Social dynamics of community drug use: a case of offinso district
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Date
2000-02-05
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Abstract
Drug use is impacted by a complex web of knowledge, attitudes practices and influences that goes beyond the usual biomedical model Socio-cultural and organizational environment in which medicines are used should be examined in any attempt to promote appropriate use of drugs among the public. Thus, the main objective of the study was to explore the social dynamics influencing treatment - seeking behaviours and drug use among communities in Offinso District, Ashanti Region of Ghana, as a case.
The core of the study on community drug use is a cross - sectional household survey, which was preceded with a review of literature on drug use studies conducted worldwide under the WHO Action Programme on Essential Drugs. This was complemented with information gathered from informal group discussions with patients attending medical review at two health centers.
A sample of 100 households with a person reporting sick in the month preceding the week of survey was drawn based on the statistical assumption of expected prevalence rate of 50% with a tolerable margin of error of 10%, at a confidence interval of 95%. The sample size was distributed over four communities with health care facilities (namely Offinso ,Abofour, Nkenkenso, and Akomadan), based upon probability proportional to sub-districts population size.
Data Analysis of the responses gathered in the survey revealed the magnitude or prevalence rate of self-medication practices as a first resort in illness episodes as 57% among the communities. This stands in contrast to 39% resorting to official health care centres and 3% to traditional healers, with
one taking no action at the first signs of symptoms of illness. Medications used in self-treatment were appropriate only in 21% of the 57 cases so treated. A limitation to this finding is that multiple resorts were common (especially in treatment failures), and reliance on results of first resort may over or underestimate certain sources of treatment.
The multiple factors and variables identified to influence treatment seeking behaviour and drug use to varying extent in the communities include:
I. Aetiology, Prevalence and severity of illness.
II. Economic and opportunity cost, as well as access of service to care seeking.
III. Advice of friends, family and relatives.
IV. Perceptions on efficacy on drugs such as injections, blood tonics and herbal products
V. Drug promotion and advertisements on radio and television, and in mobile vans. There are also observed trends between treatment patterns and socio-demographic characteristics of respondents.
The strongest conclusion made is observed importance of self-treatment in the hierarchy of resort. The study recommends a systematic and targeted public education on appropriate drug use in the treatment of diseases prevalent in the district.
Pharmacist practising in the district should carve new and expanded role as public health educators on rational use of drugs. Education of chemical sellers as alternate health care providers is an important strategy to be adopted by the Pharmacy Council nationwide: they are major source of drug provision for self- treatment.
Ethical promotion of drugs and herbal products should be enforced. Drug advertisement on radio and television should be stripped off fallacious claims through strict vetting by the Food and Drugs Board.
Further studies suggested to be carried out are:
I. Treatment seeking behaviour and drug use under a different health care setting (that is communities without health care facilities) to ascertain local variations in
treatment patterns and drug use in the same geographic area.
II. Test of association between socio-demographic variables and treatment patterns using a larger sample size and stratified sampling technique.
III. Cost effective analysis of self care as an equivalent substitute, or supplement to , the use of institutional care.
Description
A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirement for the award of Master of Science in Health Services Planning and Management, 2000