (72.1%) among the 34-44-year group and low
in the extreme of ages: 59.5% among the 15-24-year
group and 62.5% in the 54 years and above group.
The association was not statistically significant.
Age and source of information (Table 3)
Patient Medicine Dealers were the most common
(31.4%) single source of information on medications
used followed by medical practitioners and other
medical staff (20.6%), fellow market women (20.6%)
and other sources - advertisement, family members,
previous illness experience (27.5%). Source of
information from patient medicine dealer was
common among the older respondents (50.0% in the
45 – 54 age group and 62.5% in those 54 years and
above). There was a negative correlation between
sources of information through advertisement/mass
media, family members, and previous illness
experience with the age of the respondents. The
association was not statistically significant.
Education and the recognition of medications
(Table 4)
The commonest (61.1%) means of recognition was
through trade and generic name followed by
common usage names (21.7%) and color (17.2%).
There was a positive correlation between recognition
through trade or generic name and educational level
of the respondents. It was 27.5% among those with
no formal education (illiterates), 46.9% among the
primary, 78.9% among the secondary and 79.2%
among those with post secondary educational. On
the other hand, most (45.0%) of the illiterates
recognized their medications by color and 34.7% of
those with primary education by common age
names. The association was statistically significant.
Education and where medication was
obtained (Table 5)
There was a positive correlation between the
education level of the respondents and the tendency
to obtain medications from the hospital/pharmacies.
The prevalence among the illiterates was 7.5%,
primary - 30.6%, secondary - 42.2% and post
secondary education - 62.5%. In contrast, there was a
negative correlation between the education level of
the respondents and the tendency to obtain
medications from patent medicine stores and local
hawkers. For patent medicine stores, the prevalence
was 75.0% of the illiterates, 53.1% of the primary,
46.7% of the secondary and 33.3% of the
respondents with post secondary education. For
those who obtained their medications from the local
hawkers, the prevalence was 17.5% of the illiterates,
16.3% of the primary, 11.1% of the secondary and
4.2% of the post secondary educational level
respondents. The association was statically
significant.
Self -medication in adults. Afolabi O. A.
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123
Marital status and where medication was
obtained (Table 6)
Most (54.7%) of the married respondents obtained
their medications from patent medicine stones
rather than hospital or pharmacies (32.1%) and local
hawkers (13.2%). In contrast, hospital or pharmacies
were the major source (61.0%) of medications for the
single respondents compared to patent medicine
stores (26.8%) and local hawkers (12.2%). In addition,
80% of the divorced, 76.9% of the widowed and
55.2% of the separated respondents obtained their
medications from patent medicine stores
respectively. Hence, the patent medicine store was
the usual source (52.5%) of drug supply compared to
hospital/pharmacies (34.8%) and local hawkers
(12.7%). The association between marital status and
where the medications were obtained was
statistically significant.
Benefits derived from self medication
One hundred and eighteen (58.0%) of the
respondents felt it cured their ailment, 65 (32.0%)
said it saved time and money while 15 (7.0%) felt
they had a feeling of independence to take care of
themselves. Other responses accounted for the
remaining 3.0% (Figure 1).
Table 1. Characteristics of respondents
Characteristics No of
subjects
(n = 205)
%
Age (years)
15-24 42 20.5
25-34 65 31.7
35-44 61 29.8
45-54 28 13.6
>54 9 4.4
Educational level
No formal education 40 19.5
Primary 49 23.9
Secondary 90 43.9
Post secondary 26 12.7
Marital status
Single 41 20.0
Married 107 52.2
Separated 29 14.2
Divorced 15 7.3
Widowed 13 6.3
Table 2. Age and utilization of self-medication
Utilization of
self-medication
Age (years) Total (%)
15-24 (%) 25-34 (%) 35-44 (%) 45-54 (%) ≥55 (%)
Single 17 (40.5) 23 (35.9) 17 (27.9) 9 (32.1) 3 (37.5) 69 (34.0)
Combination 25 (59.5) 41 (64.1) 44 (72.1) 19 (67.9) 5 (62.5) 134 (66.0)
Total 42 64 61 28 8 203*
* 2 non respondents. P > .05 not statistically significant
Table 3. Age of respondents and sources of information on medications
Source of information Age (years) Total (%)
15-24 (%) 25-34 (%) 35-44 (%) 45-54 (%) ≥55 (%)
Medical practitioner/other
medical staff
9 (21.4) 15 (23.1) 15 (24.6) 2 (7.1) 1 (12.5) 42 (20.6)
Patent/General medicine
dealers
11 (26.2) 16 (24.6) 18 (29.5) 14 (50.0) 5 (62.5) 64 (31.4)
Fellow market
women/friends
7 (16.7) 12 (18.5) 15 (24.6) 7 (25.0) 1 (12.5) 42 (20.6)
Others e.g., family
members previous illness
experience
15 (35.7) 22 (33.8) 13 (21.3) 5 (17.9) 1 (12.5) 56 (27.5)
Total 42 65 61 28 8 204*
* 1 non respondent P > .05 not statistically significant
Self -medication in adults. Afolabi O. A.
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Table 4. Education of respondents and recognition of medications
None Primary Secondary Post Secondary Total (%)
Trade/generic
name (%)
11 (27.5) 23 (46.9) 71 (78.9) 19 (79.2) 24 (61.1)
Color (%) 18 (45.0) 9 (18.4) 5 (5.6) 3 (12.5) 35 (17.2)
Common usage
name (%)
11 (27.5) 17 (34.7) 14 (15.6) 2 (8.3) 44 (21.7)
Total 40 49 90 24 203*
*2 non respondents P < .05 statistically significant
Table 5. Education of respondents and where medications was obtained
None Primary Secondary Post secondary Total (%)
Hospital/pharmacy (%) 3 (7.5) 15 (30.6) 38 (42.2) 15 (62.5) 71 (35.0)
Patent medicine dealers (%) 30 (75.0) 26 (53.1) 42 (46.7) 8 (33.3) 106 (52.2)
Local hawkers (%) 7 (17.5) 8 (16.3) 10 (11.1) 1 (4.2) 26 (12.8)
Total 40 49 90 24 203*
*2 non respondents P < .05 statistically significant
Table 6. Marital status of respondents and where medications were obtained
Single Married Separated Divorced Widowed Total (%)
Hospital/pharmacy (%) 25 (61.0) 34 (32.1) 8 (27.6) 3 (20.0) 1 (7.6) 71 (34.8)
Patent medicine
dealers (%)
11 (26.8) 58 (54.7) 16 (55.2) 12 (80.0) 10 (76.9) 107 (52.5)
Local hawkers (%) 5 (12.2) 14 (13.2) 5 (17.2) 0 (0.00) 2 (15.4) 26 (12.7)
Total 41 106 49 90 24 204
*2 non respondents P < .05 statistically significant
Figure 1. Reasons for using self-medication
Discussion
The study was carried out among market women
most of whom were petty traders who sell foodstuffs
and household items and are mainly of Yoruba ethnic
group. This group of respondents is expected to
share the same experience with respect to gender,
occupation, race/tribe, socioeconomic status and
income levels. Hence, an attempt was made to assess
the effect of other factors like age, education and
marital status on the pattern of self-medication.
For all age groups, respondents used medications
combined with each other rather than in single
doses. Other studies reported similar findings.
28, 29
The use of medications in combinations was low in
the extreme of ages. This low prevalence among the
elderly agrees with an earlier study
30
while others
16,
29, 31
reported high prevalence among the younger
age group. Plausible explanation for the high used
rate of medications consumed in combination among
the 35-44year group might be due to the fact that
these were the active group and tends to have more
complaints, for instance, blood loss of menstruation,
stress of daily market schedule and family problems,
hence more drug use. The lowest used rate among
the 15-24-year group might be attributed to their
younger age; some may still be in school or learning a
trade, low purchasing power and usually have less
complaint. However, the fact that there was no
association between age and self-medication agrees
with previous studies.
14, 32, 33
The finding that most of the respondents
recognized their medications by trade or generic
name was consistent with an earlier study.
18
The
positive correlation between education of the
respondents and recognition of medication by trade
