Prevalence and Associated Factors of Self-Medication among Adults in Borama, Awdal Region, Somaliland (2024)

Prevalence and Associated Factors of Self-Medication among Adults in Borama, Awdal Region, Somaliland (2024) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Prevalence and Associated Factors of Self-Medication among Adults in Borama, Awdal Region, Somaliland (2024) Abdihakim Mohamed H. Ali, Abdirasak mohamoud Qalinle, quman Abdullahi Moalin, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6685115/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 12 You are reading this latest preprint version Abstract Introduction : Self-medication is defined as “the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. (esan et al, 2018). Every year, are practicing self-medication in the form of self-care of health. Around the1960’s in the west-self-care and self-medication were regarded as unnecessary and potentially even unhealthy practices. This paternalistic approach to medicine, supported by health systems designed to treat sickness (rather than to prevent disease) remains a familiar aspect of health care in many countries to this day (1). Methods: this study is a community-based descriptive cross-sectional study that is conducted in Borama District, this study applied cross-sectional study design which the data collected one point at the time, cost, time and also require small sample size. The sampling technique and procedures: systematic sampling followed by simple random sampling. The final sample size was 227. Data collection: The self-administered questionnaire consisting of socio-demographic and socioeconomic factors, self-medication. Result : The study found that 75% of adults in Borama Town have used self-medication in the past year, with females being 1.85 times more likely than males. Younger adults, particularly those aged 20-25, were more likely to self-medicate. Lower income groups and non-formal education were associated with higher self-medication. However, there was no significant association between belief in traditional remedies and self-medication practices. A history of self-medication and belief in its safety were strong predictors of current practices. Conclusion : The study revealed that 75% of adults in Borama Town use self-medication, with females being more likely. Younger adults, lower-income groups, and non-formal education are more likely. A history of self-medication and safety are strong predictors. Recommendation : The Ministry of Health is investing in infrastructure, educating the public, and running public awareness campaigns to improve healthcare services and encourage safer behaviors. They are also enforcing more stringent laws pertaining to the distribution and sale of medications. Pharmacists, healthcare providers, and community involvement are collaborating to guarantee accessible and safe pharmaceutical practices. prevalence associated factors self-medication Borama Awdal Somaliland Introduction Self-medication refers to the use of medicines without a healthcare professional's consultation to treat self-diagnosed conditions or symptoms. Though sometimes viewed as a convenient and cost-effective method for managing minor illnesses, self-medication can lead to significant health risks, such as adverse drug reactions (ADRs), the development of antibiotic resistance, and complications from misdiagnosing or mistreating conditions ( 1 ). In many low- and middle-income countries (LMICs), limited healthcare access and economic constraints drive the population toward self-medication, often exacerbated by the easy availability of over-the-counter (OTC) drugs ( 2 ). In Somaliland, the prevalence of self-medication is particularly concerning, with rates in some areas exceeding 70% ( 3 ). In Borama, prior reports indicated a growing trend in self-medication practices, with figures rising from 80% in 2015 to 95.3% in 2017 ( 4 ). This study seeks to provide an updated assessment of the prevalence of self-medication among adults in Borama and explore the associated sociodemographic, cultural, and regulatory factors. Background Globally, self-medication has both benefits and risks. The World Health Organization (WHO) advocates for responsible self-medication for minor illnesses in areas with overburdened healthcare systems, as this can reduce healthcare costs and free up resources for more critical care ( 5 ). However, irresponsible self-medication—particularly in LMICs—poses dangers, including delayed treatment, adverse reactions, and the emergence of drug-resistant pathogens ( 6 ). In Borama, Somaliland, like in many other regions with limited healthcare access, self-medication is a widely accepted practice. Despite its perceived short-term benefits, the long-term public health consequences are significant. This study aims to provide current data on the prevalence of self-medication among adults and to identify the associated risk factors, which can guide public health policies. Methods A cross-sectional, community-based study was conducted in Borama District, Somaliland, in 2024. A total of 225 adults were selected using systematic and simple random sampling from three main zones in Borama. Data were collected using a structured questionnaire, which gathered information on sociodemographic characteristics, self-medication practices, sources of medication information, and knowledge of government regulations. The collected data were analyzed using SPSS version 23, with descriptive statistics used to report the prevalence and chi-square tests and binary logistic regression to examine associations between self-medication practices and other variables. Clinical trial number: not applicable. Results 1.4.1 Sociodemographic Characteristics The majority of the study participants were female (71.1%), and the most common age group was 20–25 years (49.4%). A significant portion of participants (32.9%) had a monthly income between $ 101 and $ 200, while 24% of the participants had non-formal education. The prevalence of self-medication was higher among females, younger adults, those with lower income, and individuals with less formal education, shown table below (Table 2 ). Table 2 Sociodemographic Characteristics of Study Participants among adults in Borama Awdal Region, Somaliland (N = 225) Variable Frequency Percentage (%) Sex Male 65 28.9 Female 160 71.1 Age 20–25 years 111 49.4 26–30 years 45 20.0 31–35 years 28 12.4 36–40 years 27 12.0 41–45 years 7 3.1 > 45 years 7 3.1 Income (USD/month) $ 400 40 17.8 Education Level Non-formal Education 54 24.0 Primary Education 39 17.3 Secondary Education 67 29.8 University Level 65 28.9 1.5 Prevalence of Self-Medication The study conducted in Borama indicates a high prevalence of self-medication among adults, with 75.6% of participants reporting engaging in self-medication practices. Notably, the majority of these individuals self-medicated without consulting a healthcare professional, highlighting potential concerns regarding the safety and appropriateness of such practices. Conversely, 24.4% of the surveyed adults reported they did not practice self-medication shown the table below (Table 1 ). Table 1 Prevalence of Self-Medication among adults in Borama Awdal Region, Somaliland. Self-Medication Practice Frequency Percentage Yes 170 75.6% No 55 24.4% Total 225 100.0% 1.6 Associated Factors of Self-Medication Sex : Females were 1.85 times more likely to engage in self-medication compared to males (OR = 1.85, 95% CI: 1.15–2.98, p = 0.011). Age : Adults aged 20–25 were 3.21 times more likely to self-medicate compared to older adults (OR = 3.21, 95% CI: 1.25–8.24, p = 0.015). Income : Participants earning less than $ 50 per month were 5.34 times more likely to self-medicate (OR = 5.34, 95% CI: 1.54–18.49, p = 0.008). Similarly, those earning between $ 51- $ 100 per month were 3.77 times more likely to self-medicate (OR = 3.77, 95% CI: 1.34–10.58, p = 0.012). Education : Non-formally educated individuals were 3.02 times more likely to self-medicate compared to those with university education (OR = 3.02, 95% CI: 1.50–6.08, p = 0.002). Primary education also increased the likelihood of self-medication (OR = 2.47, p = 0.017). Previous Use of Self-Medication : Participants who had previously engaged in self-medication were 6.34 times more likely to continue self-medicating (OR = 6.34, 95% CI: 3.83–10.51, p < 0.001). Belief in Safety of Self-Medication : Those who believed self-medication was safe were 2.29 times more likely to engage in the practice (OR = 2.29, 95% CI: 1.41–3.71, p = 0.001). Consulting Pharmacists : Individuals who regularly consulted pharmacists before purchasing medications were 0.32 times less likely to self-medicate (OR = 0.32, 95% CI: 0.11–0.93, p = 0.036) shown table below (Table 3 ). Table 3 Odds Ratios for Sociodemographic and Behavioral Factors among adults in Borama Awdal Region, Somaliland. Factor Odds Ratio (OR) 95% Confidence Interval (CI) P-value Sex (Female) 1.85 1.15–2.98 0.011 Age (20–25 years) 3.21 1.25–8.24 0.015 Income (< $50) 5.34 1.54–18.49 0.008 Non-formal Education 3.02 1.50–6.08 0.002 Ever Used Self-Medication 6.34 3.83–10.51 < 0.001 Belief in Safety 2.29 1.41–3.71 0.001 Consulting Pharmacists 0.32 0.11–0.93 0.036 Discussion The study found that 75.6%of adults in Borama engage in self-medication, with females, younger adults (20–25 years), those with lower incomes, and less formal education more likely to engage in the practice. the prevalence of self-medication in Borama is higher than that reported in other African countries, such as Uganda (75%) and Kenya (58.2%) ( 7 ). This higher prevalence could be attributed to several factors. One potential reason may be differences in healthcare access; if residents in Borama face barriers to professional medical advice and services, they may be more inclined to self-medicate. Furthermore, variations in cultural norms and health education might influence attitudes towards self-medication. 1.5.1 Sociodemographic Factors Age, sex, and income were significantly associated with self-medication practices. Younger adults, particularly those aged 20–25, were 3.21 times more likely to self-medicate, possibly due to a perception of invulnerability or lack of access to healthcare ( 8 ). Similarly, lower-income individuals (< $ 50/month) were 5.34 times more likely to self-medicate, possibly due to the high costs of healthcare services in the region ( 9 ). Furthermore, individuals with non-formal education were 3.02 times more likely to self-medicate, underscoring the need for public health education campaigns ( 10 ). 1.5.2 Cultural and Behavioral Factors Although belief in traditional remedies was not significantly associated with self-medication, previous use of self-medication and the belief that it is safe were strong predictors. Those who had self-medicated in the past were 6.34 times more likely to engage in the practice again, indicating the role of habit and experience in determining future behaviors ( 11 ). 1.5.3 Government Regulations Awareness of government regulations surrounding medication use was low, with 58.7% of participants unaware of any policies. This lack of awareness suggests that public health campaigns and stricter enforcement of regulations are needed to reduce the prevalence of self-medication (12). Conclusion The prevalence of self-medication among adults in Borama is 24.4% , with females, younger adults, low-income individuals, and those with lower educational levels being more likely to engage in the practice. The study highlights the need for targeted public health interventions to reduce self-medication and promote safer medication practices. Recommendations For the Ministry of Health : Public Awareness Campaigns: To address the issue of self-medication and promote safer health practices, concerted efforts are needed from various stakeholders, including the Ministry of Health, the community, health professionals, and pharmacies. Launch educational campaigns to inform the public about the risks and proper use of medications. Use media outlets such as radio, TV, and social media to reach a broad audience. Provide clear information on when and how to seek professional healthcare. Strengthening Healthcare Services : Improve access to affordable healthcare services, especially in underserved areas. Increase funding for healthcare infrastructure and resources in both urban and rural areas. Encourage the development of community health programs that provide basic healthcare and education. Regulation of Medication Sales: Implement stricter regulations on the sale of over-the-counter medications. Ensure that pharmacies adhere to guidelines for dispensing medications only with proper prescriptions. Monitor and control the distribution of potentially harmful medications. For the Community: Promote Healthy Practices: Engage Community Leaders : Encourage community discussions and workshops about the dangers of self medication. Foster a culture where seeking professional medical advice is valued and normalized. Involve local leaders and influencers in promoting safe medication practices. Use traditional gatherings and community events to spread awareness about healthcare issues. Support Each Other : Encourage neighbors and friends to seek professional help for health issues. Share information about available healthcare resources within the community. For Health Professionals : Patient Education : Take time to educate patients about the correct use of medications and the importance of adhering to prescribed treatments. Provide clear instructions and explanations for any prescribed or recommended treatments. Accessible Healthcare : Work towards making healthcare services more accessible and patient-friendly. Collaborate with community health workers to extend healthcare reach and provide support. Monitoring and Follow-Up: For Pharmacies : Responsible Dispensing : Establish follow-up procedures to ensure patients understand and correctly use their medications. Create support systems for patients with chronic conditions to prevent reliance on self-medication. Adhere to regulations regarding the sale of medications and ensure that potentially harmful drugs are only provided with proper prescriptions. Refuse to sell medications for self-medication purposes and instead guide customers towards professional healthcare services. 1.10 Limitations and strengths of the Study While this study provides valuable insights into the prevalence and factors associated with self-medication among adults in Borama Town, Somaliland, it is important to acknowledge several limitations that may affect the generalizability and interpretation of the findings. The data on self-medication practices and associated factors were based on self-reported information, which can be subject to recall bias or social desirability bias. Participants might have underreported or over reported their practices and beliefs to conform to perceived norms or expectations. Temporal Limitations: The cross-sectional nature of the study means it captures a snapshot in time and does not account for changes in self-medication practices over time. The strengths use of chi-square tests and binary logistic regression provided robust statistical analyses to examine associations between sociodemographic factors and self-medication practices. These analytical methods strengthen the validity of the study's findings. Declarations Acknowledgements and contributors Dr. Abdihakim Mohamed H. Ali served as the Principal Investigator and Supervisor of this study. His role involved designing the research framework, providing guidance throughout the data collection and analysis processes, and ensuring the academic rigor and integrity of the findings. Dr. Abdihakim's expertise in public health and medical research was instrumental in shaping the study's methodology and final conclusions. The following students contributed as Research Assistants : Zadia Mohamed Hassan , Rakia Isse Osman , Rahma Hassan Muse , Yurub Ahmed Omer , Istaahil Abdi Ashuar , Markabo Abdirisak Osman , Shukri Ahmed Isse We confirm that all changes have been made as per the reviewers' suggestions, and all co-authors have approved the final version of the manuscript. Furthermore, we confirm that all methods were carried out in accordance with relevant guidelines and regulations. Funding mechanism This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Human Ethics and Consent to Participate : Ethical approval was obtained from the horn international university and local government committee and informed consent was obtained from all participants before data collection. Authors’ contributions Quman handled data collection and entry, Abdirsak wrote the background part, and Abdihakim Mohamed provided methodology and result. Data analysis has been provided by Abdeq Hassan. Abadir Omer Mohammed has helped with the planning and gathering of the data. Availability of data and materials There is no public access to all data generated or analyzed during this study to preserve the privacy of the identities of the individuals. The dataset that supports the conclusions is available to the corresponding author upon request. Consent for publication Not applicable. Competing interests The authors disclose no conflicts of interest References Bennadi D. Self-medication: A current challenge. J Basic Clin Pharm. 2013;5(1):19-23. World Health Organization. WHO guidelines on self-care interventions for health and well-being. Geneva: WHO; 2018. Abdullah AA. Self-medication practices and associated factors in Somaliland: a cross-sectional study. East Afr Med J. 2019;96(4):123-9. Borama Health Report. Self-medication statistics in Borama District. Borama: Ministry of Health Somaliland; 2017. World Health Organization. WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights. Geneva: WHO; 2020. Mohseni M, Ahmadi S, Azami-Aghdash S. Self-medication in developing countries: a systematic review. Arch Public Health. 2018;76(1):1-11. Kassie AD, Bifftu BB, Mekonnen HS. Self-medication practice and associated factors among adult household members in Meket district, Northeast Ethiopia. BMC Pharmacol Toxicol. 2018;19(1):15. Raut A, Rijal KR, Basnet R, Shrestha DR. Self-medication practice: a case study in Pokhara valley, Nepal. Int J Pharm Sci Res. 2014;5(11):737-41. Beyene HA, Beedemariam GY, Abdu N, Jemal M. Assessment of self-medication practices in Assendabo town, Jimma zone, Southwest Ethiopia. Res Social Adm Pharm. 2017;13(1):317-23. Gyawali S, Shankar PR, Poudel PP, Saha A. Knowledge, attitude and practice of self-medication among basic science undergraduate medical students in a medical school in western Nepal. J Clin Diagn Res. 2015;9(12):FC17-22. Wazaify M, Albsoul-Younes A, Abu-Gharbieh E, Tahaineh L. Societal perspectives on over-the-counter (OTC) drugs in Jordan: a qualitative study of consumers' views. Eur J Clin Pharmacol. 2017;73(10):1299-1307. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 12 Aug, 2025 Reviews received at journal 02 Aug, 2025 Reviews received at journal 01 Aug, 2025 Reviews received at journal 29 Jul, 2025 Reviewers agreed at journal 24 Jul, 2025 Reviewers agreed at journal 24 Jul, 2025 Reviewers agreed at journal 23 Jul, 2025 Reviewers invited by journal 14 Jul, 2025 Editor assigned by journal 14 Jul, 2025 Editor invited by journal 24 Jun, 2025 Submission checks completed at journal 11 Jun, 2025 First submitted to journal 11 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6685115","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":485424651,"identity":"8484b60b-1dea-48a3-bdce-339dc967dcf1","order_by":0,"name":"Abdihakim Mohamed H. 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Though sometimes viewed as a convenient and cost-effective method for managing minor illnesses, self-medication can lead to significant health risks, such as adverse drug reactions (ADRs), the development of antibiotic resistance, and complications from misdiagnosing or mistreating conditions (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In many low- and middle-income countries (LMICs), limited healthcare access and economic constraints drive the population toward self-medication, often exacerbated by the easy availability of over-the-counter (OTC) drugs (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn Somaliland, the prevalence of self-medication is particularly concerning, with rates in some areas exceeding 70% (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). In Borama, prior reports indicated a growing trend in self-medication practices, with figures rising from 80% in 2015 to 95.3% in 2017 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). This study seeks to provide an updated assessment of the prevalence of self-medication among adults in Borama and explore the associated sociodemographic, cultural, and regulatory factors.\u003c/p\u003e"},{"header":"Background","content":"\u003cp\u003eGlobally, self-medication has both benefits and risks. The World Health Organization (WHO) advocates for responsible self-medication for minor illnesses in areas with overburdened healthcare systems, as this can reduce healthcare costs and free up resources for more critical care (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). However, irresponsible self-medication—particularly in LMICs—poses dangers, including delayed treatment, adverse reactions, and the emergence of drug-resistant pathogens (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn Borama, Somaliland, like in many other regions with limited healthcare access, self-medication is a widely accepted practice. Despite its perceived short-term benefits, the long-term public health consequences are significant. This study aims to provide current data on the prevalence of self-medication among adults and to identify the associated risk factors, which can guide public health policies.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA cross-sectional, community-based study was conducted in Borama District, Somaliland, in 2024. A total of 225 adults were selected using systematic and simple random sampling from three main zones in Borama. Data were collected using a structured questionnaire, which gathered information on sociodemographic characteristics, self-medication practices, sources of medication information, and knowledge of government regulations. The collected data were analyzed using SPSS version 23, with descriptive statistics used to report the prevalence and chi-square tests and binary logistic regression to examine associations between self-medication practices and other variables.\u003c/p\u003e\u003cp\u003eClinical trial number: not applicable.\u003c/p\u003e"},{"header":"Results","content":"\u003ch2\u003e1.4.1 Sociodemographic Characteristics\u003c/h2\u003e\u003cp\u003eThe majority of the study participants were female (71.1%), and the most common age group was 20–25 years (49.4%). A significant portion of participants (32.9%) had a monthly income between \u003cspan\u003e$\u003c/span\u003e101 and \u003cspan\u003e$\u003c/span\u003e200, while 24% of the participants had non-formal education. The prevalence of self-medication was higher among females, younger adults, those with lower income, and individuals with less formal education, shown table below (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSociodemographic Characteristics of Study Participants among adults in Borama Awdal Region, Somaliland (N = 225)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e71.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20–25 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e111\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e49.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26–30 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e20.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e31–35 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e36–40 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e41–45 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt; 45 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncome (USD/month)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt; \u003cspan\u003e$\u003c/span\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cspan\u003e$\u003c/span\u003e51–100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7.1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cspan\u003e$\u003c/span\u003e101–200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e32.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cspan\u003e$\u003c/span\u003e201–300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22.7\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cspan\u003e$\u003c/span\u003e301–400\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e16.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u003cspan\u003e$\u003c/span\u003e400\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation Level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNon-formal Education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary Education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e17.3\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary Education\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e29.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUniversity Level\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e28.9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003ch2\u003e1.5 Prevalence of Self-Medication\u003c/h2\u003e\u003cp\u003eThe study conducted in Borama indicates a high prevalence of self-medication among adults, with \u003cb\u003e75.6%\u003c/b\u003e of participants reporting engaging in self-medication practices. Notably, the majority of these individuals self-medicated without consulting a healthcare professional, highlighting potential concerns regarding the safety and appropriateness of such practices. Conversely, \u003cb\u003e24.4%\u003c/b\u003e of the surveyed adults reported they did not practice self-medication shown the table below (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of Self-Medication among adults in Borama Awdal Region, Somaliland.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSelf-Medication Practice\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e170\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e75.6%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e24.4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e225\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e100.0%\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003ch2\u003e1.6 Associated Factors of Self-Medication\u003c/h2\u003e\u003cp\u003e\u003cb\u003eSex\u003c/b\u003e: Females were \u003cb\u003e1.85 times\u003c/b\u003e more likely to engage in self-medication compared to males (OR = 1.85, 95% CI: 1.15–2.98, p = 0.011). \u003cb\u003eAge\u003c/b\u003e: Adults aged 20–25 were \u003cb\u003e3.21 times\u003c/b\u003e more likely to self-medicate compared to older adults (OR = 3.21, 95% CI: 1.25–8.24, p = 0.015). \u003cb\u003eIncome\u003c/b\u003e: Participants earning less than \u003cspan\u003e$\u003c/span\u003e50 per month were \u003cb\u003e5.34 times\u003c/b\u003e more likely to self-medicate (OR = 5.34, 95% CI: 1.54–18.49, p = 0.008). Similarly, those earning between \u003cspan\u003e$\u003c/span\u003e51-\u003cspan\u003e$\u003c/span\u003e100 per month were \u003cb\u003e3.77 times\u003c/b\u003e more likely to self-medicate (OR = 3.77, 95% CI: 1.34–10.58, p = 0.012). \u003cb\u003eEducation\u003c/b\u003e: Non-formally educated individuals were \u003cb\u003e3.02 times\u003c/b\u003e more likely to self-medicate compared to those with university education (OR = 3.02, 95% CI: 1.50–6.08, p = 0.002). Primary education also increased the likelihood of self-medication (OR = 2.47, p = 0.017). \u003cb\u003ePrevious Use of Self-Medication\u003c/b\u003e: Participants who had previously engaged in self-medication were \u003cb\u003e6.34 times\u003c/b\u003e more likely to continue self-medicating (OR = 6.34, 95% CI: 3.83–10.51, p \u0026lt; 0.001). \u003cb\u003eBelief in Safety of Self-Medication\u003c/b\u003e: Those who believed self-medication was safe were \u003cb\u003e2.29 times\u003c/b\u003e more likely to engage in the practice (OR = 2.29, 95% CI: 1.41–3.71, p = 0.001). \u003cb\u003eConsulting Pharmacists\u003c/b\u003e: Individuals who regularly consulted pharmacists before purchasing medications were \u003cb\u003e0.32 times\u003c/b\u003e less likely to self-medicate (OR = 0.32, 95% CI: 0.11–0.93, p = 0.036) shown table below (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eOdds Ratios for Sociodemographic and Behavioral Factors among adults in Borama Awdal Region, Somaliland.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOdds Ratio (OR)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e95% Confidence Interval (CI)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eSex (Female)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.15–2.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.011\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge (20–25 years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.25–8.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.015\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIncome (\u0026lt; $50)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.54–18.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.008\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNon-formal Education\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.50–6.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEver Used Self-Medication\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3.83–10.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eBelief in Safety\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e1.41–3.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eConsulting Pharmacists\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.11–0.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.036\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study found that 75.6%of adults in Borama engage in self-medication, with females, younger adults (20–25 years), those with lower incomes, and less formal education more likely to engage in the practice. the prevalence of self-medication in Borama is higher than that reported in other African countries, such as Uganda (75%) and Kenya (58.2%) (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). This higher prevalence could be attributed to several factors. One potential reason may be differences in healthcare access; if residents in Borama face barriers to professional medical advice and services, they may be more inclined to self-medicate. Furthermore, variations in cultural norms and health education might influence attitudes towards self-medication.\u003c/p\u003e\u003ch2\u003e1.5.1 Sociodemographic Factors\u003c/h2\u003e\u003cp\u003eAge, sex, and income were significantly associated with self-medication practices. Younger adults, particularly those aged 20–25, were 3.21 times more likely to self-medicate, possibly due to a perception of invulnerability or lack of access to healthcare (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Similarly, lower-income individuals (\u0026lt; \u003cspan\u003e$\u003c/span\u003e50/month) were 5.34 times more likely to self-medicate, possibly due to the high costs of healthcare services in the region (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Furthermore, individuals with non-formal education were 3.02 times more likely to self-medicate, underscoring the need for public health education campaigns (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e\u003ch2\u003e1.5.2 Cultural and Behavioral Factors\u003c/h2\u003e\u003cp\u003eAlthough belief in traditional remedies was not significantly associated with self-medication, previous use of self-medication and the belief that it is safe were strong predictors. Those who had self-medicated in the past were 6.34 times more likely to engage in the practice again, indicating the role of habit and experience in determining future behaviors (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e\u003ch2\u003e1.5.3 Government Regulations\u003c/h2\u003e\u003cp\u003eAwareness of government regulations surrounding medication use was low, with 58.7% of participants unaware of any policies. This lack of awareness suggests that public health campaigns and stricter enforcement of regulations are needed to reduce the prevalence of self-medication (12).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe prevalence of self-medication among adults in Borama is \u003cb\u003e24.4%\u003c/b\u003e, with females, younger adults, low-income individuals, and those with lower educational levels being more likely to engage in the practice. The study highlights the need for targeted public health interventions to reduce self-medication and promote safer medication practices.\u003c/p\u003e"},{"header":"Recommendations","content":"\u003cp\u003e\u003cb\u003eFor the Ministry of Health\u003c/b\u003e:\u003c/p\u003e\u003cp\u003ePublic Awareness Campaigns: To address the issue of self-medication and promote safer health practices, concerted efforts are needed from various stakeholders, including the Ministry of Health, the community, health professionals, and pharmacies.\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eLaunch educational campaigns to inform the public about the risks and proper use of medications.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eUse media outlets such as radio, TV, and social media to reach a broad audience.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eProvide clear information on when and how to seek professional healthcare.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003cb\u003eStrengthening Healthcare Services\u003c/b\u003e:\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eImprove access to affordable healthcare services, especially in underserved areas.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eIncrease funding for healthcare infrastructure and resources in both urban and rural areas.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eEncourage the development of community health programs that provide basic healthcare and education.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eRegulation of Medication Sales:\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eImplement stricter regulations on the sale of over-the-counter medications.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e Ensure that pharmacies adhere to guidelines for dispensing medications only with proper prescriptions.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eMonitor and control the distribution of potentially harmful medications. For the Community: Promote Healthy Practices:\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003cb\u003eEngage Community Leaders\u003c/b\u003e:\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eEncourage community discussions and workshops about the dangers of self medication.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eFoster a culture where seeking professional medical advice is valued and normalized.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eInvolve local leaders and influencers in promoting safe medication practices.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eUse traditional gatherings and community events to spread awareness about healthcare issues.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003cb\u003eSupport Each Other\u003c/b\u003e:\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eEncourage neighbors and friends to seek professional help for health issues.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eShare information about available healthcare resources within the community.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003cb\u003eFor Health Professionals\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cb\u003ePatient Education\u003c/b\u003e:\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eTake time to educate patients about the correct use of medications and the importance of adhering to prescribed treatments.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eProvide clear instructions and explanations for any prescribed or recommended treatments.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003cb\u003eAccessible Healthcare\u003c/b\u003e:\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eWork towards making healthcare services more accessible and patient-friendly.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eCollaborate with community health workers to extend healthcare reach and provide support. Monitoring and Follow-Up:\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003cp\u003e\u003cb\u003eFor Pharmacies\u003c/b\u003e:\u003c/p\u003e\u003cp\u003e\u003cb\u003eResponsible Dispensing\u003c/b\u003e:\u003c/p\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003eEstablish follow-up procedures to ensure patients understand and correctly use their medications.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eCreate support systems for patients with chronic conditions to prevent reliance on self-medication.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eAdhere to regulations regarding the sale of medications and ensure that potentially harmful drugs are only provided with proper prescriptions.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003eRefuse to sell medications for self-medication purposes and instead guide customers towards professional healthcare services.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003ch2\u003e1.10 Limitations and strengths of the Study\u003c/h2\u003e\u003cp\u003eWhile this study provides valuable insights into the prevalence and factors associated with self-medication among adults in Borama Town, Somaliland, it is important to acknowledge several limitations that may affect the generalizability and interpretation of the findings. The data on self-medication practices and associated factors were based on self-reported information, which can be subject to recall bias or social desirability bias. Participants might have underreported or over reported their practices and beliefs to conform to perceived norms or expectations. Temporal Limitations: The cross-sectional nature of the study means it captures a snapshot in time and does not account for changes in self-medication practices over time. The strengths use of chi-square tests and binary logistic regression provided robust statistical analyses to examine associations between sociodemographic factors and self-medication practices. These analytical methods strengthen the validity of the study's findings.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements and contributors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDr. Abdihakim Mohamed H. Ali\u003c/strong\u003e served as the \u003cstrong\u003ePrincipal Investigator and Supervisor\u003c/strong\u003e of this study. His role involved designing the research framework, providing guidance throughout the data collection and analysis processes, and ensuring the academic rigor and integrity of the findings. Dr. Abdihakim\u0026apos;s expertise in public health and medical research was instrumental in shaping the study\u0026apos;s methodology and final conclusions.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe following students contributed as \u003cstrong\u003eResearch Assistants\u003c/strong\u003e:\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eZadia Mohamed Hassan\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eRakia Isse Osman\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eRahma Hassan Muse\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eYurub Ahmed Omer\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eIstaahil Abdi Ashuar\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eMarkabo Abdirisak Osman\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eShukri Ahmed Isse\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe confirm that all changes have been made as per the reviewers\u0026apos; suggestions, and all co-authors have approved the final version of the manuscript. Furthermore, we confirm that all methods were carried out in accordance with relevant guidelines and regulations.\u003c/p\u003e\n\u003ch4\u003e\u003cstrong\u003eFunding mechanism\u0026nbsp;\u003c/strong\u003e\u003c/h4\u003e\n\u003ch4\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/h4\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate\u003c/strong\u003e: Ethical approval was obtained from the horn international university and local government committee and informed consent was obtained from all participants before data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQuman handled data collection and entry, Abdirsak wrote the background part, and Abdihakim Mohamed provided methodology and result. \u0026nbsp;Data analysis has been provided by Abdeq Hassan.\u0026nbsp;\u003cbr\u003e\u0026nbsp;Abadir Omer Mohammed has helped with the planning and gathering of the data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Availability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;There is no public access to all data generated or analyzed during this study \u0026nbsp;to preserve the privacy of the identities of the individuals. The dataset that \u0026nbsp;supports the conclusions is available to the corresponding author upon \u0026nbsp;request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Competing interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThe authors disclose no conflicts of interest\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBennadi D. Self-medication: A current challenge. J Basic Clin Pharm. 2013;5(1):19-23.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. WHO guidelines on self-care interventions for health and well-being. Geneva: WHO; 2018.\u003c/li\u003e\n\u003cli\u003eAbdullah AA. Self-medication practices and associated factors in Somaliland: a cross-sectional study. East Afr Med J. 2019;96(4):123-9.\u003c/li\u003e\n\u003cli\u003eBorama Health Report. Self-medication statistics in Borama District. Borama: Ministry of Health Somaliland; 2017.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. WHO consolidated guideline on self-care interventions for health: sexual and reproductive health and rights. Geneva: WHO; 2020.\u003c/li\u003e\n\u003cli\u003eMohseni M, Ahmadi S, Azami-Aghdash S. Self-medication in developing countries: a systematic review. Arch Public Health. 2018;76(1):1-11.\u003c/li\u003e\n\u003cli\u003eKassie AD, Bifftu BB, Mekonnen HS. Self-medication practice and associated factors among adult household members in Meket district, Northeast Ethiopia. BMC Pharmacol Toxicol. 2018;19(1):15.\u003c/li\u003e\n\u003cli\u003eRaut A, Rijal KR, Basnet R, Shrestha DR. Self-medication practice: a case study in Pokhara valley, Nepal. Int J Pharm Sci Res. 2014;5(11):737-41.\u003c/li\u003e\n\u003cli\u003eBeyene HA, Beedemariam GY, Abdu N, Jemal M. Assessment of self-medication practices in Assendabo town, Jimma zone, Southwest Ethiopia. Res Social Adm Pharm. 2017;13(1):317-23.\u003c/li\u003e\n\u003cli\u003eGyawali S, Shankar PR, Poudel PP, Saha A. Knowledge, attitude and practice of self-medication among basic science undergraduate medical students in a medical school in western Nepal. J Clin Diagn Res. 2015;9(12):FC17-22.\u003c/li\u003e\n\u003cli\u003eWazaify M, Albsoul-Younes A, Abu-Gharbieh E, Tahaineh L. Societal perspectives on over-the-counter (OTC) drugs in Jordan: a qualitative study of consumers\u0026apos; views. Eur J Clin Pharmacol. 2017;73(10):1299-1307.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-health-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dihs","sideBox":"Learn more about [Discover Health Systems](https://www.springer.com/44250)","snPcode":"44250","submissionUrl":"https://submission.nature.com/new-submission/44250/3","title":"Discover Health Systems","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"prevalence, associated factors, self-medication, Borama, Awdal, Somaliland","lastPublishedDoi":"10.21203/rs.3.rs-6685115/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6685115/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e: Self-medication is defined as “the use \u0026nbsp;\u0026nbsp;of drugs to treat self-diagnosed disorders or symptoms, or the intermittent \u0026nbsp;\u0026nbsp;or continued use of a prescribed drug for chronic or recurrent disease or \u0026nbsp;\u0026nbsp;symptoms. (esan et al, 2018). Every year, are practicing self-medication in \u0026nbsp;\u0026nbsp;the form of self-care of health. Around the1960’s in the west-self-care and \u0026nbsp;\u0026nbsp;self-medication were regarded as unnecessary and potentially even unhealthy \u0026nbsp;\u0026nbsp;practices. This paternalistic approach to medicine, supported by health systems \u0026nbsp;\u0026nbsp;designed to treat sickness (rather than to prevent disease) remains a \u0026nbsp;\u0026nbsp;familiar aspect of health care in many countries to this day (1).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e this study is a community-based \u0026nbsp;\u0026nbsp;descriptive cross-sectional study that is conducted in Borama District, this \u0026nbsp;\u0026nbsp;study applied cross-sectional study design which the data collected one point \u0026nbsp;\u0026nbsp;at the time, cost, time and also require small sample size.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe sampling technique and procedures:\u003c/strong\u003e \u0026nbsp;systematic sampling followed by simple random sampling. The final sample size \u0026nbsp;\u0026nbsp;was 227. Data collection: The self-administered questionnaire consisting of \u0026nbsp;\u0026nbsp;socio-demographic and socioeconomic factors, self-medication.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult\u003c/strong\u003e: The study found that 75% of \u0026nbsp;\u0026nbsp;adults in Borama Town have used self-medication in the past year, with \u0026nbsp;\u0026nbsp;females being 1.85 times more likely than males. Younger adults, particularly \u0026nbsp;\u0026nbsp;those aged 20-25, were more likely to self-medicate. Lower income groups and \u0026nbsp;\u0026nbsp;non-formal education were associated with higher self-medication. However, \u0026nbsp;\u0026nbsp;there was no significant association between belief in traditional remedies \u0026nbsp;\u0026nbsp;and self-medication practices. A history of self-medication and belief in its \u0026nbsp;\u0026nbsp;safety were strong predictors of current practices. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The study revealed that 75% of adults in Borama Town use self-medication, with females being more likely. Younger adults, lower-income groups, and \u0026nbsp;\u0026nbsp;non-formal education are more likely. A history of self-medication and safety \u0026nbsp;\u0026nbsp;are strong predictors. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecommendation\u003c/strong\u003e: The Ministry of \u0026nbsp;\u0026nbsp;Health is investing in infrastructure, educating the public, and running \u0026nbsp;\u0026nbsp;public awareness campaigns to improve healthcare services and encourage safer \u0026nbsp;\u0026nbsp;behaviors. They are also enforcing more stringent laws pertaining to the \u0026nbsp;\u0026nbsp;distribution and sale of medications. Pharmacists, healthcare providers, and \u0026nbsp;\u0026nbsp;community involvement are collaborating to guarantee accessible and safe \u0026nbsp;\u0026nbsp;pharmaceutical practices.\u003c/p\u003e","manuscriptTitle":"Prevalence and Associated Factors of Self-Medication among Adults in Borama, Awdal Region, Somaliland (2024)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-16 17:16:19","doi":"10.21203/rs.3.rs-6685115/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-08-12T11:16:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-02T06:40:36+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-01T18:28:22+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-29T16:47:01+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"236746581790511746542416412447931144277","date":"2025-07-24T15:38:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"219564551987666152068236698958363890965","date":"2025-07-24T14:06:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"160837132007127625929727111979912884184","date":"2025-07-23T10:36:17+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-14T14:50:29+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-14T14:48:05+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-06-24T13:09:06+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-11T10:47:50+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Health Systems","date":"2025-06-11T10:12:54+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-health-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dihs","sideBox":"Learn more about [Discover Health Systems](https://www.springer.com/44250)","snPcode":"44250","submissionUrl":"https://submission.nature.com/new-submission/44250/3","title":"Discover Health Systems","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"785b3d78-aa7e-4365-87be-c5fa83946311","owner":[],"postedDate":"July 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-13T10:26:51+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-16 17:16:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6685115","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6685115","identity":"rs-6685115","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}