Self-Medication Practices among Clients of Shanan-

Gibe Hospital, Jimma, Ethiopia

Azeb Tessema

A Research Paper to be submitted to Jimma University College of Health

Sciences, Department of Health Officer in Partial Fulfillment of the
Requirements for Bachelor Degree of Science in Health Officer.

May, 2015

Jimma, Ethiopia

1
Jimma University

College of Health Sciences, Department of Health Officer

Self-Medication Practice among Clients of Shana

Gibe Hospital, Jimma, Ethiopia

ByAzeb Tessema

Advisor:
Habtewold Deti (B.Pharm, MSc)
Shimeles Ololo (BSc.PH,MPH)

May 2015
Jimma, Ethiopia

2
Abstract

Back-ground:Self-medication makes consumers more health conscious, reduces treatment

burden on healthcare facilities and curtails the cost and time of obtaining access to
treatment. However, it increases risks such as drug resistance, adverse drug reactions,
incorrect diagnosis, drug interactions and poly-pharmacy. No data is available on the current
status of self-medication practices among Shanangibe hospital which the current study is
aimed.

Objective: The purpose of this study is to assess the practices and factors associated with
self-medication in Shanan Gibe hospital, Jimma, Ethiopia.

Methods:A cross-sectional study was undertaken in Shanan Gibe hospital fromJune 11 to

16, 2015. According to the data from the hospital, which clients used SM before one month,
the number of patientsserved at adult OPD in March,was 450,112 patients who are expected
to come into one week period were taken consecutively for the study. A pre-tested structured
questionnaire was used for data collection to assess self-medication practices. The data
were collected by threefourth year three health officer students. The validity and reliability
of the data collection format was (pre-tested) before the actual study period. Data was
analyzed using statistical package for social sciences (SPSS) version 20.0. An official letter
was taken from Jimma university communtiy Based Education office to Shanangibe
hospital administrative office.

3
Acknowledgement

I would like to thanks my advisor Habtewold Deti (B.Pharm,MSc) & Shiemeiles

Ololo(BSc.PH,MPH)

4
Abbreviation

IPF = International Pharmaceutical Federation

OPD=Out Patient Department

SGH= Shanan-Gibe hospital

SPSS= Statistical Package for Social Sciences

SM= Self-Medication

WHO=World Health Organization

5
Table of content

Abstract .................................................................................................................................
Acknowledgment ...................................................................................................................
Abbreviations .........................................................................................................................
Table of contents....................................................................................................................
List of Figures and tables .......................................................................................................
Chapter one: Introduction ......................................................................................................
1.1. Background...................................................................................................................
1.2. Statement of the problem..............................................................................................
1.3. Significant of the study.................................................................................................
Chapter two: Literature review ..............................................................................................
Chapter three: Objectives ......................................................................................................
3.1. General objective ............................................................................................................
3.2. Specific objectives ..........................................................................................................
Chapter four: Methods and Materials ....................................................................................
4.1. Study area and Period .....................................................................................................
4.2. Study design....................................................................................................................
4.3. Populations .....................................................................................................................
4.3.1. Source Population ........................................................................................................
4.3.2. Study population ..........................................................................................................
4.3.3. Inclusion and exclusion criteria ...................................................................................
4.4. Sample size and sample procedure .................................................................................
4.4.1. Sample size determination ...........................................................................................
4.4.2. Sampling technique .....................................................................................................
4.5. Study variables ...............................................................................................................

6
4.5.1. Dependent variables ....................................................................................................
4.5.2. Independent variables ..................................................................................................
4.6. Data collection procedure ..............................................................................................
4.6.1. Data collection instrument ...........................................................................................
4.6.2. Personnel......................................................................................................................
4.6.3. Data collection technique ............................................................................................
4.7. Operational definition .....................................................................................................
4.8. Data analysis plan ...........................................................................................................
4.9. Data quality management ...............................................................................................
4.10. Ethical considerations ...................................................................................................
4.11. Limitation of the study..................................................................................................
4.12. Dissemination of the findings .......................................................................................
Chapter Five: Result…………………………………………………………………………
Chapter Six: Discussion………………………………………………………………………
Chapter Seven: Conclusion & Recommendation……………………………………………...

Annex I

Plan and Budget .....................................................................................................................

5.1. Work Plan .......................................................................................................................
5.2. Budget breakdown ..........................................................................................................
Annex II
Questionnaires…………………………………………………………………………………
.Dummy table…………………………………………………………………………………
References……………………………………………………………………………………..

7
List of figures and tables

Table 1 Types of illness reported and action taken in SGH, May,2015.

Table 2 Source of modern medication in SGH,May,2015

Table 3 Factors associated with SM in SGH,May, 2015

Fig 1. Reason for SM in SGH, May,2015.

Fig2. Source of information for SM in SGH,May,2015

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Chapter One

Introduction

1.1. Background

Self-care is what people do for their own selves to establish and maintain health, prevent and
deal with illness (WHO, 1998). It is a broad concept encompassing hygiene, nutrition,
lifestyle, environmental factors, socioeconomic factors and self-medication (Al Khaja et al.,
2006, Alano et al., 2009). Self-medication, as one element of self-care, is the selection and
use of medicines by individuals to treat self recognized illnesses or symptoms (WHO, 1998).
It is use of nonprescription medicines by people on the basis of their own initiatives. Husain
A and Khanum A, (2008) also defined self-medication as obtaining and consuming
medication without professional supervision regarding indication, dosage, and duration of
treatment. However, self medication is not necessarily means the consumption of modern
medicines but also of herbs.

The International Pharmaceutical Federation defines self-medication as the use of non-

prescription medicines by people on their own initiative. Self-care, including self-
medication, has been a feature of healthcare for many years and people have always been
keen to accept more personal responsibility for their health status( IPF,2013).

Self-medication is a fairly widespread practice in the world, particularly in economically

deprived communities. When practiced correctly, self-medication has a positive impact on
individual and healthcare system. It allows patients to take responsibility and build
confidence to manage their own health, thereby, promoting self-empowerment. Furthermore,
it can save the time spent in waiting for a doctor, and even save life in acute condition and
may contribute to decrease healthcare cost( Almasdy D.,Sherif 2011)

The World Health Organization has also pointed out that responsible self-medication can
help to prevent and treat ailments that do not require medical consultation and provides a
cheaper alternative for treating common illnesses. Nevertheless, the individual bears primary
responsibility for the use of self-medication products. All parties involved in self-medication
should be aware of the benefits and risks of any self-medication product. Self-medication

9
may be associated with certain risks such as drug resistance, drug interactions, adverse drug
reactions, increased poly-pharmacy, incorrect diagnosis and drug dependence (Hughes
CM,2001; Sapkota AR,2010). The study will thus conduct to evaluate the practices of self-
medication and to identify factors associated with it in Shanangibe hospital,Jimma , Ethiopia

10
1.2.Statement of the problem

Medicines for self-medication are often called ‘non- prescription’ or ‘over the
counter’ (OTC) and are available without a doctor’s prescription through
pharmacies. In some countries OTC products are also available in supermarkets and
other outlets. Medicines that require a doctor’s prescription are called prescription
products (Rx products).
Self-medication with OTC medicines is sometimes referred to as ‘responsible’ self-
medication to distinguish it from the practice of purchasing and using a prescription
medicine without a doctors’ prescription. Self- medication is widely practiced in
both developed and developing countries. As a result medications may be approved
as being safe for self-medication by the national drug regulatory authority. Such
medicines are normally used for the prevention or treatment of minor ailments or
symptoms, which do not justify medical consultation. In some chronic or recurring
illnesses, after initial diagnosis and prescription, self-medication is possible with the
doctor retaining an advisory role (Partha et al., 2002). Studies revealed that there is
an increase in trends of self- medications particularly among the youth. This can be
attributed to socio-economic factors, life style, ready access to drugs, the increased
potential to manage certain illnesses through self-care, and greater availability of
medicinal products, socio-demographic, epidemiological, availability of healthcare
and health professional, law, society and exposure to advertisement; high level of
education and professional status (Alano et al., 2009).
Moreover, knowledge of drugs and their use are the main causes of self-medication
especially among pharmacists and physicians (Al Khaja et al, 2006). In most illness
episodes, self-medication is the first option which makes it a common practice
worldwide. In the treatment of minor illness, when problems are self-limited, self-
care can be used. The criteria for considering health problems as a minor illness
include having limited duration and being perceived as non- threatening to the
patients. For government institutions, this can reduce costs while allowing health
professionals to focus on more serious health problems (Alano et al., 2009). In
economically deprived countries most episodes of illness are treated by self-
medication (G/Mariam and Worku, 2003). In a number of developing countries

11
including Ethiopia, many drugs are dispensed over the counter without medical
supervision. In this case, self- medication provides a lower cost-alternative for
people who cannot afford the cost of clinical services. The common episodes for
which most people go for self-medication include, but not limited to colds and flu,
heart burn, infrequent and difficulty of passing stool, minor skin problems, insect
bites and many others (G/Mariam A and Worku S, 2003). Though the practice of
self- medication is as old as mankind itself, little has been exploited. If used
appropriately, self-medication could lighten the demand on doctors and make people
more health conscious. However, if abused, it could delay accurate diagnosis and
appropriate treatment, and could cause toxicity, side-effects, drug interaction and
unnecessary expenditure (Arzi A et al., 2010). The use of drugs from informal
sectors such as open markets and village kiosks encourage the practice of self-
medication (Baruzaig A a Bashrahil K, 2008).
In order to handle unnecessary health risk and bacterial resistance due to improperly
obtained drugs, it is important to consider the manners of drug availability to
consumers. Unlike in the developed countries, illegal purveyors of drugs are
common in developing countries along with some practitioners. There is much
anecdotal evidence of self-medication with such drugs and inappropriate purchasing
of medicines for a particular condition though few studies have quantified their
extent (G/Mariam and Worku, 2003). No data is available on the current status of
self-medication practices among Shanangibe hospital. wWhich the current study was
aimed.

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1.3. Significance of the Study

Due to lack of proper health education to the population, the practice of self-medication is
becoming one of the public health problems.

The rising level of resistance of infectious disease to the drug effect can be related to self-
medication as one main factor. The aim of this study is to assess self-medication practice in
Shanan Gibe hospital. The result will help in recognizing possible intervention measure and
provide the base line information to plan health education activities on self-medication
practice. Finally based on the study finding feasible recommendation and conclusion was
forwarded.

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CHAPTER TWO

LITERATURE REVIEW

Unlike the developed countries, illegal providers of drugs are common in developing
countries, which is a further source of irrational and potentially dangerous drug use
(http//www.ncbi.nig.gov))Improvements in people’s general knowledge, level of education
and socio-economic status in many countries form a reasonable basis for successful self-
medication (WHO,200).

A cross-sectional observational study done in 155 community pharmacies with 800

participants in Amman, Jordan, reported that self-medication is a common practice among
Jordanians (42.5%). The variable that was associated with extent of self-medication was
respondents’ age, where patients younger than 16 years and those older than 60 years were
less likely to self-treat. The most common reasons for self-medication in the study were that
the ailments were too minor to see a doctor (46.4%), the long waiting time to be seen by
doctors (37.7%) and avoiding the cost of doctor’s visits (31.4%) (http//www.nlm.nih.gov). A
survey done in Jordanian population on a sample of 1943 households (9281 persons) showed
that 842(39.5%) of 2133 antibiotic users identified via the survey had used antibiotics
without a prescription with in a one month study period ((http//www.nlm.nih.gov).).
Another study conducted in Khartoum state, Sudan, on self-medication showed that from
1,200 individuals included in the study 81.8% of respondents used medicines including
herbs without a medical consultation with in two months prior to the study period.

14
Proprietary medicines alone were used by 28.3%, herbs alone by 20.7%, while 32.8% had
used both.

In the study self-medication with proprietary medicines was least common with the middle
aged, the elderly and low level of education. It was most associated with low and middle
income, but no gender difference was found. Self-medication behavior with herbs was most
associated with middle-age, female gender and lowest income earners (Badeg W.&
Tsigi.G,2002). A preliminary assessment conducted in Addis Ababa showed that almost all
(99.5%) respondents have used herbal remedies for self-care. 20% of the respondents
preferred traditional medicine (TM); while 75% preferred both TM and modern medicine
(MM) for selfcare (Mecganaw F.& Getu D. 2003).

In another study conducted in Amhara region of Ethiopia on 17,780 people, from people
claimed they were sick 995(5.6%) the most important reasons for not visiting health
institutions were they believed that the disease did not need treatment in health institutions
(31.9%), bought drugs from drug vendors (27.2%) and visited traditional healers (20.2%)
(WHO,2004). A study in southern Ethiopia showed that 15% of the persons with perceived
illnesses performed self-medication. In another study conducted in Addis Ababa and central
Ethiopia the magnitude of self-care was as high as 50% (Tefera A.& Alemayhu W.2003).

A community based cross-sectional survey in north west Ethiopia conducted on 1880

households with 1070 individuals reveal that self-mediation (by the patient themselves or
care takers) was employed in 324(27.2%) cases, where as in 332(27.9%) cases no action was
taken. 164(13.8%) of self-medicated persons used modern drugs obtained from pharmacy or
drug shop. Among the reasons for self-medication in the study include unaffordability (in
financial terms) of the modern health services (37.4%), low severity of the symptoms
(29.9%) and remoteness of modern health care (4.3%) (Tefera A.& Alemayhu W.2003).

A cross-sectional study conducted in Jimma zone, on 198 households reported that from 93
responds whose family member was ill in the previous month, 8.6% took drugs by
themselves without prescription. About 68% of the 93 respondents were cured: of whom
74.6% got treatment in the health institutions while 14.3% use traditional medicines
(Solomon W.& Abebe G.2003).

15
A similar study conducted in Jimma town showed that the prevalence of self-medication in
the town is 27.6% which is almost similar with the studies done in Mexico (30%), India
(34.5%) and china (32.5%) (9). Another study conducted on 630 households in Butajira,
southern Ethiopia, it was reported that 294(46.7%) of respondents had visited health
institutions after taking anti malarial drugs at home and 112 (17.8%) had self-medicated at
home with antimalarial drugs (Tsegaye G.1998).

According to the 1982-83 rural health survey, more than half of health service seekers relied
on traditional healers, lay treatment or self-care. The use of traditional medicine among the
urban population is also very high. For instance, in Addis Ababa, where modern health
service is relatively better, a significant percentage of the population has been shown to have
used traditional medicine (Mecganaw F.& Getu D. 2003).

Reasons for self-diagnosis and self-medication in participants of a prospective study

conducted in Addis Ababa, reported that 36.6% replied they believed the disease is not
serious, 19.8% the illness emergency care, 18.2% prior experience to the illness and/or drugs
and 12.6% less expensiveness were mentioned (Tenaw A and Tsige G.2004).

16
Chapter Three

Objectives

3.1 General objectives

To assess self-medication practices among clients of Shannan gibe hospital.

3.2 Specific Objectives

 To determine the prevalence of self-medication. .

 To identify reasons for self-medication.
 To identify source of information for self-medication.
 To identify commonly treated ailments by self-medication.
 To determine factors associated with self-medication

17
Chapter Four:

Method aAnd Materials

4.1 Study Area and Period

Shanan Gibe hospital started giving service to the community in 2011 by oromia health
office. It has 60 beds and OPD which has the capacity of giving service to 450 people.
Generally in the hospital there are 74 medical staffs, 9 doctors, 6 Libratory technician, 39
Nurse, 8 midwife, 4 anesthesia with one environmentalist and 7 pharmacists. It also have its
own pharmacy, the activities done in the hospital are minor surgery, family planning and
antenatal care, emergency OPD for rural areas.

4.2 Study Design

A community based cross-sectional study design wasemployed.

4.3 Populations

4.3.1 Source of population

All patients who visit the hospital.

4.3.2 Study population

Systematically selected patients.(all 3rdpatients)

4.3.3. Exclusion criteria

The following was preclude because we aimed to describe self-medication behavior: (i)
patients unable to participate because of cognitive impairment, neuropsychiatric disorders,

18
language barriers or having presented with an unstable medical illness in the absence of a
near relative who could answer for them: (ii) declining study participate

4.4 Sample size and Sampling procedure

According to the information from the Jimma zone shanan gibe hospital, the maximum
population that came to the hospital at the end of May was 450. .By using systematic
random sampling technique the minimum sample size was determined from the total OPD
patient of the SGH by the following formula:-

n=NZ2pq/d2(N-1)+Z2pq

Where

N=Total population

n = minimum sample size

p= estimate of the prevalent of self medication, since from previous research

p=27.6% is used. (8)

Z = The standard normal variable at (1   ) %

2

confidence level and  is mostly 5% (i.e. with 95%

confidence level)

d= tolerated error 0.05(5%)

n=450(1.96)2 0.276(1-0.276)

(0.05)2(449)+(1.962)(o.276)

19
 n = 158

4.5 Study variables

4.5.1 Dependent variables

 Self-medication practice

4.5.2 Independent variables

 Age
 Sex
 Marital status
 Religion
 Ethnicity
 Educational status
 occupation
 Income
 Peer pressure
 Past experience

4.6 data collection procedure

4.6.1 data collection instrument

Using semi-structured questionnaire, consisting of the general socio-demographic, socio-

economic, perceived illnesses and actions taken to overcome the illness, among patients
with one months of illness prior to the interview the data will collect. The questioner was
answered by face to face interview and the data was analyzed by using tally sheet. .

20
4.6.2 Personnel

Four data collectors will be recruited among third year health officer students. One
supervisor will be recruited from graduating class Health Officer Student. One day training
will be given to both data collectors and supervisors. Close supervision will be done both by
the supervisor and principal investigator.

4.6.3 Data collection technique

Before data collection, training was given for data collectors to enable them to have
common understanding on the objectives of the study the data collection methods and each
of the questions in the .

4.8 Data analysis

The collect data was checked for completeness of information and consistency. The data
wasentered, and analyzed using SPSS version 20. And results were presented using tables
and figures. Chi-square test was used to determine association between dependent and
independent variables

4.9 Data quality management

Before data collection, training was given for data collectors to enable them to have
common understanding on the objectives of the study, the data collection methods and
each of the questions in the questionnaire. Therefore, the personal variations on
interpretation of the questions was minimize. The data collection was supervised by the
principal investigator.

4.10 Ethical considerations

An official letter were taken from Jimma university community based education office to
administration of hospital then verbal consent will obtain from the hospital administrator.

21
 The study subjects was clearly be informed about the purpose of the study before
administering the questions.

4.11 Dissemination of the findings

The study finding will be submitted to college of Health Sciences,department of health

officer.

Chapter Five
RESULT

The questioners were completed for 158peoples who visitedsthe shanan gibe hospital . oOut of
that the respondents 75(60.23%)were in the age of 35 and above 93(58.8%)and 65(41.2%) were
female and male respectively.mMajority of the respondents 101(63.93%) were literate while
57(36.07%) illiterate. Christian represented 65(41.12%) and muslims 93(58.86%). the majority
73(46.20%) earns monthly income of 301-600 birr and 46(25.31%) earns monthly income of 150-
300. The common illnesses for which the subjects took action where headache /fever 58(23.87%),
abdominal problem /GI 57(23.46%), cough 53(21.81%),eye infection 7(2.88%) sore throat
10(4.11%), skin disease 20(8.23%) and others 38(15.64%). who had reported headache /fever and
cough respectively, were self medicated.

Table1. Types of illness reported and action taken in Shanangibe hospital, May 2015 .

Action taken

Illness/symptom MM TM N/F Total

Headache/ fever 48 10 0 58

GI/abdominal problem 40 12 5 57

Cough 32 14 7 53

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Eye infection 2 5 0 7

/inflammation

Sore throat 2 8 0 10

Skin disease 4 11 5 20

Others 18 13 7 38

Total 146 73 24 243

Reason of self medication

85(53.79%), 67(42.40%) and 58(36.7%) reported that they used self medication because its'
previous experience for similar illness, illness was minor to see health care provider and low coast
alternative respectively,

23
 36.7
53.79

previous experince
illness was minor
low cost
42.4

Fig 1. Reason for self- medication in Shanagibe hospital, May 2015.

Source of modern medication

56(35.44%), 14(8.86%), 7(4.43%)and 3(1%) said they obtained the drugs from DRO ,left over from
privies use , neighbor / relative and kiosk

Table 2. sources of modern medicine in Shanangibe hospital,May 2015.

Sources of modern drugs Frequency %

DRO 56 35.44

Left over from previous use 14 8.86

Neighbor/relative 7 4.43

Kiosk 3 1

Source of information for SM

24
24(15.18%),18(11.39),71(44.93), 45(28.48); there source of information was personal of drug outlet
other health professional, previous experience and neighbor/relative

Chart Title

15%
1 2 29%
11%

3 4
45%

Fig.2 Source of information for SM in Shanangibe hospital,May 2015.

Factors associated with self medication

25
85(53.79),67(42.40),32(20.25), 8(5.06),58(36.70);there reason for self medication previous
experience for similar illness,illness was minor to see health care provider,long waiting time ,un
satisfaction by the service of H/F and low cost alternative.

Table 3. Factors associated with self medication in shanangibe hospitals, May 2015.

Reason for self medication Frequency %

Previous experience for similar illness 85 53.79

Illness was minor to see health care 67 42.40

provider

Long waiting time 32 20.25

Un satisfaction by the service of H/F 8 5.06

Low cost alternative 58 36.70

CHAPTER SIX

26
Discussion

Female practiced more SM (58.8%) than males (41.13%) and this findings is
in agreement with the study done in Mexico that identified women as the
fundamental element in the consumption of drugs and employment of SM
(Angeles 1992).The commonest illnesses that led to SM in this study
(headache/fever, cough, GI) where also reported similarly.

Unlike the study done in China where people used SM mainly because they
felt that they know what to do, in this study one of the commonest reason
for practice of SM was previous experience for similar illness 85(53.79%)
and its relative less cost 58 (36.7%). As who noted, SM provides a cheap
alterative to people who cannot afford to pay medical practitioners. Thus,
SM is often the first response to illness among people with low income (Lam
CL,1994).

8.86% said they obtained the drugs from over from previous use, 4.43%
from neighbor/relative, 1% from kiosk. Where majority of 35.44% are
obtained the drugs from DRO while in the studies done in Jimma
(Ethiopia) about one third and in France about three over from previous
use and from DROs(Tejedor.N,1995).

CHAPTER Seven

27
Conclusion

A significant number of people use self medication among shenen gibe clients of Jimma
town. the self medication behavior of the shenen gibe clients varies significantly with a
number of socio-demographic characteristics and its more prevalent among females
middle age and lowest income earning individuals. there is also between the types of
illness/symptoms, educational level marital status occupation and monthly income or the
population. but no association is found between the action taken for illness/symptoms and
religion of the population.

the major reason for self medication is reported to be previous experience for the
illness/symptoms and majors taken. DRO are cited to be the major source of drugs that
used for self medication. the similar illness/symptoms and drugs left over from previous
use contribute to the increases in the self medication practices .

RECOMMENDATION

28
Much has to be done in educating the public including the health care providers on the type of
illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, the
proper use of antihelmentics and the dangers of sharing and using left over drugs.

Drug Administration and Control Authority (DACA) needs to effectively implement laws on drug
handling and dispensing so as to take necessary measures on illegal providers of drugs.

The Federal Ministry of Health (MOH) and the regional health bureau may need to facilitate ways
so as to increase health service delivery institutions and quality of service delivered as well, so that
more people can have access for utilizing health facilities. Finally, further study needs to be done in
the study area to understand especially self-treatment practice of malaria in the study area.

Annex I

Work Plan and Budget

work plan

Table 1

29
 No. Activities Months
March April May June
1 Proposal X X
development
2 Recruitment X
of data
collectors
3 Training of X
data
collectors
4 Pre-testing X
the tools
5 Main Data X
collection
6 Data Entry X
& analysis
7 Report X
writing
8 Submission X
of the thesis

Table 2

5.2 Budget breakdown

30
 Unit Quantity Unit price Total Price

Birr Cents Birr Cents

Principal Per Day 1 for 3 50 150
investigator day
Advisor Per day 1 for 3 100 300
day
Data Collector Per day 1 for 3 50 150
Personal

day
Secretary Per day 1 150 150
Pans Each 5 10
Pensile Each 1 50 50
Eraser Each 1 1 1
Paper Ream 1 70 70
Stationary

Diskettes Each 1 20 20
Binder Each 1 25 15
Transportation Per trip 3 10 30
Duplication Per page 3 15 45
Binding the Each 3 6 18
report
Ground Total 24 50 959 50

Annexes
Annex I
Questioner
Part I
Socio-demographic information

31
 1. Address: Kebele _______________ House Number ____________
2. Respondent’s Age ___________ Sex____________
Head of household’s

3. Marital status _____________

4. Religion _______________
5. Educational status __________________
6. Ethnicity ______________
7. Occupational status ________________
8. Income per month (in Birr or in kind) _________________

PART – II

HEALTH RELATED information

1. Was there any health problem in your house in the last two year?
Yes  No

2. If yes, for above

S.N Age Sex Educational Marital Religion Disease/symptom Action taken

status status

3. From these actions which one did you take?

a. Bought medicine our selves without the health worker prescription.
b. Use holly water.
c. Prayed for the patient.
d. Took medicine given from the health worker.

32
 e. Use valuable traditional medicine.

4. If answered self-medication for above, reasons for preferring it?

a. Low cost alternative
b. The illness was minor
c. Emergency
d. In accessibility of health care providers
e. No satisfaction from health care providers
f. Health facilities are over burdened
g. Previous experience with similar ailments
h. Others (specify)_______________________________
5. Source of information for choosing self-medication?
a. Personnel of drug retail outlet
b. Other health professionals
c. Previous experience
d. Neighbor/relative
e. Other (specify)___________________________________
6. What was the category of the medicinal agent used?
(Could you show if there is any leftover)

a. Analgesic /antipyretic d. Antimalarial

b. Antimicrobial e. Antihelminthics

c. Traditional medicine f. Other (specify)___________________

7. If modern medicine for above, what was the source?

a. Drug retail outlets(DROs) d. Kiosk
b. Neighbors/Relative e. Other (specify) _______
c. Leftover from previous use
8. Outcome of the self-medication?
a. Improved the health condition c. No change
b. Worsen health condition d. Other (specify) _________

33
9. Your plan for future about the same perceived illness /symptom?

34
 a. Continue self-medication b. Look for modern health care

c. Other (specify) ______________________

10. Do you hoard modern drugs

a. Yes  b. No

11. If yes, why?

a. Leftover c. For emergency use
b. To treat similar ailment d. Other (specify) ___________

12. To what category do they belong, could you show sample of the drugs?
a. Analgesic /antipyretic c. Antimalarial e. other(specify)___
b. Antimicrobial d. Anthelminthics

35
 ANNEX II

DUMMY TABLE

Table 3

Socio-demographic characteristics of sample patients, Shanangibe hospital

May,2015

Socio-demographic characteristics Frequency Percentage

Sex* Male 65

Female 93

Total 158

18-24 20

25-34 43

Age* 35-44 25

45-54 15

55-64 32

>65 23

Total 158

Un married 29

Martial status Married 97

36
 Widow 14

Divorce 18

Total 158

Orthodox 43

Religion Muslim 93

Protestant 20

Catholic 2

Total 158

Illiterate 57

Informal 9

Educational status Elementary (1-4) 16

Junior (5-8) 34

Secondary (9-12) 15

10+/12+ 27

Total 158

Business man 8

Daily laborer 23

Occupation Private employee 36

37
 Government 34
employee

Farmer 47

Retire 10

Other 0

Total 158

< 150 32

Income 150-300 40

301-600 73

>600 13

Total 158

38
 Illness/symptom Frequency %
TABLE:4: frequency of
Headache/fever 53
illness/symptom in Shanangibe

GI/Abdominal 46 hospital, May 2015

cough 37

Eye infection 6

Sore throat 8

Skin disease 9

Other 24

39
 Table 5, Action taken by individuals with the socio-demographic characteristics of the individuals.
Shanangibe hospital, May 2015

Statistical test

Socio-demographic Self-medication
characteristics
MM TM N/F Total

Sex Male 34 28 13 75

Female 42 52 18 108

Total 76 80 31 183

18-24 11 16 4 31

25-34 36 25 14 75

35-44 20 17 7 44

45-54 8 15 11 34

55-64 18 27 21 66

> 65 13 17 9 39

Total 106 117 66 289

Unmarried 18 22 5 45

Marital status Married 57 35 19 111

Widow 10 13 4 27

Divorce 15 17 2 34

Total 100 87 30 217

Orthodox 32 16 7 55

Religion Muslim 27 45 16 88

Protestant 16 11 0 27

Others 2 2 0 2

40
 Total 77 74 23 172

Pre school

Illiterate 15 46 17

Educational Informal 3 7 2

status
Kindergarten

Elementary 12 8 5

(grade 1-4)

Junior 24 27 6

(grade 5-8)

Secondary 13 9 3

(grade 9-12)

Above grade 22 11 1

10 and 12*

Total 89 108 34

* Individuals who had completed grade 10/12, and attended higher education

Keys

mm-Modern medicine H/F – Health facility C/S – Chi-

square

TM – Traditional medicine T/H – Traditional healer D/F –

Degree of freedom

N/F – Non-pharmacological N/A –No action taken P –

Probability

41
 Table 6 : reported symptom/illness and action taken in Shanagibe hospital, May2015

ACTION TAKEN

MM TM N/F TOTAL

Headache/ 48 10 0 58

fever

GI/abdominal 40 12 5 57
Illness/sym
problem
ptom
Cough 32 14 7 53

Eye infection 2 5 0 7

/inflammatio
n

Sore throat 2 8 0 10

Skin disease 4 11 5 20

Others 18 13 7 38

Total 146 73 24 243

TABLE 7: reason for conducting self medication in Shanagibe hospital, May 2015

Reason for self medication Frequency %

Previous experience for similar illness 85

42
Illness was minor to see health care 67
provider

Long waiting time 32

Un satisfaction by the service of H/F 8

Low cost alternative 58

TABLE 8source of information for self medication in Shanagibe hospital, May 2015

43
Source of information Frequency %

Personnel of drug retail out let 19 12.02

Other health professional 15 9.49

Previous experience 58 36.70

Neighbor/ relative 42 26.58

Other 0 -

44
TABLE 9: distribution of category of medication in Shanagibe hospital, May 2015.

Category of medication Frequency %

Anti malarial 37

Analgesic/antipyretic 48

Traditional 80

Antimicrobial 8

Antihelmentic 2

Other 4

N/F 31

TABLE 10: sources of modern medicine in Shanangibe hospital, May 2015.

Sources of modern drugs Frequency %

DRO 56 35.44

45
 Left over from previous use 14 8.86

Neighbor/relative 7 4.43

Kiosk 3 1.89

TABLE 11: outcome of self medication in Shanagibe hospital, May 2015.

Outcome of self medication Frequency %

Improved 46 29.11

Worsen 28 17.72

No change 70 44.30

Other 0 -

TABLE 12: distribution of future plan for the same illness in shanangibe hospital, May 2015.

Future plan Frequency %

Continue S/M 56 35.44

Visit H/F 44 27.84

Visit higher H/F 12 7.59

Other 23 14.55

46
TABLE 13: reason for hoard medication in shanagibe hospital, May 2015.

Hoard medicine Frequency %

Left over 39 24.68

To treat similar ailments 32 20.25

For emergency 58 36.70

Other 29 18.35

47
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