Prevalence of Self-Medication and the Influence of Environmental Factors and Healthcare Accessibility Barriers Among Young People Aged 15–24 Years in Ilorin Metropolis, Kwara State, Nigeria

Abstract

Self-medication, the use of medicines without consulting a qualified health professional, is a major public health concern in Nigeria, and young people are particularly vulnerable. Community-based evidence from Ilorin Metropolis, Kwara State, is scarce. This study estimated the extent of self-medication and examined the environmental factors and healthcare accessibility barriers associated with it among young people aged 15–24 years in Ilorin Metropolis. A descriptive cross-sectional survey was conducted among 384 young people in six wards of Ilorin East, Ilorin West and Ilorin South Local Government Areas (LGAs), selected by multistage sampling in which the final stage (households) was convenience-based. Data were collected with a validated, structured, researcher-designed questionnaire (test–retest r = 0.84) and analysed in SPSS version 27 using frequencies, percentages, means, chi-square tests and binary logistic regression at the 0.05 significance level. Of 400 questionnaires administered, 384 were valid (response rate 96.0%). Across seven practice items, 57.6% of pooled responses indicated engagement in self-medication (a pooled response proportion, not a prevalence; grand mean = 2.65), and 227 of 384 respondents (59.1%) were classed as self-medicators. Analgesic use without medical advice (77.6% always or often) and purchase of medicines without a prescription (71.6%) were the most common practices. Self-medication was more frequent among respondents with high than low environmental-factor exposure (67.0% vs 49.1%; χ²(1) = 11.77, p < .001); the environmental model was significant overall (Nagelkerke R² = .110), but no single environmental item was independently associated. Self-medication was also more frequent among respondents who perceived high barriers to healthcare access (69.3% vs 47.5%; χ²(1) = 17.87, p < .001), with lack of health insurance (mean = 2.89) and cost of consultation (mean = 2.76) the most prominent financial barriers. Self-medication is common among young people in the sampled wards of Ilorin Metropolis and is associated with a permissive drug-retail environment and perceived financial barriers to formal care. Because the final sampling stage was non-probabilistic and the design is cross-sectional, the results show associations, not causes. Enforcement of prescription-only rules by the Pharmacists Council of Nigeria, NAFDAC and the Kwara State Ministry of Health, and affordable health insurance and primary care for young people, merit consideration.