Safe medication practices for under-five children: a call to action in southwestern Nigeria

Main highlight:

  • Prevalence of self-medication practices for under-five children in Southwestern Nigeria was found to be 73% among caregivers.
  • Caregivers relied on a mix of herbal, orthodox, and faith-based medications for common childhood illnesses, attributing the causes to natural phenomena.
  • Factors such as age, education, occupation, income, religion, and relationship with the children influenced caregivers' self-medication practices.
  • Policy recommendations include educating caregivers on responsible drug use, enforcing prescription of medicines for under-five children, and promoting public health awareness campaigns to improve healthcare quality

Background and introduction: 

Self-medication, the act of using medications without a prescription, is a major global health concern. The World Health Organization defines it as the use of previously prescribed or informally recommended medications. In Nigeria, self-medication is a common practice, especially among caregivers of under-five children. 

Caregivers in southwestern Nigeria often resort to self-medication for their children before seeking professional healthcare services. Individual health-seeking behavior, a lack of access to high-quality healthcare facilities, and weaknesses in the healthcare system are a few factors that affect this practice. Additionally, peer pressure, age, gender, and location also play a role in promoting self-medication among caregivers.

Self-medication among caregivers of under-five children in Southwestern Nigeria poses serious risks to the health and well-being of these vulnerable individuals. This policy brief aims to address the prevalence and driving factors of self-medication in this population and proposes strategies to promote responsible medication practices and safeguard the health of under-five children in the region.


Our study utilized a combination of qualitative and quantitative methods to investigate the prevalence and factors driving self-medication practices among caregivers of under-five children in southwestern Nigeria. Data was collected through interviewer-administered questionnaires via the Open Data Kit (ODK), Key Informant Interviews (KIIs), and Focus Group Discussions (FGDs).  Qualitative data analysis was conducted using thematic analysis with the assistance of ATLAS Ti, while quantitative data was analyzed using STATA 14 software. The analysis included frequency counts and percentages at both the univariate and bivariate levels to provide a comprehensive understanding of the issue.

Key Findings: 

  1. There is a high prevalence (73%) of self-medication for under-five children among caregivers in southwestern Nigeria.
  2. Common childhood illnesses like malaria, otitis media, gastro-enteritis, measles, mumps, respiratory infections, and febrile convulsions are often treated through self-medication.
  3. Caregivers attribute childhood illnesses mainly to natural causes.
  4. Self-medication involves a mix of herbal, orthodox, and faith-based remedies.
  5. Reasons for self-medication include timing of illness, financial constraints, and convenient payment systems at pharmacies.
  6. Pharmacists at regulated pharmacy shops have oversight, while chemist shops lack regulatory agencies.
  7. Traditional and faith-based practitioners consider their practices divine and inherited.


Age, education, occupation, income, religion, and cultural beliefs are just a few of the factors that can affect caregivers' use of self-medication on young children in southwestern Nigeria. Caregivers have a good understanding of common childhood illnesses and often attribute them to natural causes. Economic constraints and the availability of convenient payment systems at pharmacies drive caregivers to self-medicate their children. Medications used include herbal, orthodox, and faith-based remedies. It is evident that self-medication among caregivers of under-five children in Nigeria is deeply rooted in social, economic, and cultural norms. This practice poses significant risks to the health and well-being of young children. Urgent interventions are needed to promote responsible medication practices and ensure the safety of under-five children in the region.


  1. Implement targeted household-based education programs to promote responsible medication practices for under-five children in southwestern Nigeria.
  2. Launch public health campaigns emphasizing the risks of self-medication and promoting safe healthcare practices for young children.
  3. Strengthen regulations in pharmacies and chemist shops to ensure the quality and safety of medications used for under-five children.
  4. Engage the Federal Ministry of Health to support initiatives that promote responsible medication practices and improve healthcare quality for young children.
  5. Collaborate with traditional and faith-based practitioners to integrate safe medication practices into their approaches for under-five children.
  6. Partner with community leaders, schools, and religious organizations to disseminate information on responsible medication practices and encourage caregivers to seek professional healthcare services when needed.
  7. Enforce prescription of medicines for under-five children and ensure caregivers are informed about the risks of self-medication.
  8. Provide free healthcare delivery services for under-five children to encourage seeking professional healthcare services.
  9. Train healthcare professionals treating under-five children to provide health education on self-medication and appropriate use, and to recommend medical advice when necessary.
  10. Strengthen collaboration between government agencies, informal sources, and healthcare providers to ensure effective healthcare delivery for under-five children.

By implementing these recommendations, we can promote responsible medication practices, safeguard the health of under-five children, and improve healthcare quality in southwestern Nigeria.

Author (s) and affiliation(s):

  1. Oluseye Ademola Okunola, PhD (Medical and Health Services, Obafemi Awolowo University, Nigeria)
  1. Mabayoje Anthony Olaniyi Aluko, Prof. (Sociology and Anthropology Department, Obafemi Awolowo University, Nigeria)
  1. Abdulrahman Azeez Aroke, PhD (Demography and Social Statistics Department, Obafemi Awolowo University, Nigeria)

The main source of policy brief:  

PhD Thesis: (Sociological analysis of self-medication practices by caregivers to under-five children in southwestern Nigeria)

Other references:

  • Adane, M., Mengistie, B., Mulat, W., Kloos, H., & Medhin, G. (2017). Utilization of health facilities and predictors of health-seeking behavior for under-five children with acute diarrhea in slums of Addis Ababa, Ethiopia: a community-based cross-sectional study. Journal of Health, Population, and Nutrition, 36(1), 9.
  • Butler, L. D., Mercer, K. A., McClain-Meeder, K., Horne, D. M., & Dudley, M. (2019). Six domains of self-care: Attending to the whole person. Journal of Human Behavior in the Social Environment, 29(1), 107–124.
  • Machado-alba, J., Echeverri-cataño, L., Londoño-builes, M. J., Moreno-gutiérrez, P. A., Ochoa-orozco, S. A., & Ruiz-villa, J. O. (2014). Social , cultural and economic factors associated with self-medication. Biomedica, 34, 580–588.
  • Mortazavi, S. S., Shati, M., Khankeh, H. R., Ahmadi, F., & Mehravaran, S. (2017). Self-medication among the elderly in Iran : a content analysis study. BMC Geriatrics, 17(198), 1–12.
  • Okoh, M., & Enabulele, J. (2017). Herbal / Traditional medicine use and self-medication among patients prior to seeking oral health care in a tertiary health facility in Nigeria. The Journal of Medical Research, 3(3), 127–131.
  • Okunola, O. A. (2020). Patterns of Self-medication Practices by Caregivers to Under-five Children in South-Western Nigeria. Child Care in Practice, 0(0), 1–11.
  • Okunola, O. A., Aluko, M. A. O., & Aroke, A. A. (2023). Knowledge and perspectives in management of common childhood illnesses by caregivers to under-five children in southwestern nigeria: synopsis of self-medication practices. Cogent Public Health, 10(1)., K., & Adesanwo, O. (2015). The practice of self-medication for treatment of illnesses for under-five children by mothers in ibadan, Nigeria. Research Journal of Drug Abuse, 2(1), 2.

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