Abstract
BackgroundSelf-medication which is the act of obtaining and using one or more medicines without medical supervision is a common practice among pregnant women. Unless proper caution is taken, it may result in maternal and fetal adverse outcomes. In Ethiopia, information on self-medication practice during pregnancy is scanty. Hence, this study aimed to assess self-medication practice and associated factors among pregnant women in government health centers in Addis Ababa.MethodsAn institution-based mixed study design using a sequential explanatory approach was employed among 617 pregnant women and nine key informants in Addis Ababa from May 8, 2017, to June 30, 2017. Multi-stage sampling technique was used to select study participants, and purposive sampling technique was used to select the key informants. The quantitative data were collected using a structured interview questionnaire and analyzed using Statistical Product and Service Solutions (SPSS) version 23.0 whereas semi-structured questionnaire was used for in-depth interviews. Binary logistic regression was used for quantitative data analysis, and thematic analysis method was used for qualitative data.ResultsThe prevalence of self-medication practice was 26.6%. Previous medication use (Adjusted odds ratio (AOR) = 4.20, 95% CI 2.70–6.53), gestational period (AOR = 0.63, 95% CI 0.41–0.98), education on self-medication (AOR = 0.36, 95% CI 0.21–0.62), previous pregnancy and delivery related problems (AOR = 1.71, 95% CI 1.06–2.76), and knowledge about risk of self-medication (AOR = 0.64, 95% CI 0.42–0.97) were significantly associated with self-medication practice. Lack of attention and priority of program designers, absence of strategies and guidelines; weak screening mechanisms, and regulatory enforcement were cited by the key informants as contributing factors for self-medication practices.ConclusionsConsiderable proportion of pregnant women practiced self-medication, including medicines categorized to have high risks. Gestational period, previous medication use, education on self-medication, previous pregnancy- and delivery-related problems, and knowledge were significantly associated with self-medication practice. In addition, there are correctable gaps in program designing, screening of pregnant women, regulatory enforcement, and strategies and guidelines. Hence, necessary measures at all levels must be taken to reduce risks of self-medication during pregnancy.
Highlights
Self-medication which is the act of obtaining and using one or more medicines without medical supervision is a common practice among pregnant women
Socio-demographic characteristics Out of the 634 study participants, 617 pregnant women participated in the study making the response rate of 97.3%
At the time of interview, 273 (44.2%) of pregnant women were on the first antenatal care (ANC) visit (Table 2)
Summary
Self-medication which is the act of obtaining and using one or more medicines without medical supervision is a common practice among pregnant women. This study aimed to assess self-medication practice and associated factors among pregnant women in government health centers in Addis Ababa. Pregnancy is a period of great physiological changes to the mother and fetus [5]. During this period, a pregnant woman may take medication to alleviate pregnancyrelated symptoms [6]. Medication use during pregnancy has been a concern both for the mother and fetus since the discovery of birth defects resulting from thalidomide crisis in early pregnancy in 1960s and teratogenic effects discovered related to use of diethylstilboestrol in 1971 [7,8,9,10].This necessitates critical evaluation of the risk level of medicines during pregnancy [11]. Medicines in category D have positive evidence of human fetal risk, and those in category X are totally contraindicated in pregnancy because they have proven fetal risks [11]
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