Knowledge and perspectives in management of common childhood illnesses by caregivers to under-five children in southwestern nigeria: synopsis of self-medication practices

Abstract

The information and opinions of the caregivers about various childhood ailments serve as a fundamental foundation for the practice of self-medication among under-five-year-old children. The outcome of the health status of children under five is greatly influenced by the scope of such knowledge and perception. The usage of medications for children is a major global problem since they are viewed as a vulnerable population. Although self-medication behaviors are widespread in Nigeria, little is known about how they affect the youngest, most vulnerable children. The knowledge and perceived management of common pediatric disorders among children under the age of five by their caregivers in southwest Nigeria were the subjects of this study. Based on their degree of cosmopolitanism and lack of cosmopolitanism, two local government areas from the states of Lagos and Osun were chosen for the study. Nine hundred and sixty-eight caregivers to under-five children were systematically randomly selected for the study. Data were collected with the aid of structured interviewer-administered questionnaire through the use of Open Data Kit. The knowledge and the perception of caregivers were assessed via vignette-designed questions that were explained to the respondents by the trained research assistants. The data were analyzed using the STATA Package software. The unit of analysis was frequency distribution and percentages. The common childhood illnesses identified by the respondents were malaria, otitis media (ear infection), gastro-enteritis (diarrheal and vomiting), measles, mumps, respiratory tract infection, and febrile convulsion. In general, the caregivers showed a very good knowledge of the CCI presented to them. They identified correctly the illnesses associated with the symptoms. In assessing the possible causes of these CCI, the caregivers commonly attributed the cause to natural phenomena like weather, seasonal changes, dust, and sunny environment. Also, poor hygienic conditions and infection by parasites were identified to be responsible for these CCI. However, their perceived causes of some CCI were very poor. The most visited source of procurement of medicaments was pharmacy or chemist shops in their locality. Pharmacists, friends, and parents were the sources of medication by adolescents as they procured over-the-counter drugs, analgesics, and antibiotics to self-medicate. The classes of products used mostly were drugs prescribed by doctors and any available medicine in their home. The predominant reason given by a greater proportion of the respondents is their affordability of the products which was represented by the cheap cost of self-medication practice in this study. In conclusion, the caregivers in this study are very knowledgeable on the various CCI affecting their under-five children and their belief in the probable causes of the CCI are tuned towards natural causes, infection by parasites, and environmental causes. It is believed that the degree of the caregiver’s knowledge will determine the quality of childcare practice to their under-five children.

Keywords:

• Caregiver
• under-five children
• common childhood illnesses
• self-medication practices

Public Interest Statement

The perception and knowledge of caregivers in identifying the causes of common childhood illnesses (CCI) will translate to the management of these ailments among the under-five children. This study investigated; the classes of the products used to manage the CCI; possible or perceived cause of the illnesses; means of the managing the CCI; and the caregivers’ rationale for performing self-medication to treat the CCI.

This paper revealed the caregivers were knowledgeable in noticing various signs and symptoms pertaining to their children’s illnesses. Herbs, concoctions, and some other home remedies were used for under-five children. Caregivers commonly attributed the causes to natural phenomena, hygienic conditions, environmental factors and infection by parasites. The most visited source of procurement of medicaments was pharmacy or chemist shops in their locality. These caregivers self-medicate with orthodox drugs in managing CCI in this study. Caregivers’ affordability and belief systems accounted for their choice of self-medication.

Proposed strategy For parental decision enhancement derived From this study

This study proposes the below strategies for parental decision enhancement on the practice of self-medication to their under-five children:

1. Considering the various interplay of the social factors in the delivery of healthcare to under-five children, different informal or non-medical sources of seeking healthcare for the children should be identified and subsequently trained or enlightened on the need for a safe and responsible self-medication practice especially to the under-five children population. This can be achieved through a very strong and committed synergy among specialist healthcare practitioners and other informal healthcare practitioners in the community.

2. Also, health education on self-medication should be introduced at the community level to enlighten the parents and other community members on the risks and benefits of self-medication, especially for under-five children. This could be done through community awareness and public enlightenment in the form of town hall meetings or community outreach. This gives community members the opportunities to get involved and be part of the solution to under-five self-medication.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The Consortium for Advanced Research Training in Africa provided funding for this study (CARTA). In addition to being supported by the Carnegie Corporation of New York Grant No. G-19-57145 (Grant No. B 8606.R02), Sida (Grant No:54100113) (Grant No. 54100113), the DELTAS Africa Initiative (Grant No. 107768/ Z/15/Z), and Deutscher Akademischer Austauschdienst, CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand (DAAD). The DELTAS Africa Initiative is a stand-alone funding initiative of the Alliance for Accelerating Excellence in Science in Africa (AESA) of the African Academy of Sciences (AAS), and it is funded by the NEPAD Agency, which receives funding from the UK’s Wellcome Trust 107768/Z/15/Z and the UK government.

Notes on contributors

Oluseye Ademola Okunola

The author is a public health physician who specializes in medical sociology researches with interest in health systems and behavioral health studies. My research interests involve research design using both qualitative and quantitative methods to explore or explain the social context of public healthcare or services delivery. This would help mitigate the ravaging effects of epidemic and deepen strategic interventions aimed at improving the well-being of the populace. I have conducted various researches that focused on health behaviors to illnesses and towards healthcare services in all. I have a desire to understand how human beings in society function on an individual, group and societal level and how culture, religion and ethnicity influence the health and illness within society. I believe that socio-cultural context of illness and health, if well researched in the Sub-Saharan region will help in reducing the burden of most communicable and non-communicable diseases ravaging our continent.