Use Of Non-Prescription Medications Andassociated Factors By Adults In Nyando Sub-County, Kenya

ABSTRACT

The global rise of use of nonprescription medications (NPMs) misuse may lead to unanticipated health risks and challenges. Studies in Canada, Brazil, Pakistan, Egypt, Nigeria, Eritrea, among other countries have indicated the use of NPM. In Kenya, patients visit retail drug outlets (RDOs) to purchase medicines mainly for self-medication much as they would in a supermarket. The Kisumu County Integrated Development Plan 2018-2022 report points out misuse of Non-Prescription Medication as one of the challenges to sustainable health care in the county. In the same vein, The Urban Sustainability Review: Ahero, Kisumu County (2017) recognizes misuse of Non-Prescription Medication as a threat to its public health initiatives. Since Ahero is the headquarters of the larger Nyando Sub-County, there was need for a study to map out misuse of Non-Prescription Medication and its associated factors among adults which could then help the policy makers in coming up with appropriate intervention measures to improve on the public health in the Sub-County. The specific objectives of the study were to: Determine the rate of prevalence of misuse of Non-Prescription Medication by adult residents of Nyando Sub-County, assess the socio-demographic factors that influence the misuse of Non-prescription Medication by adults in Nyando Sub-County, identify the knowledge factors associated with the misuse of Non-Prescription Medication by adults in Nyando Sub-County, and examine the health care system factors that influence misuse of Non-Prescription Medication by adults in Nyando Sub-County. The study was based on the modified Andersen (2001) model of health service utilization. The study relied on a descriptive cross-sectional survey design in the collection of its data. The 86,972 residents of Nyando Sub-County formed the target population of the study out of which a sample of 423 (Fisher’s et al., 1983) adults was drawn using systematic random sampling. Questionnaires were used to collect data from consumers of Non-Prescription Medication. Key informant guides were also used to collect data that corroborated information from the adults who engaged in Non-Prescription medication use. Key informants included 4 retail drug outlets (RDOs) and the medical superintendent from the sub county hospital. Descriptive analysis of health care system, NPM prevalence, knowledge and socio-demographic determinants were relayed in frequencies percentages, means, standard deviation, Chi-Square, ANOVA and Linear Regression equations. Content analysis of interview data was reported verbatim. Out of the total number of respondents used in this study, 57.4% were male while 42.6% were female, 37.3%, 51.8% and 10.9% were youth, middle-aged and elderly respectively, 36.5%, 46.3%, and 17.2% were formally employed, self-employed and unemployed in that order, 6.9%, 47.4%, 35.4%, 15.4% and 15.3% had university, tertiary, secondary and primary education respectively, 93.6% were Christians while 4.4% and 1.9% were Muslims and non-religious respectively. The study findings revealed that the rate of prevalence of use of Non-Prescription Medications (NPMs) was high as 61.8% of the respondents reported its use. The socio-demographic factors: - age, gender, education, employment status and religion did not influence the use of NPMs since a Chi-Square test on association between Age (χ2=0.47, p=0.52), gender (χ2=0.63, p=0.43), education (χ2=3.24, p=0.09), employment status (χ2=0.32, p=0.58) and Religion (χ2=0.44, p=0.51) and Use of NPMs yielded statistically insignificant results. However, marital status was found to influence the use of NPMs (χ2=4.24, p=0.04). Previous knowledge of disease (86.4%), advice from friends (88.9%), media advertisements (80.0%), previous prescription from the doctor (81.4%), perceived effectiveness of previous NPMs (77.7%) and belief among respondents in their ability to read and understand instructions for use of NPMs (88.9%) were identified as the key knowledge factors associated with NPMs. An analysis of the relationship between Health care system factors and use of NPMs using One-Way ANOVA revealed a statistically significant relationship (ANOV, F (5,401) =133.67, p=0.000). Hence Healthcare system factors positively influenced the misuse of NPMs. The current study provides researched information to stipulate a local policy applicable to Nyando sub County healthcare system specifically as well as the Ministry of Health at large.