School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
Department of Environmental Health & Sanitation Education, Akenten Appiah-Menka University of Skills Training and Entrepreneurial Development, Mampong, Ashanti, Ghana.
BMJ Open. 2023 Mar 24;13(3):e064627. doi: 10.1136/bmjopen-2022-064627.
This study estimates the prevalence of self-medication and provides an understanding of the reasons for self-medication in Ghana through the synthesis of relevant literature.
A comprehensive search was conducted in PubMed, Science Direct and African Journals Online to identify observational studies published from inception to March 2022. Google scholar and institutional websites were searched for grey literature. We included studies reporting primary data on the prevalence and/or reasons for self-medication in Ghana. Random-effects meta-analysis was used to estimate the prevalence of self-medication. Subgroup analysis was performed with the study population (pregnant women, patients and students), geopolitical zone (coastal, middle and northern) and study setting (rural and urban). Using inductive thematic analysis, reasons for self-medication were classified and tallied under key themes.
Thirty studies involving 9271 participants were included in this review. The pooled prevalence of self-medication in Ghana was 53.7% (95% CI 46.2% to 61.0%; I²=98.51%, p<0.001). Prevalence of self-medication was highest among pregnant women (65.5%; 95% CI 58.1% to 72.5%; I=88%), in the middle belt of the country (62.1%; 95% CI 40.9% to 82.0%; I²=98%; p<0.001) and in rural settings (61.2%; 95% CI 36.5% to 84.5%; I²=98%; p<0.001). The most cited reasons for self-medication included long waiting time at health facilities (73.3%), previous use of drugs (66.7%) and the perceived unseriousness of diseases (53.3%).
This study has revealed that self-medication is still an unresolved public health challenge in Ghana, with a high prevalence estimate. Self-medication is influenced by inconveniences associated with accessing healthcare coupled with poor health seeking behaviours. There is the need for improved access to quality healthcare and the promotion of appropriate health-seeking behaviours.
本研究通过综合相关文献,估计加纳自我用药的流行率,并了解自我用药的原因。
在 PubMed、Science Direct 和 African Journals Online 上进行全面检索,以确定从成立到 2022 年 3 月发表的观察性研究。谷歌学术和机构网站也被用来搜索灰色文献。我们纳入了报告加纳自我用药流行率和/或原因的原始数据的研究。使用随机效应荟萃分析估计自我用药的流行率。根据研究人群(孕妇、患者和学生)、地缘政治区域(沿海、中部和北部)和研究地点(农村和城市)进行亚组分析。使用归纳主题分析,将自我用药的原因归类并汇总到关键主题下。
本综述共纳入 30 项研究,涉及 9271 名参与者。加纳自我用药的总流行率为 53.7%(95%CI 46.2%至 61.0%;I²=98.51%,p<0.001)。孕妇自我用药的流行率最高(65.5%;95%CI 58.1%至 72.5%;I=88%),在该国中部地区(62.1%;95%CI 40.9%至 82.0%;I²=98%;p<0.001)和农村地区(61.2%;95%CI 36.5%至 84.5%;I²=98%;p<0.001)最高。自我用药最常被提及的原因包括在卫生机构等待时间长(73.3%)、以前使用过药物(66.7%)和认为疾病不严重(53.3%)。
本研究表明,自我用药在加纳仍然是一个未解决的公共卫生挑战,流行率估计较高。自我用药受到与获得医疗保健相关的不便以及不良的寻医行为的影响。需要改善获得高质量医疗保健的机会,并促进适当的寻医行为。