MOTHERS' KNOWLEDGE AND PRACTICES RELATING TO USE OF NON-PRESCRIBED MEDICINES FOR HOME MANAGEMENT OF CHILDHOOD ILLNESSES IN IDO LOCAL GOVERNMENT AREA, OYO STATE, NIGERIA

Abstract

In Nigeria the use of Non-Prescribed Medicines (NPM) by mothers for the Home Management of Childhood Illnesses (HMCI) is a public health concern. The prevalence of the phenomenon and nursing mothers' knowledge of the associated adverse effects of the practice in medically underserved peri-urban communities are, however, yet to be fully investigated. Results from such studies are useful for instituting educational interventions for promoting rational use of medicines among mothers of Under-five Children (U5C). This study was designed to determine mothers' knowledge and practices related to NPM for the HMCI involving U5C in Ido Local Government Area (LGA), Nigeria. A cross-sectional design was adopted using a five-stage sampling technique to select 700 mothers of U5C from wards, communities, compounds, houses and households. A semi structured interviewer-administered questionnaire which included questions on socio-demographic characteristics, a 19-point knowledge scale on adverse effects of NPM and practices relating to use of NPM was used for data collection. Knowledge scores of ≤ 7, >7-13 and >13 were rated as poor, fair and good respectively. Ten Focus Group Discussion (FGD) sessions were also conducted. Quantitative data were analysed using descriptive statistics, student t-test and logistic regression at p=0.05 while the FGDs data were analyzed thematically. Respondents' age was 30.0±5.7 years, 74.9% were married and 36.3% had secondary education. Respondents' knowledge score on the possible adverse effects of NPM was 9.5±6.7; those with poor, fair and good knowledge were 37.1%, 27.7% and 35.2% respectively. Eighty-three percent had ever used NPM to treat U5C and majority (88.6%) administered NPM on their children within the month preceding the study. Malaria (54.2%) was the commonest childhood illness reported by respondents, followed by common cold (35.5%). The NPM commonly given to U5C by mothers included antipyretics (76.3%) vitamins (51.9%) haemantinics (49.6%), antibiotics (43.3%) and antimalarial (41.4%). Factors that motivated use of NPM by mothers included perceived need for first aid care (84.5%), perceived ability to treat illnesses which do not require hospitalization (76.6%) and intention to promote child’s health (75.9%). Only 32.7% of the mothers had ever listened to health talk on harmful effects on NPM on U5C. Knowledge Scores of respondents aged ≥25 years and ≤24 years were 9.9±6.6 and 7.3±6.6 respectively with a significant difference. Significantly more respondents with no formal education (91.9%) compared with those with formal education (81.8%) had ever used NPM for HMCI among U5C. Respondents with formal education were less likely to use NPM compared to those with no formal education (OR=0.39; C.I. 0.88-1.88). Most FGD participants disclosed that the practice of using NPM for HMCI among U5C was common among mothers. The reason adduced by FGD participants for the practice included long waiting time in formal health care facilities and easy access to medicines sold by patent medicine vendors in case of emergency. Respondents' knowledge of adverse effects of non-prescribed medicines was inadequate and prevalence of use of non-prescribed medication was high among mothers. Public enlightenment and community based medication counseling activities are needed to promote rational use of medicines among mothers in the study area.