CHAPTER ONE

INTRODUCTION

• Introduction

This chapter shall focus on the background of study, statement of the problem, Research objectives, Research questions, Hypothesis, significance of study, Scope of study, study justification, and operational definition of terms.

1.1 Background of the Study

Self-medication is defined as the acquisition and use of one or more medicines without a physician’s opinion or diagnosis as well as without prescription or therapeutic monitoring, including the use of herbal or allopathic medicines (      WHO, 2008). Nowadays, the excessive use of medicines and generally self-medication is considered as one of the major health and socio-economic problems in different countries (Shafie et al., 2018). The most common ailments for which the pregnant women practiced self-medication were the common cold, headache, anemia and nausea/vomiting (Alonso-Castro et al., 2018). There is a general fear among women in the use of allopathic or herbal medications during pregnancy. Some of the reasons for the increased rate of self-medication are the followings: the urge to self-care, feeling sympathy for the family members during illness, lack of health care services, poverty, ignorance, misconceptions, extensive advertisements on drugs and the availability of drugs in places other than pharmacies, high cost of consultation of private doctors, emergency use and prior experience about illness, ready access to drugs, greater availability of medicinal products (Ahmad et al., 2014). The adverse effects of self-medication become more serious when the self-medicating person is a pregnant woman. Self-medication by pregnant women especially in the first trimester of pregnancy can cause some serious effects to the unborn baby and the mother. These effects may include malformation of children, or hindrance in normal growth of the baby, defects in the development of the reproductive organs, urinary retention, intersex, undescended testis and other problems with the urethral (Bagheri and Abbaszadeh, 2014).

 Studies reported in Ethiopia revealed a prevalence of auto medication among pregnant women of 50.4% (Bayisa et al., 2014) and 69.4% (Jambo et al., 2018), in Nigeria 85% self-medication was reported among pregnant women, 59.9% of pregnant women auto medicated in Democratic Republic of Congo (Mbarambara et al., 2016) and prevalence of auto-medication with antimicrobials in Cameroon was 68.4% (Amin et al. 2019). These figures suggest that prevalence of self-medication is high in many regions of the globe.In most developing countries such as Cameroon where there is ready accessibility to drugs, the likelihood that people will auto medicate is high, with the inclusion of pregnant women (Shafie et al., 2018; Joseph et al., 2017). Nevertheless, many medicinal plants lack scientific evidence for their toxicity, chemical composition, and pharmacological effects. Despite improving access to healthcare in urban areas, many people rely on medicinal plants (Alonso-Castro et al., 2018). In developing countries, and particularly in Africa, studies have revealed a higher burden (30% – 85%) of self-medication (Elong Ekambi et al., 2019). The practice of self-medication among pregnant women continues to be alarming, despite the associated risks. However, there is little documentary evidence on what has been done to ascertain the knowledge, and practice of self-medication among pregnant women in Cameroon especially in the Limbe Sub-division.

1.2 Statement of problem

There is an increasing tendency to use medications indiscriminately, making this practice a public health problem (Kasulkar & Gupta, 2015) in the developing countries just as much as in the already developed nations. Globally, self-medication is a generalized common practice. Although the prevalence of self-medication may vary from country to country, several factors have shown a very consistent association with this practice (Carrasco-Garrido et al., 2014; Martins et al., 2002). 

Self-medication put patients at serious risks which could cause major public health issues of drug resistance. Rising pathogen resistance to drugs and antibiotics, resulting from self-medication, remains a real issue of global concern. Regardless of public awareness and concern of health care providers/professionals, irrational use of antibiotics is increasing ranging from about 50% to almost a 100% (Kretchy J.P et al, 2021). Fake drugs and medicines have worsened self-medication due to the easy access of fake drugs and medications. Counterfeiting of drugs was first mentioned at the WHO conference of professionals held in Nairobi in 1985 (Kretchy J.P et al, 2021). Self-medication with antibiotics has been identified with late diagnosis of different conditions and this affects the result of the treatment process. It has been estimated that about 70% to 80% of cervical cancer cases are diagnosed at late stages resulting from delay as patients treat themselves personally in light of getting better. (Kretchy J.P et al, 2021). A study conducted in France by Buccellato (2015) showed that the risk of negative reactions (17.6%) can be intense and result in hospitalization.

The inherent risks of self-medication include drug resistance, inappropriate self-diagnosis, delays in seeking medical advice when needed, intense negative reactions, dangerous drug interactions, inappropriate manner of administration, wrong dosage, wrong choice of therapy and risk of over-dependence as well as abuse.

Excessive and wrong use of antibiotics has led to recurring infections and high emergence of antibiotic resistance which is a global issue with a strong impact on disease and death rates.

Therefore, self-medication when frequent, has many risks to the individual and causes a large social burden in terms of public health work and rise of drug resistance. More so, drugs used as home palliatives may be fake with difference in quality and wrong doses. Infections are often self-medicated with antibiotics which could sometimes be inappropriately dosed. While this may provide some quick relief of some symptoms, it may hide some other symptoms which are latently present, and can cause resistance, complications and other negative side effects of long-term use of the antibiotics.

In a recent study conducted in Bonadikombo community, in Limbe (MASEKE Fernandez, 2023.) revealed that high prevalence of self-medication amongst adults. Bearing in mind the different risks of Self-medication and the realization of the study, the researcher sought then to find out specifically the level at which pregnant women of the community were involved in this practice

And assess their knowledge on the practice.

1.3 Research Objectives

1.3.1 General Objective

To assess knowledge of the practices and effects of pregnant women towards Self-medication in the Bonadikombo community, Limbe during pregnancy

1. 3.2 Specific Objectives
2. To determine the knowledge of pregnant women towards Self-medication of the Bonadikombo Community, Limbe
3. To assess practices of pregnant women towards Self-medication of the Bonadikombo Community, Limbe.
4. to determine the effects of self-medication with pregnant women of Bonadikombo Community.

1.4 Research Questions

1. What level of knowledge do pregnant women in the Bonadikombo Community, Limbe have towards Self-medication in pregnancy?
2. What are the attitudes of pregnant women in Bonadikombo community, Limbe towards the practice of Self-medication in pregnancy?
3. What are the effects of self-medication on pregnant women in Bonadikombo community?