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Self medication and its impact on public health in Africa

Self-medication is a global phenomenon. People around the world, irrespective of their age, gender, or education, practice self-medication. However, the practice of self-medication is particularly rife in developing countries, like those in Africa, with poor healthcare systems and lower socioeconomic status.

Nowadays, for many reasons, the rate of people managing their health without consulting qualified health personnel is on the increase. In many African countries, it is not uncommon to find medications freely displayed for sale in unauthorized places such as markets, shops, roadside stalls, motor parks and other public places by individuals not duly licensed.

Self-medication is also closely associated with the global antibiotic resistance crisis. Hence, it should be a top-priority for healthcare authorities globally, and increasing public awareness is critical to protect the health of individuals and communities.

Given the high prevalence of self-medication in Africa and its associated adverse health and socio-economic effects, self-medication poses an enormous threat to public health and a burden on the already strained health systems on the continent

What is self-medication?

Self-medication, as defined by the World Health Organization (WHO), is the use of medicinal products to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a medication prescribed for chronic or recurring diseases or symptoms. Self-medication is also defined as the taking of drugs, herbs or home remedies on one’s own initiative, or on the advice of another person, without consulting a doctor.

Like in many other African countries, the rate of self-medication in Nigeria with both OTC and prescription medicines has been reported to be approximately 90% among the population, and as high as 94.1% in rural communities.

Impact of self-medication on public health in Africa

Self-medication is a double-edged sword with advantages and disadvantages. On one hand, it is recognised in healthcare as an element of self-care and contributes a fair degree of success to the management of minor ailments with “over the counter” (OTC) medicines. On the other hand, it can harm individuals, families, and communities, and its risks and negative effects largely outweigh its benefits.

Self-medication provides temporary relief of sickness instead of a permanent cure by suppressing and masking the signs and symptoms of sicknesses, delaying diagnosis and causing relapse. It also increases the possibilities of wrong self-diagnosis and therapy, drug overdose, underdose and abuse, incorrect route of administration, treatment-seeking delay, drug interactions, contraindications, polypharmacy, and increased hospitalization and healthcare costs. To the community, self-medication could lead to drug-induced diseases and antibiotic resistances.

Given the high prevalence of self-medication in Africa and its associated adverse health and socio-economic effects, self-medication poses an enormous threat to public health and a burden on the already strained health systems on the continent.

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Factors facilitating self-medication in Africa

In Africa, self-medication is facilitated by many factors including weak drug regulatory practices, poor supply chain management and chaotic drug distribution, lack of access to health care and/or non-availability of essential drugs in many public health facilities, long delays in hospitals, poverty and relatively high cost of hospital treatment.

Other common reasons for indulgence in self-medication include ignorance and poor health literacy among the public, previous experience in treating a similar illness, and illness being considered too trivial.

Strategies to curb harmful self-medication practices in Africa

Given the impact of self-medication on public health, there is an urgent need for the development and implementation of practical measures to control self-medication practices across Africa. All stakeholders in public health have a role to play here.

In view of this, Bloom Public Health proposes the following strategies to curb harmful self-medication practices in Africa:

• Strengthening drug regulations and control: African governments and NMRAs must strengthen drug laws and enforcement activities. There should be effective and efficient enforcement of the existing regulations against free display and sales of drugs in unauthorized places and by unlicensed persons.

• Increasing access to healthcare by strengthening primary health centres (PHCs): Equipping PHCs with healthcare providers and ensuring availability of essential drugs is necessary to increase access to healthcare, particularly in rural communities. Improved access and availability of health services will encourage individuals and communities to consult qualified health personnel for the management of their health needs.

In view of this, Bloom Public Health, along with its strategic partners, is working with some State Governments in Nigeria to establish functional Drug Revolving Fund (DRF) schemes in these States. This project will ensure that essential medicines and medical products are accessible, available, and affordable in all public health facilities within these states.

• Optimizing the health insurance schemes: This involves ensuring that there is a wider coverage for health insurance schemes in African countries, by putting some mechanisms in place to include the vulnerable and the underserved population in the schemes. Provision of health insurance is critical to reduce the costs of healthcare services.

• Education and awareness campaigns: Patient education on the risks and long-term implications of self-medication and interventions to enhance health literacy among the public is critical to curtail harmful self-medication practices in Africa.

Conclusion

Although self-medication holds some benefits in the management of minor illnesses, harmful self-medication poses a major threat to public health in Africa. It must therefore be addressed as a matter of top priority, with strategies deployed to curtail SM practices in Africa.

Anyakora is the CEO of Bloom Public Health and a public health expert &

Odibeli is a pharmacist and the regional communications manager at Bloom Public Health

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