Caregivers’ self-medication practices for perceived febrile illnesses among under-five children in central river region, the Gambia

Drug use for under-five children by their caregivers without professional advice constitutes a public health challenge due to its potential for drug-drug interactions, overdose, and antimicrobial resistance. In the Gambia, there are only a handful of programs that control self-medication despite its harmful effects on children. Self-medication of under-five children has been rarely reported in rural areas of the Gambia. Therefore, we assessed the knowledge, practices, and reasons for the self-medication of under-five children for perceived febrile illnesses by their caregivers in the Central River Region, the Gambia.

This cross-sectional study was conducted between September and October 2023 among caregivers (n=406) of under-five children from the Central River Region, The Gambia. A mixed-method approach was used to collect data. Knowledge of childhood febrile illnesses was assessed using 9-item questions. Focus group discussions and In-depth interviews were conducted using question guides. Data were analyzed using descriptive statistics, Chi-square test, and binary logistic regression (α=5%). Qualitative data were analyzed using Atlas Ti.

The caregivers' mean age (SD) was 31.1±9.6 years and most 330(81.3%) were females. The prevalence of self-medication was 21.43% and 165(40.6%) of the caregivers had good knowledge of childhood febrile illnesses. Respondents who received information from friends (aOR=2.564; p=0.002) and those who got advice from neighbours (aOR=7.008; p=0.011) on childhood febrile illnesses were likelier to self-medicate than those who did not. Long waiting hours, lack of drugs at health facilities, and experience in self-medication were the reasons promoting self-medication in under-five children.

The prevalence of self-medication among caregivers of under-five children is low, and more than half of them had poor knowledge of childhood febrile illnesses. The practice of self-medication for under-five children was more common among younger caregivers. Caregivers of under-five children should be sensitized on the health implications of self-medication in The Gambia.

Self-medication is the process of taking drugs without prescription or advice from a professional health care provider. The practice of self-medication has always been a problem worldwide, especially among caregivers of under-five children. A limited number of studies on self-medication have been conducted in rural areas of the Gambia. Therefore, this study was conducted in one of the rural regions (Central River Region) in the Gambia between September and October 2023. We assessed the knowledge, practices, and reasons for self-medication of under-five children in the region.

The study participants involved 406 caregivers of under-five children who were either their biological parents or guardians. Both quantitative and qualitative data were collected from the participants using questionnaires and interview guides.

In this study, we found that only 81 out of 406 participants practiced self-medication and the majority had poor knowledge of childhood febrile illnesses. The practice of self-medication was more common among caregivers who got advice from friends and neighbours on childhood febrile illnesses. The reasons that promoted self-medication of under-five children by their caregivers include: long waiting hours & lack of drugs at health facilities, and experience in self-medication. With these findings, it is crucial that caregivers of under-five children are sensitized on the dangers that come with self-medication.