Factors influencing irresponsible self-medication in rural Ethiopia: Insights from Gimbichu district

Abstract

Background: Irresponsible self-medication practice (ISMP) defined as the use of modern or traditional medicines without professional consultation, guidance or prescription, which poses health risks, is a major challenge in rural Ethiopia, where access to formal healthcare is limited and traditional remedies are widely used.
Aim: To determine the prevalence and factors influencing ISMP among community-based health insurance (CBHI) member and non-member households (HHs) in Gimbichu district, Ethiopia.
Setting: The study was conducted in the rural Gimbichu district of Ethiopia, characterised by limited healthcare access, predominantly agrarian communities, and active CBHI schemes, impacting healthcare-seeking behaviors.
Methods: A cross-sectional analytic survey was conducted among 541 rural adults using multistage sampling. Data were collected via structured interviews and analysed using descriptive statistics and multilevel regression.
Results: The prevalence of ISMP was 66.2%, higher among uninsured HHs (78.6%) than insured HHs (54.9%). Both groups practised self-medication using traditional and modern medicines without professional advice. Key predictors included low educational attainment, HH role (housewives, dependents), medicine hoarding, dissatisfaction with healthcare services, increased travel time to facilities, and perceived minor illness severity. Uninsured respondents were five times more likely to engage in ISMP. Social influences, notably recommendations from family and friends, were strong predictors, especially among the uninsured.
Conclusion: Irresponsible self-medication practice is highly prevalent and shaped by sociodemographic, structural and perceptual factors. Community-based health insurance membership plays a crucial protective role in mitigating ISMP by enhancing access to formal healthcare and reducing reliance on self-treatment.
Contribution: Targeted strategies to expand CBHI enrolment and retention, alongside improving health literacy and healthcare access, are vital to effectively reduce ISMP in rural Ethiopian communities.