The Paradox of Self-Medication among Future Public Health Leaders: Evidence from MPH Students in Nigeria

The Paradox of Self-Medication among Future Public Health Leaders: Evidence from MPH Students in Nigeria | 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 Research Article The Paradox of Self-Medication among Future Public Health Leaders: Evidence from MPH Students in Nigeria Ekwu Chinonso Emmanuel, Polycarp Dauda Madaki, Oghenerhoro Reuben, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8070985/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background Self-medication (SM) is a significant public health concern, particularly in low- and middle-income countries with weak drug regulatory frameworks. Alarmingly, healthcare professionals, including future public health leaders, are often frequent practitioners. This study assessed the knowledge, attitude, practice, and associated factors of SM among Master of Public Health (MPH) students at a Nigerian university. Methods A descriptive cross-sectional study was conducted among MPH students at Ahmadu Bello University's Distance Learning Centre from July to August 2025. A Google Forms questionnaire was distributed via WhatsApp, employing a convenience sampling technique. Data on socio-demographics, knowledge, attitudes, and practices of SM were collected. Descriptive statistics, chi-square tests, and logistic regression were performed using SPSS version 27, with a significance level of p < 0.05. Results Out of 357 participants (mean age 31.2 ± 5.8 years; 64.2% female), the vast majority were healthcare professionals. A high proportion (82.0%) had good knowledge of SM. Paradoxically, the prevalence of SM practice in the preceding six months was 82.7%. The most common reasons for SM were easy access to pharmacies (75.5%), self-perceived knowledge of correct drugs (72.0%), expensive hospital bills (68.3%), and prior experience with the illness (68.2%). Analgesics (63.8%) and antimalarials (49.6%) were the most frequently used drugs, primarily for headaches (86.0%) and cough/flu (47.2%). SM was significantly associated with younger age (< 30 years), being single, lower educational level (BSc/MSc vs. PhD), monogamous family structure, and, notably, a higher knowledge score (p < 0.05 for all). Conclusions Despite high knowledge levels regarding SM risks, its practice remains pervasive among future public health professionals in Nigeria. Confidence in personal medical knowledge and easy drug access appear to override risk awareness. These findings highlight an urgent need for targeted educational interventions and stricter enforcement of drug dispensing policies within this key demographic to curb this dangerous trend and align their practices with their public health advocacy roles. Self-Medication Public Health Health Knowledge Attitudes Practice Nigeria Health Personnel Students Drug Utilization Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Self-Medication (SM) refers to the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. It is a global phenomenon, with an increasing trend in recent years [1, 2]. The World Health Organization recognizes that responsible SM for minor ailments can be part of self-care, provided this is informed by evidence-based knowledge to prevent harm [3]. It becomes a public health concern when it involves prescription-only medicines or is based on insufficient information; serious risks include an incorrect diagnosis, adverse drug reactions, antimicrobial resistance, and delayed effective treatment [4, 5]. It is more common in low-income and middle-income countries because of factors like easy availability of medicines through informal sources, weak enforcement of regulations, high costs of healthcare, and long waiting times at health facilities that promote the practice [6,7]. Studies in Nigeria have reported prevalence rates of 54.6% to over 86% in the general population, thus making it a pervasive problem [8,9]. Commonly self-medicated drugs include analgesics, antimalarials, and antibiotics, usually obtained from community pharmacies and patent medicine vendors without a prescription [10,11]. One of the most disturbing trends is the reportedly high prevalence of SM among healthcare professionals and students in general [12, 13]. Despite formal knowledge of medicine and the ensuing risks, this group practices SM at a rate equal to or higher than that seen among the general public. Cited reasons for this include convenience, perceived ability to self-diagnose, busy schedules, and avoidance of assuming the "patient role" [14, 15]. This forms a critical paradox: those entrusted to advocate for rational drug use themselves practice potentially irrational medication use. The implications are serious and extend beyond personal health risks to poor patient counseling, unhealthy behavior modeling, and reduced capacity to lead public health campaigns against drug misuse [16]. While a few have assessed SM among undergraduate medical and pharmacy students in Nigeria, little or no research has focused on postgraduate public health students [17, 18]. This category is unique, being made up of practicing health professionals-doctors, pharmacists, nurses-who further their careers to become future leaders in public health, policy makers, and advocates. Yet, their SM practices need to be understood since personal behavior could have a strong impact on professional credibility and the success or otherwise of public health communications seeking to promote the rational use of drugs. This therefore calls for an assessment of the knowledge, attitude, and practices of SM among students of the Master of Public Health at Ahmadu Bello University, Nigeria. The findings will highlight the determinants of SM use in this important population and provide evidence that is important in the development of specific interventions aimed at making their practices complement their responsibilities as public health advocates. Methods Study Design and Setting A descriptive cross-sectional study was conducted among Master of Public Health (MPH) students at the Distance Learning Centre (DLC) of Ahmadu Bello University (ABU), Zaria, Nigeria. Data collection took place over four weeks, from July 20 to August 20, 2025. The DLC provides postgraduate education to a diverse cohort of working professionals, predominantly from healthcare backgrounds, spread across Nigeria. Study Population and Sampling The study population comprised all students enrolled in the MPH program at ABU DLC during the 2024 academic session. The minimum sample size was calculated as 357 using Cochran's formula, with a prevalence (p) of SM assumed to be 66.7% [9], a 95% confidence level (Z = 1.96), and a 5% margin of error (d = 0.05). A 10% non-response rate was factored in. A convenience sampling technique was employed. The study was open to all eligible MPH students who voluntarily chose to participate after seeing the announcement. Inclusion and Exclusion Criteria Inclusion criteria Current enrollment in the MPH program at ABU DLC. Provision of informed consent. Exclusion criteria MPH students who did not provide consent to participate. Data Collection Tool and Technique A structured, self-administered questionnaire was developed by the researchers after an extensive review of relevant literature [9, 19, 20]. The questionnaire was hosted online using Google Forms and distributed to students through their official class WhatsApp groups. The instrument consisted of five sections: Section A: Socio-demographic characteristics (age, sex, profession, highest educational qualification, marital status, etc.). Section B: Knowledge of SM. This section contained 10 questions assessing understanding of SM concepts. A knowledge score was calculated, and participants were categorized as having "poor" (0-3), "moderate" (4-6), or "good" (7-10) knowledge. Section C: Attitude towards SM. This section used a 5-point Likert scale (Strongly Agree to Strongly Disagree) to gauge perceptions regarding the acceptability, risks, and regulations of SM. Section D: Practice of SM. This section assessed the prevalence of SM (defined as using drugs without a prescription in the last 6 months), frequency, reasons for SM, types of drugs used, sources of drugs, and experiences of side effects. Section E: Open-ended section for additional comments (data not reported in this analysis). Operational Definitions For this study: Self-Medication: The use of medication (over-the-counter or prescription) without a current prescription from a qualified medical doctor for self-recognized symptoms. This included the use of leftover prescribed drugs, taking drugs on the advice of non-professionals, or adjusting the dosage of a prescribed drug without consultation. Good Knowledge: A score of 7-10 on the knowledge assessment scale. Data Management and Statistical Analysis Data from Google Forms were exported and analyzed using the Statistical Package for the Social Sciences (SPSS) version 27. Descriptive statistics were computed for all variables and presented as frequencies, percentages, means, and standard deviations. The association between socio-demographic variables, knowledge scores, and the practice of SM was assessed using the Chi-square test. A binary logistic regression was planned to identify independent predictors of SM; variables with a p-value < 0.05 in the bivariate analysis were considered for inclusion in the model. A p-value of less than 0.05 was considered statistically significant. Ethical Consideration The study received expedited ethical approval from the Health Research Ethics Committee (HREC) of the Kaduna State Ministry of Health, with approval number MOH/ADM/744/VOL.1/1110031, dated 6th May 2025 (NHREC/17/03/2018). Participation was voluntary, and informed consent was obtained electronically at the beginning of the online questionnaire. Participants were informed of the study objectives, their right to withdraw at any time without penalty, and the assurance of confidentiality. All procedures were conducted in accordance with the Declaration of Helsinki and NHREC guidelines Results A total of 357 Master of Public Health students participated in the study, yielding a response rate of 100% based on the calculated sample size. The socio-demographic characteristics of the respondents are summarized in Table 1. The mean age of participants was 31.2 years (±5.8), and the majority were female (64.2%). Most respondents were married (61.9%) and held a Bachelor's degree (57.8%) as their highest qualification. The cohort was predominantly composed of healthcare professionals, including medical doctors, pharmacists, and nurses. Ethnically, the sample was diverse, with the largest groups being Igbo (37.8%) and Yoruba (28.9%). Table 1. Socio-demographic characteristics of the study participants (N=357) Characteristic Category Frequency (n) Percentage (%) Sex Male 128 35.9 Female 229 64.2 Age (years) Mean (SD) 31.2 (5.8) - Marital Status Single 89 24.9 Married 221 61.9 Divorced 17 4.8 Separated 8 2.2 Widowed 22 6.2 Highest Education BSc 206 57.8 MSc 104 29.1 PhD 47 13.2 Family Type Monogamous 267 74.8 Polygamous 90 25.2 Tribe Hausa 72 20.2 Yoruba 103 28.9 Igbo 135 37.8 Others 47 13.2 Knowledge, Attitude, and Prevalence of Self-Medication Assessment of knowledge revealed that a large proportion of participants (82.0%, n=293) had good to moderate knowledge of self-medication (Table 2). However, the practice of SM was highly prevalent, with 82.7% (n=295) of respondents reporting they had taken medication without a prescription in the preceding six months. Table 2. Knowledge and practice of self-medication among participants Variable Category Frequency (n) Percentage (%) Knowledge Level Good (7–10) 157 44.0 Moderate (4–6) 136 38.1 Poor (0–3) 64 17.9 SM Practice (6 months) Yes 295 82.7 No 62 17.3 Attitudes towards SM were mixed (Table 3). While an overwhelming majority recognized the risks 92.8% agreed SM is harmful without proper knowledge, and 86.0% supported the need for a medical license for drug administration opinions on its acceptability were divided. A combined 39.6% of respondents (Agree/Strongly Agree) found SM acceptable, while 42.4% (Disagree/Strongly Disagree) did not. Table 3. Attitudes and perceptions towards self-medication (n=357) Statement Strongly Agree (%) Agreed(%) Unsure (%) Disagree (%) Strongly Disagree(%) SM is acceptable to me. 51 (14.3) 90 (25.2) 85 (23.8) 90 (25.2) 41 (11.5) I don’t need to see a doctor before using drugs. 34 (9.5) 79 (22.1) 102 (28.6) 94 (26.3) 48 (13.4) SM is harmful without proper knowledge. 269 (75.4) 62 (17.4) 17 (4.8) 6 (1.7) 3 (0.8) A medical license is needed for drug administration. 241 (67.5) 66 (18.5) 17 (4.8) 24 (6.7) 9 (2.5) Medication duration should be completed. 295 (82.6) 51 (14.3) 11 (3.1) 0 (0.0) 0 (0.0) Caution is needed with over-the-counter meds. 308 (86.3) 40 (11.2) 6 (1.7) 2 (0.6) 1 (0.3) Factors, Sources, and Substances in Self-Medication Practice The most frequently cited reasons for engaging in SM were the easy accessibility of pharmacies (75.5%), self-perceived knowledge of the correct drugs (72.0%), and the high cost of hospital bills (68.3%) (Figure 1) The most common symptoms prompting SM were headache (86.0%), cough/flu-like symptoms (47.2%), and general pain (46.0%) (Figure 2). Consequently, the most frequently used drug categories were analgesics (63.8%), antimalarials (49.6%), and cough/flu medications (46.2%) (Figure 3). Participants primarily sourced drugs for SM from pharmacy shops (84.7%), patent medicine stores (21.6%), and leftover medications at home (20.9%) (Figure 4). When procuring drugs, the vast majority (81.8%) directly requested the drug by name. The choice of drug was predominantly influenced by the individual's own medical knowledge (84.3%) and previous experience with a similar illness (25.4%). Factors Associated with Self-Medication Practice Bivariate analysis revealed several factors significantly associated with the practice of SM (Table 4). Participants under 30 years of age, those who were single, and those with a BSc or MSc as their highest qualification were significantly more likely to self-medicate compared to their older, married, or PhD-holding counterparts. Furthermore, individuals with a higher knowledge score were significantly more likely to practice SM (χ² = 35.16, p < 0.001). Table 4. Association between socio-demographic variables, knowledge, and self-medication practice Variable Category SM Practice: Yes (%) SM Practice: No (%) χ² value p-value Age Group < 30 years 170 (91.4) 16 (8.6) 17.09 <0.001* ≥ 30 years 125 (73.1) 46 (26.9) Marital Status Single 82 (92.1) 7 (7.9) 25.05 <0.001* Married 170 (76.9) 51 (23.1) Others 43 (65.2) 23 (34.8) Education BSc 181 (87.9) 25 (12.1) 6.37 0.041* MSc 93 (89.4) 11 (10.6) PhD 21 (44.7) 26 (55.3) Knowledge Score Low (0–3) 45 (70.3) 19 (29.7) 35.16 <0.001* Moderate (4–6) 108 (79.4) 28 (20.6) Good (7–10) 142 (90.4) 15 (9.6) Statistically significant at p < 0.05. DISCUSSION This study aimed to assess the knowledge, attitudes, and practices of self-medication among a cohort of future public health leaders in Nigeria. The key and most captivating finding is the striking paradox between knowledge and practice: an overwhelming majority (82.0%) of MPH students had good to moderate knowledge of the risks of SM, yet an equally high proportion (82.7%) practiced it. This prevalence is substantially higher than the 54.6% − 86.7% reported in the general Nigerian population [8, 9] and corroborates global evidence showing that healthcare professionals and students are among the highest self-medicating groups [12, 13]. This discrepancy emphasizes that knowledge is not enough to be a deterrent and that there is a strong influence of other enabling factors. The reasons cited for SM in this study are instructive. Easy access to pharmacies, perceived knowledge of correct drugs, and high hospital costs were the primary drivers. This suggests that for this highly educated group, confidence in their own medical expertise overrides their awareness of the potential dangers. This phenomenon, where professional knowledge fosters a false sense of security in self-diagnosis and treatment, has been observed among medical and pharmacy students elsewhere [15, 21]. Furthermore, the high cost of formal healthcare remains a significant push factor, even for this professional cohort, highlighting systemic issues within the Nigerian health system that incentivize risky coping strategies [7]. Our findings on the substances and sources of SM are in consonance with patterns from Nigeria and other similar settings [10, 11]. The predominance of analgesics for headaches and antimalarials for fever-like symptoms reflects the commonality of these ailments and the ease with which these drugs are obtained. That 84.7% sourced drugs from pharmacies establishments meant to be guardians of rational drug use is a finding of particular import. It shows a gross failure in the regulatory and professional gatekeeping role of pharmacies in Nigeria, where prescription-only medicines are often sold without due diligence [22]. A particularly noteworthy finding was the strong positive association between higher knowledge scores and the likelihood of practicing SM. This unexpected relationship strengthens the contention that, in this context, knowledge enables rather than prohibits. It gives individuals the confidence to bypass formal healthcare channels, a behavior similarly remarked on among pharmacy students in Zambia and medical students in Tanzania [21, 23]. This challenges conventional health education models and suggests that interventions must move beyond knowledge dissemination to address the underlying attitudes and professional norms that justify this behavior. A number of socio-demographic factors appeared to be significant predictors of SM: the higher odds among younger students and those who were single could have reflected a more risk-inclined lifestyle or fewer familial responsibilities which would encourage more cautious health-seeking behavior [24, 25]. The lower prevalence among PhD holders, meanwhile, may indicate that greater maturity, more clinical experience, or even a deeper understanding of public health consequences serves as a protective factor. Less intuitive is the finding of an association with a monogamous family structure, which may relate to socioeconomic factors or decision-making dynamics not captured here but warranting qualitative exploration. Implications for Public Health Policy and Practice These findings have huge implications. If the future generation of public health professionals, who are expected to champion rational use of drugs and combat threats such as antimicrobial resistance, are themselves heavily engaged in irrational SM, it seriously compromises the credibility and effectiveness of public health campaigns. There is an urgent need for: Targeted Educational Interventions: Specific modules on responsible self-care, ethics of self-treatment relevant for health professionals, and the wider societal implications of SM, including antimicrobial resistance, should be incorporated into the MPH curriculum. Strengthening Regulation: Regulatory agencies must enforce laws banning over-the-counter sales of prescription-only medicines, focusing most on holding pharmacies and patent medicine vendors responsible for these offenses. Professional Accountability: Professional associations for doctors, pharmacists, and public health workers should explicitly address and discourage irresponsible SM among their members as a matter of professional conduct. Limitations The present study has several limitations. Its cross-sectional nature precludes the establishment of causal relationships. Though the use of convenience sampling was practical, it may make generalization to all MPH students in Nigeria difficult. Moreover, the data were self-reported and susceptible to social desirability and recall bias. Despite these limitations, the study provided crucial insights into a severely under-researched population that plays a critical role in the health system. Conclusion This study demonstrates a wide gap between knowledge and practice regarding self-medication among future leaders in Nigeria's public health system. Although most of the MPH students are well aware of the risks, the overwhelming majority practice SM, which is significantly influenced by perceived clinical competence, accessibility of the medication, and economic factors. In fact, the finding that higher knowledge promotes the likelihood of greater engagement with SM emphasizes the ineffectiveness of awareness alone as a public health approach. These findings sound an alarm for public health education and policy. Ensuring the protection of the health of individuals and the population requires the creation of specific interventions within postgraduate public health training that focus on the normative and attitudinal drivers of this behavior. In addition, strict enforcement of regulations on the dispensing of drugs is needed to check the uncontrolled access to prescription medicines. In empowering these future advocates to align their personal practices with professional mandates lies a critical step towards building a more effective and credible foundation for rational drug use in Nigeria. Abbreviations SM Self-Medication MPH Master of Public Health ABU Ahmadu Bello University DLC Distance Learning Centre OTC Over-the-Counter (medications) SPSS Statistical Package for the Social Sciences SD Standard Deviation χ² Chi-square CI Confidence Interval AOR Adjusted Odds Ratio COR Crude Odds Ratio p-value Probability value WHO World Health Organization Declarations Ethics Approval and Consent to Participate Ethical approval for this study was obtained from the Health Research Ethics Committee (HREC) of the Kaduna State Ministry of Health (Approval No: MOH/ADM/744/VOL.1/1110031, dated 6th May 2025; NHREC/17/03/2018). The Ahmadu Bello University Distance Learning Centre (ABU-DLC) granted a waiver for additional institutional review because the study involved minimal risk and used non-identifiable data. Participation was entirely voluntary, and informed consent was obtained electronically from all participants at the beginning of the survey. Anonymity and confidentiality of the data were maintained throughout the research process. Consent for Publication Not applicable. This manuscript does not contain any individual person’s data, images, or other identifying information Availability of Data and Materials The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing Interests The authors declare that they have no competing interests. Funding This research received no external funding. Authors’ Contributions Ekwu Chinonso Emmanuel: Conceptualization, study design, data collection, manuscript drafting. Polycarp Dauda Madaki: Data analysis, interpretation, manuscript writing, critical revision, overall supervision. Oghenerhoro Reuben: Literature review, data entry, editing of manuscript. Abdullahi Naimat Ololade: Methodology support, validation, review of final manuscript. Ruth Sabo Manzo: Review of discussion, policy interpretation, final manuscript review. Acknowledgements The authors appreciate all participants who took part in this research and colleagues who provided support during data collection. References World Health Organization. The role of the pharmacist in self-care and self-medication. Report of the 4th WHO Consultative Group on the Role of the Pharmacist. The Hague: World Health Organization; 1998. Al-Worafi YM. Self-Medication. In: Elsevier eBooks. 2020. p. 73–86. Available from: https://doi.org/10.1016/b978-0-12-819837-7.00007-8 World Health Organization. Self-care for health and well-being. WHO: Geneva; 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/self-care-health-interventions Bennadi D. Self-medication: A current challenge. J Basic Clin Pharm. 2013;5(1):19–23. Torres N, Chibi B, Middleton L, Solomon V, Mashamba-Thompson T. Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review. Public Health. 2019;168:92–101. Ocan M, Obuku EA, Bwanga F, Akena D, Richard S, Ogwal-Okeng J, et al. Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries. BMC Public Health. 2015;15:742. Cobbold J, Morgan A. An integrative review of the prevalence, patterns and predictors of self-medication in Ghana. Cogent Public Health. 2022;9(1):2098567. Akande-Sholabi W, Ajamu AT, Adisa R. Prevalence, knowledge and perception of self-medication practice among undergraduate healthcare students. J Pharm Policy Pract. 2021;14(1):3. Nwoga H, Ajuba M, Okorie O. Self-Medication among Medical Students in a Tertiary Health Facility in Enugu State, South East Nigeria. IOSR J Pharm. 2021;11(3):22–30. Bassi P, Osakwe A, Builders M, Ettebong E, Kola G, Binga B, et al. Prevalence and Determinants of Self-Medication Practices among Nigerians. Afr J Health Sci. 2021;34(5):634–49. Rathod P, Sharma S, Ukey U, Sonpimpale B, Ughade S, Narlawar U, et al. Prevalence, Pattern, and Reasons for Self-Medication: A Community-Based Cross-Sectional Study From Central India. Cureus. 2023;15(1):e33917. Babatunde OA, Fadare JO, Ojo OJ, Durowade KA, Atoyebi OA, Ajayi PO, et al. Self-medication among health workers in a tertiary institution in South-West Nigeria. Pan Afr Med J. 2016;24:312. Fekadu G, Dugassa D, Negera G, Bakala T, Turi E, Tolossa T, et al. Self-Medication Practices and Associated Factors Among Health-Care Professionals in Selected Hospitals of Western Ethiopia. Patient Prefer Adherence. 2020;14:353–61. Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, et al. Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Front Public Health. 2021;9:679397. Tarkowski Z, Piątkowski W, Bogusz R, Majchrowska A, Nowakowski M, Sadowska A, et al. When a doctor becomes a patient, the unique expectations and behaviours in a disease: preliminary report. Prog Health Sci. 2016;6(2):160–4. World Health Organization. Antimicrobial resistance. Fact Sheet. WHO: Geneva; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance Osemene KP, Lamikanra A. A Study of the Prevalence of Self-Medication Practice among University Students in Southwestern Nigeria. Trop J Pharm Res. 2012;11(4):683–9. Esan DT, Fasoro AA, Odesanya OE, Esan TO, Ojo EF, Faeji CO. Assessment of Self-Medication Practices and Its Associated Factors among Undergraduates of a Private University in Nigeria. J Environ Public Health. 2018;2018:5439079. Eyisi IG, Njelita IA, Akabuike J, Nwachukwu C, Eyisi CS. Knowledge, Attitude and Practice of Self Medication amongst Medical Students in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka. Med Pub Health Res J. 2022;3(3):1–18. Musa Y, Awosan KJ, Ibrahim MTO, Abdullahi Z, Jafaar M, Peter G, et al. Knowledge and Practice of Self-Medication among Undergraduates Students of Usmanu Danfodiyo University, Sokoto. Ann Int Med Den Res. 2016;2(1):83–8. Banda O, Vlahakis PA, Daka V, Matafwali SK. Self-medication among medical students at the Copperbelt University, Zambia: A cross-sectional study. Saudi Pharm J. 2021;29(11):1233–7. Popoola OO, Adebisi IA, Adeyemi AS, Adepitan DS, Oladeru OF. Assessing ethical practices among community pharmacists in Nigeria: prevalence, drivers, challenges, and implications—a mixed methods study. Front Public Health. 2025;13:1495328. doi:10.3389/fpubh.2025.1495328. Shitindi L, Issa O, Poyongo BP, Horumpende PG, Kagashe GA, Sangeda RZ. Comparison of knowledge, attitude, practice and predictors of self-medication with antibiotics among medical and non-medical students in Tanzania. Front Pharmacol. 2024;14:1301561. Park H, Lee KS. The association of family structure with health behaviour, mental health, and perceived academic achievement among adolescents: a 2018 Korean national representative survey. BMC Public Health. 2020;20:510. Vahedi S, Jalali FS, Bayati M, Delavari S. Predictors of Self-Medication in Iran: A Notional Survey Study. Iran J Pharm Res. 2021;20(1):e124479. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 29 Dec, 2025 Reviews received at journal 23 Dec, 2025 Reviewers agreed at journal 21 Dec, 2025 Reviewers agreed at journal 21 Dec, 2025 Reviewers agreed at journal 12 Dec, 2025 Reviewers invited by journal 12 Dec, 2025 Editor assigned by journal 08 Dec, 2025 Editor invited by journal 12 Nov, 2025 Submission checks completed at journal 12 Nov, 2025 First submitted to journal 12 Nov, 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-8070985","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":559990772,"identity":"9c092f5a-fa49-4fce-b6c9-b0c204f086a0","order_by":0,"name":"Ekwu Chinonso Emmanuel","email":"","orcid":"","institution":"Ahmadu Bello University","correspondingAuthor":false,"prefix":"","firstName":"Ekwu","middleName":"Chinonso","lastName":"Emmanuel","suffix":""},{"id":559990773,"identity":"701de9d0-f495-4d2d-a526-9b4a0be7c1b5","order_by":1,"name":"Polycarp Dauda Madaki","email":"data:image/png;base64,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","orcid":"","institution":"University of Port Harcourt","correspondingAuthor":true,"prefix":"","firstName":"Polycarp","middleName":"Dauda","lastName":"Madaki","suffix":""},{"id":559990774,"identity":"df527d01-4577-420d-8616-a64cfdc58bb8","order_by":2,"name":"Oghenerhoro Reuben","email":"","orcid":"","institution":"Ahmadu Bello University","correspondingAuthor":false,"prefix":"","firstName":"Oghenerhoro","middleName":"","lastName":"Reuben","suffix":""},{"id":559990775,"identity":"db490508-017d-4d68-8378-80c5f3954949","order_by":3,"name":"Abdullahi Naimat Ololade","email":"","orcid":"","institution":"Ahmadu Bello University","correspondingAuthor":false,"prefix":"","firstName":"Abdullahi","middleName":"Naimat","lastName":"Ololade","suffix":""},{"id":559990776,"identity":"c9260697-1e74-4e2c-9164-89d3ac18671a","order_by":4,"name":"Ruth Manzo Sabo","email":"","orcid":"","institution":"African Centre for Disease Control and Prevention","correspondingAuthor":false,"prefix":"","firstName":"Ruth","middleName":"Manzo","lastName":"Sabo","suffix":""}],"badges":[],"createdAt":"2025-11-09 19:38:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8070985/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8070985/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":98449901,"identity":"6973defb-cfd8-477b-bf24-7dc1f0afdec2","added_by":"auto","created_at":"2025-12-17 17:30:05","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":60894,"visible":true,"origin":"","legend":"","description":"","filename":"ManuscriptRevisedTheParadoxofSelfMedicationamongFuturePublicHealthLeadersEvidencefromMPHStudentsinNigeria.docx","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/1278b29a0f279ac853af7978.docx"},{"id":98449444,"identity":"d7d8b235-03f9-4650-8652-c627023a7ce1","added_by":"auto","created_at":"2025-12-17 17:29:32","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":7558,"visible":true,"origin":"","legend":"","description":"","filename":"33ab3bd17fe4439998d8d33491e4f469.json","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/b779464755a679ab81857398.json"},{"id":98449548,"identity":"3277c452-dc45-4baa-8c3a-88932ab09f64","added_by":"auto","created_at":"2025-12-17 17:29:43","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":68013,"visible":true,"origin":"","legend":"","description":"","filename":"33ab3bd17fe4439998d8d33491e4f4691enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/ab8f44acb70fe4421ea2c591.xml"},{"id":98449363,"identity":"4248dbeb-9d32-4a42-be93-eba0cdd37620","added_by":"auto","created_at":"2025-12-17 17:29:29","extension":"xml","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":65636,"visible":true,"origin":"","legend":"","description":"","filename":"33ab3bd17fe4439998d8d33491e4f4691structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/32b3cd38ffaef7f44e87caf1.xml"},{"id":98449960,"identity":"293eb4ad-e936-4a9f-a2b8-ae4a3427a38e","added_by":"auto","created_at":"2025-12-17 17:30:06","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":74656,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/ac8c9f3b4ec38a4d27a2a12d.html"},{"id":98449774,"identity":"aecf9ff3-8c01-4b8a-946a-ab4b6f90050f","added_by":"auto","created_at":"2025-12-17 17:29:58","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":61903,"visible":true,"origin":"","legend":"\u003cp\u003eReasons for practicing self-medication among Master of Public Health students in Nigeria (n=295). Values represent the percentage of respondents who engaged in self-medication and endorsed each reason. Respondents could select multiple reasons.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/064f97edb2f15447e77467ff.png"},{"id":98449775,"identity":"e7a048a4-6b75-4f84-8bbc-3aee1aa13649","added_by":"auto","created_at":"2025-12-17 17:29:59","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":52516,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSymptoms prompting self-medication among Master of Public Health students in Nigeria (n=295).\u003c/strong\u003e The chart shows the percentage of respondents who self-medicated for each specific symptom. Headache was the most frequently reported symptom.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/1eade1f96b93464d5d76f7de.png"},{"id":98449423,"identity":"a909006d-a3ff-4f8f-81f1-85cf249ecd27","added_by":"auto","created_at":"2025-12-17 17:29:30","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":54820,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDrug categories used for self-medication among Master of Public Health students in Nigeria (n=295).\u003c/strong\u003e Analgesics were the most commonly used category, followed by antimalarials. Respondents could report using multiple drug categories.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/098e2907dec371f840b596ad.png"},{"id":98449786,"identity":"d7d2f829-6d29-4cbb-ba52-c91c2cac7d03","added_by":"auto","created_at":"2025-12-17 17:30:00","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":49910,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSources of drugs for self-medication among Master of Public Health students in Nigeria (n=295).\u003c/strong\u003e Community pharmacies were the primary source for obtaining medications without a prescription. Respondents could indicate multiple sources.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/87bf4bc7f2184ebc0e9706b7.png"},{"id":98451478,"identity":"fc944c8d-2fb4-4e7b-a9aa-98ca44975a73","added_by":"auto","created_at":"2025-12-17 17:32:54","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1439039,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8070985/v1/d3a28521-5564-46d6-903c-6f3460c77d3e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eThe Paradox of Self-Medication among Future Public Health Leaders: Evidence from MPH Students in Nigeria\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSelf-Medication (SM) refers to the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. It is a global phenomenon, with an increasing trend in recent years [1, 2]. The World Health Organization recognizes that responsible SM for minor ailments can be part of self-care, provided this is informed by evidence-based knowledge to prevent harm [3]. It becomes a public health concern when it involves prescription-only medicines or is based on insufficient information; serious risks include an incorrect diagnosis, adverse drug reactions, antimicrobial resistance, and delayed effective treatment [4, 5].\u003c/p\u003e \u003cp\u003eIt is more common in low-income and middle-income countries because of factors like easy availability of medicines through informal sources, weak enforcement of regulations, high costs of healthcare, and long waiting times at health facilities that promote the practice [6,7]. Studies in Nigeria have reported prevalence rates of 54.6% to over 86% in the general population, thus making it a pervasive problem [8,9]. Commonly self-medicated drugs include analgesics, antimalarials, and antibiotics, usually obtained from community pharmacies and patent medicine vendors without a prescription [10,11].\u003c/p\u003e \u003cp\u003eOne of the most disturbing trends is the reportedly high prevalence of SM among healthcare professionals and students in general [12, 13]. Despite formal knowledge of medicine and the ensuing risks, this group practices SM at a rate equal to or higher than that seen among the general public. Cited reasons for this include convenience, perceived ability to self-diagnose, busy schedules, and avoidance of assuming the \"patient role\" [14, 15]. This forms a critical paradox: those entrusted to advocate for rational drug use themselves practice potentially irrational medication use. The implications are serious and extend beyond personal health risks to poor patient counseling, unhealthy behavior modeling, and reduced capacity to lead public health campaigns against drug misuse [16].\u003c/p\u003e \u003cp\u003eWhile a few have assessed SM among undergraduate medical and pharmacy students in Nigeria, little or no research has focused on postgraduate public health students [17, 18]. This category is unique, being made up of practicing health professionals-doctors, pharmacists, nurses-who further their careers to become future leaders in public health, policy makers, and advocates. Yet, their SM practices need to be understood since personal behavior could have a strong impact on professional credibility and the success or otherwise of public health communications seeking to promote the rational use of drugs. This therefore calls for an assessment of the knowledge, attitude, and practices of SM among students of the Master of Public Health at Ahmadu Bello University, Nigeria. The findings will highlight the determinants of SM use in this important population and provide evidence that is important in the development of specific interventions aimed at making their practices complement their responsibilities as public health advocates.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Setting\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA descriptive cross-sectional study was conducted among Master of Public Health (MPH) students at the Distance Learning Centre (DLC) of Ahmadu Bello University (ABU), Zaria, Nigeria. Data collection took place over four weeks, from July 20 to August 20, 2025. The DLC provides postgraduate education to a diverse cohort of working professionals, predominantly from healthcare backgrounds, spread across Nigeria.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Population and Sampling\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study population comprised all students enrolled in the MPH program at ABU DLC during the 2024 academic session. The minimum sample size was calculated as 357 using Cochran\u0026apos;s formula, with a prevalence (p) of SM assumed to be 66.7% [9], a 95% confidence level (Z = 1.96), and a 5% margin of error (d = 0.05). A 10% non-response rate was factored in.\u003c/p\u003e\n\u003cp\u003eA convenience sampling technique was employed. The study was open to all eligible MPH students who voluntarily chose to participate after seeing the announcement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion and Exclusion Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eCurrent enrollment in the MPH program at ABU DLC.\u003c/li\u003e\n \u003cli\u003eProvision of informed consent.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eMPH students who did not provide consent to participate.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eData Collection Tool and Technique\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA structured, self-administered questionnaire was developed by the researchers after an extensive review of relevant literature [9, 19, 20]. The questionnaire was hosted online using Google Forms and distributed to students through their official class WhatsApp groups.\u003c/p\u003e\n\u003cp\u003eThe instrument consisted of five sections:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003e\u003cstrong\u003eSection A:\u003c/strong\u003e Socio-demographic characteristics (age, sex, profession, highest educational qualification, marital status, etc.).\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSection B:\u003c/strong\u003e Knowledge of SM. This section contained 10 questions assessing understanding of SM concepts. A knowledge score was calculated, and participants were categorized as having \u0026quot;poor\u0026quot; (0-3), \u0026quot;moderate\u0026quot; (4-6), or \u0026quot;good\u0026quot; (7-10) knowledge.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSection C:\u003c/strong\u003e Attitude towards SM. This section used a 5-point Likert scale (Strongly Agree to Strongly Disagree) to gauge perceptions regarding the acceptability, risks, and regulations of SM.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSection D:\u003c/strong\u003e Practice of SM. This section assessed the prevalence of SM (defined as using drugs without a prescription in the last 6 months), frequency, reasons for SM, types of drugs used, sources of drugs, and experiences of side effects.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eSection E:\u003c/strong\u003e Open-ended section for additional comments (data not reported in this analysis).\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eOperational Definitions\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;For this study:\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eSelf-Medication:\u003c/strong\u003e The use of medication (over-the-counter or prescription) without a current prescription from a qualified medical doctor for self-recognized symptoms. This included the use of leftover prescribed drugs, taking drugs on the advice of non-professionals, or adjusting the dosage of a prescribed drug without consultation.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eGood Knowledge:\u003c/strong\u003e A score of 7-10 on the knowledge assessment scale.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eData Management and Statistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData from Google Forms were exported and analyzed using the Statistical Package for the Social Sciences (SPSS) version 27. Descriptive statistics were computed for all variables and presented as frequencies, percentages, means, and standard deviations. The association between socio-demographic variables, knowledge scores, and the practice of SM was assessed using the Chi-square test. A binary logistic regression was planned to identify independent predictors of SM; variables with a p-value \u0026lt; 0.05 in the bivariate analysis were considered for inclusion in the model. A p-value of less than 0.05 was considered statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study received expedited ethical approval from the Health Research Ethics Committee (HREC) of the Kaduna State Ministry of Health, with approval number MOH/ADM/744/VOL.1/1110031, dated 6th May 2025 (NHREC/17/03/2018). Participation was voluntary, and informed consent was obtained electronically at the beginning of the online questionnaire. Participants were informed of the study objectives, their right to withdraw at any time without penalty, and the assurance of confidentiality. All procedures were conducted in accordance with the Declaration of Helsinki and NHREC guidelines\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 357 Master of Public Health students participated in the study, yielding a response rate of 100% based on the calculated sample size. The socio-demographic characteristics of the respondents are summarized in Table 1. The mean age of participants was 31.2 years (\u0026plusmn;5.8), and the majority were female (64.2%). Most respondents were married (61.9%) and held a Bachelor\u0026apos;s degree (57.8%) as their highest qualification. The cohort was predominantly composed of healthcare professionals, including medical doctors, pharmacists, and nurses. Ethnically, the sample was diverse, with the largest groups being Igbo (37.8%) and Yoruba (28.9%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Socio-demographic characteristics of the study participants (N=357)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e128\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e35.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e229\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e64.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge (years)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e31.2 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e24.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e61.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eSeparated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e6.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHighest Education\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eBSc\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e206\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e57.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eMSc\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e29.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003ePhD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily Type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eMonogamous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e74.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003ePolygamous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e25.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTribe\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eHausa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e20.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eYoruba\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e28.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eIgbo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e37.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 121px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 115px;\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eKnowledge, Attitude, and Prevalence of Self-Medication\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Assessment of knowledge revealed that a large proportion of participants (82.0%, n=293) had good to moderate knowledge of self-medication (Table 2). However, the practice of SM was highly prevalent, with 82.7% (n=295) of respondents reporting they had taken medication without a prescription in the preceding six months.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Knowledge and practice of self-medication among participants\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency (n)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge Level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGood (7\u0026ndash;10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModerate (4\u0026ndash;6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e38.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePoor (0\u0026ndash;3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSM Practice (6 months)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e295\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAttitudes towards SM were mixed (Table 3). While an overwhelming majority recognized the risks 92.8% agreed SM is harmful without proper knowledge, and 86.0% supported the need for a medical license for drug administration opinions on its acceptability were divided. A combined 39.6% of respondents (Agree/Strongly Agree) found SM acceptable, while 42.4% (Disagree/Strongly Disagree) did not.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Attitudes and perceptions towards self-medication (n=357)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStatement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Agree (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgreed(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUnsure (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Disagree(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eSM is acceptable to me.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e51 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e90 (25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e85 (23.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e90 (25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e41 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eI don\u0026rsquo;t need to see a doctor before using drugs.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e34 (9.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e79 (22.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e102 (28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e94 (26.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e48 (13.4)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eSM is harmful without proper knowledge.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e269 (75.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e62 (17.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e17 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e6 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e3 (0.8)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eA medical license is needed for drug administration.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e241 (67.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e66 (18.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e17 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e24 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e9 (2.5)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eMedication duration should be completed.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e295 (82.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e51 (14.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e11 (3.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 171px;\"\u003e\n \u003cp\u003eCaution is needed with over-the-counter meds.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 92px;\"\u003e\n \u003cp\u003e308 (86.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e40 (11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e6 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 74px;\"\u003e\n \u003cp\u003e2 (0.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 116px;\"\u003e\n \u003cp\u003e1 (0.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eFactors, Sources, and Substances in Self-Medication Practice\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;The most frequently cited reasons for engaging in SM were the easy accessibility of pharmacies (75.5%), self-perceived knowledge of the correct drugs (72.0%), and the high cost of hospital bills (68.3%) (Figure 1)\u003c/p\u003e\n\u003cp\u003eThe most common symptoms prompting SM were headache (86.0%), cough/flu-like symptoms (47.2%), and general pain (46.0%) (Figure 2). Consequently, the most frequently used drug categories were analgesics (63.8%), antimalarials (49.6%), and cough/flu medications (46.2%) (Figure 3).\u003c/p\u003e\n\u003cp\u003eParticipants primarily sourced drugs for SM from pharmacy shops (84.7%), patent medicine stores (21.6%), and leftover medications at home (20.9%) (Figure 4). When procuring drugs, the vast majority (81.8%) directly requested the drug by name. The choice of drug was predominantly influenced by the individual\u0026apos;s own medical knowledge (84.3%) and previous experience with a similar illness (25.4%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFactors Associated with Self-Medication Practice\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Bivariate analysis revealed several factors significantly associated with the practice of SM (Table 4). Participants under 30 years of age, those who were single, and those with a BSc or MSc as their highest qualification were significantly more likely to self-medicate compared to their older, married, or PhD-holding counterparts. Furthermore, individuals with a higher knowledge score were significantly more likely to practice SM (\u0026chi;\u0026sup2; = 35.16, p \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Association between socio-demographic variables, knowledge, and self-medication practice\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategory\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSM Practice: Yes (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSM Practice: No (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u0026sup2; value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge Group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt; 30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e170 (91.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16 (8.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e17.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026ge; 30 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e125 (73.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e46 (26.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e82 (92.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (7.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e25.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e170 (76.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e51 (23.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43 (65.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23 (34.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBSc\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e181 (87.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25 (12.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e6.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e0.041*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMSc\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e93 (89.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11 (10.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21 (44.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26 (55.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eKnowledge Score\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLow (0\u0026ndash;3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45 (70.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19 (29.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e35.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModerate (4\u0026ndash;6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e108 (79.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28 (20.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGood (7\u0026ndash;10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e142 (90.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15 (9.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eStatistically significant at p \u0026lt; 0.05.\u003c/strong\u003e\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study aimed to assess the knowledge, attitudes, and practices of self-medication among a cohort of future public health leaders in Nigeria. The key and most captivating finding is the striking paradox between knowledge and practice: an overwhelming majority (82.0%) of MPH students had good to moderate knowledge of the risks of SM, yet an equally high proportion (82.7%) practiced it. This prevalence is substantially higher than the 54.6% \u0026minus;\u0026thinsp;86.7% reported in the general Nigerian population [8, 9] and corroborates global evidence showing that healthcare professionals and students are among the highest self-medicating groups [12, 13]. This discrepancy emphasizes that knowledge is not enough to be a deterrent and that there is a strong influence of other enabling factors.\u003c/p\u003e \u003cp\u003eThe reasons cited for SM in this study are instructive. Easy access to pharmacies, perceived knowledge of correct drugs, and high hospital costs were the primary drivers. This suggests that for this highly educated group, confidence in their own medical expertise overrides their awareness of the potential dangers. This phenomenon, where professional knowledge fosters a false sense of security in self-diagnosis and treatment, has been observed among medical and pharmacy students elsewhere [15, 21]. Furthermore, the high cost of formal healthcare remains a significant push factor, even for this professional cohort, highlighting systemic issues within the Nigerian health system that incentivize risky coping strategies [7].\u003c/p\u003e \u003cp\u003eOur findings on the substances and sources of SM are in consonance with patterns from Nigeria and other similar settings [10, 11]. The predominance of analgesics for headaches and antimalarials for fever-like symptoms reflects the commonality of these ailments and the ease with which these drugs are obtained. That 84.7% sourced drugs from pharmacies establishments meant to be guardians of rational drug use is a finding of particular import. It shows a gross failure in the regulatory and professional gatekeeping role of pharmacies in Nigeria, where prescription-only medicines are often sold without due diligence [22].\u003c/p\u003e \u003cp\u003eA particularly noteworthy finding was the strong positive association between higher knowledge scores and the likelihood of practicing SM. This unexpected relationship strengthens the contention that, in this context, knowledge enables rather than prohibits. It gives individuals the confidence to bypass formal healthcare channels, a behavior similarly remarked on among pharmacy students in Zambia and medical students in Tanzania [21, 23]. This challenges conventional health education models and suggests that interventions must move beyond knowledge dissemination to address the underlying attitudes and professional norms that justify this behavior.\u003c/p\u003e \u003cp\u003eA number of socio-demographic factors appeared to be significant predictors of SM: the higher odds among younger students and those who were single could have reflected a more risk-inclined lifestyle or fewer familial responsibilities which would encourage more cautious health-seeking behavior [24, 25]. The lower prevalence among PhD holders, meanwhile, may indicate that greater maturity, more clinical experience, or even a deeper understanding of public health consequences serves as a protective factor. Less intuitive is the finding of an association with a monogamous family structure, which may relate to socioeconomic factors or decision-making dynamics not captured here but warranting qualitative exploration.\u003c/p\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eImplications for Public Health Policy and Practice\u003c/h2\u003e \u003cp\u003eThese findings have huge implications. If the future generation of public health professionals, who are expected to champion rational use of drugs and combat threats such as antimicrobial resistance, are themselves heavily engaged in irrational SM, it seriously compromises the credibility and effectiveness of public health campaigns. There is an urgent need for:\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eTargeted Educational Interventions: Specific modules on responsible self-care, ethics of self-treatment relevant for health professionals, and the wider societal implications of SM, including antimicrobial resistance, should be incorporated into the MPH curriculum.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eStrengthening Regulation: Regulatory agencies must enforce laws banning over-the-counter sales of prescription-only medicines, focusing most on holding pharmacies and patent medicine vendors responsible for these offenses.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eProfessional Accountability: Professional associations for doctors, pharmacists, and public health workers should explicitly address and discourage irresponsible SM among their members as a matter of professional conduct.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe present study has several limitations. Its cross-sectional nature precludes the establishment of causal relationships. Though the use of convenience sampling was practical, it may make generalization to all MPH students in Nigeria difficult. Moreover, the data were self-reported and susceptible to social desirability and recall bias. Despite these limitations, the study provided crucial insights into a severely under-researched population that plays a critical role in the health system.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study demonstrates a wide gap between knowledge and practice regarding self-medication among future leaders in Nigeria's public health system. Although most of the MPH students are well aware of the risks, the overwhelming majority practice SM, which is significantly influenced by perceived clinical competence, accessibility of the medication, and economic factors. In fact, the finding that higher knowledge promotes the likelihood of greater engagement with SM emphasizes the ineffectiveness of awareness alone as a public health approach.\u003c/p\u003e \u003cp\u003eThese findings sound an alarm for public health education and policy. Ensuring the protection of the health of individuals and the population requires the creation of specific interventions within postgraduate public health training that focus on the normative and attitudinal drivers of this behavior. In addition, strict enforcement of regulations on the dispensing of drugs is needed to check the uncontrolled access to prescription medicines. In empowering these future advocates to align their personal practices with professional mandates lies a critical step towards building a more effective and credible foundation for rational drug use in Nigeria.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003ctable border=\"0\" cellspacing=\"3\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSM\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSelf-Medication\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eMPH\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eMaster of Public Health\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eABU\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAhmadu Bello University\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eDLC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eDistance Learning Centre\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eOTC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eOver-the-Counter (medications)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSPSS\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eSD\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eStandard Deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u0026sup2;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eChi-square\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eCI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eConfidence Interval\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eAOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAdjusted Odds Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eCOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eCrude Odds Ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eProbability value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cstrong\u003eWHO\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eWorld Health Organization\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Health Research Ethics Committee (HREC) of the Kaduna State Ministry of Health (Approval No: MOH/ADM/744/VOL.1/1110031, dated 6th May 2025; NHREC/17/03/2018). The Ahmadu Bello University Distance Learning Centre (ABU-DLC) granted a waiver for additional institutional review because the study involved minimal risk and used non-identifiable data.\u003c/p\u003e\n\u003cp\u003eParticipation was entirely voluntary, and informed consent was obtained electronically from all participants at the beginning of the survey. Anonymity and confidentiality of the data were maintained throughout the research process.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable. This manuscript does not contain any individual person\u0026rsquo;s data, images, or other identifying information\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eEkwu Chinonso Emmanuel:\u003c/strong\u003e Conceptualization, study design, data collection, manuscript drafting.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003ePolycarp Dauda Madaki:\u003c/strong\u003e Data analysis, interpretation, manuscript writing, critical revision, overall supervision.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eOghenerhoro Reuben:\u003c/strong\u003e Literature review, data entry, editing of manuscript.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAbdullahi Naimat Ololade:\u003c/strong\u003e Methodology support, validation, review of final manuscript.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eRuth Sabo Manzo:\u003c/strong\u003e Review of discussion, policy interpretation, final manuscript review.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors appreciate all participants who took part in this research and colleagues who provided support during data collection.\u003c/p\u003e"},{"header":"References","content":"\u003col start=\"1\" type=\"1\"\u003e\n\u003cli\u003eWorld Health Organization. The role of the pharmacist in self-care and self-medication. Report of the 4th WHO Consultative Group on the Role of the Pharmacist. The Hague: World Health Organization; 1998.\u003c/li\u003e\n\u003cli\u003eAl-Worafi YM. Self-Medication. In: Elsevier eBooks. 2020. p. 73\u0026ndash;86. Available from: https://doi.org/10.1016/b978-0-12-819837-7.00007-8\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Self-care for health and well-being. WHO: Geneva; 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/self-care-health-interventions\u003c/li\u003e\n\u003cli\u003eBennadi D. Self-medication: A current challenge. J Basic Clin Pharm. 2013;5(1):19\u0026ndash;23.\u003c/li\u003e\n\u003cli\u003eTorres N, Chibi B, Middleton L, Solomon V, Mashamba-Thompson T. Evidence of factors influencing self-medication with antibiotics in low and middle-income countries: a systematic scoping review. Public Health. 2019;168:92\u0026ndash;101.\u003c/li\u003e\n\u003cli\u003eOcan M, Obuku EA, Bwanga F, Akena D, Richard S, Ogwal-Okeng J, et al. Household antimicrobial self-medication: a systematic review and meta-analysis of the burden, risk factors and outcomes in developing countries. BMC Public Health. 2015;15:742.\u003c/li\u003e\n\u003cli\u003eCobbold J, Morgan A. An integrative review of the prevalence, patterns and predictors of self-medication in Ghana. Cogent Public Health. 2022;9(1):2098567.\u003c/li\u003e\n\u003cli\u003eAkande-Sholabi W, Ajamu AT, Adisa R. Prevalence, knowledge and perception of self-medication practice among undergraduate healthcare students. J Pharm Policy Pract. 2021;14(1):3.\u003c/li\u003e\n\u003cli\u003eNwoga H, Ajuba M, Okorie O. Self-Medication among Medical Students in a Tertiary Health Facility in Enugu State, South East Nigeria. IOSR J Pharm. 2021;11(3):22\u0026ndash;30.\u003c/li\u003e\n\u003cli\u003eBassi P, Osakwe A, Builders M, Ettebong E, Kola G, Binga B, et al. Prevalence and Determinants of Self-Medication Practices among Nigerians. Afr J Health Sci. 2021;34(5):634\u0026ndash;49.\u003c/li\u003e\n\u003cli\u003eRathod P, Sharma S, Ukey U, Sonpimpale B, Ughade S, Narlawar U, et al. Prevalence, Pattern, and Reasons for Self-Medication: A Community-Based Cross-Sectional Study From Central India. Cureus. 2023;15(1):e33917.\u003c/li\u003e\n\u003cli\u003eBabatunde OA, Fadare JO, Ojo OJ, Durowade KA, Atoyebi OA, Ajayi PO, et al. Self-medication among health workers in a tertiary institution in South-West Nigeria. Pan Afr Med J. 2016;24:312.\u003c/li\u003e\n\u003cli\u003eFekadu G, Dugassa D, Negera G, Bakala T, Turi E, Tolossa T, et al. Self-Medication Practices and Associated Factors Among Health-Care Professionals in Selected Hospitals of Western Ethiopia. Patient Prefer Adherence. 2020;14:353\u0026ndash;61.\u003c/li\u003e\n\u003cli\u003eS\u0026oslash;vold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, et al. Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Front Public Health. 2021;9:679397.\u003c/li\u003e\n\u003cli\u003eTarkowski Z, Piątkowski W, Bogusz R, Majchrowska A, Nowakowski M, Sadowska A, et al. When a doctor becomes a patient, the unique expectations and behaviours in a disease: preliminary report. Prog Health Sci. 2016;6(2):160\u0026ndash;4.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Antimicrobial resistance. Fact Sheet. WHO: Geneva; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance\u003c/li\u003e\n\u003cli\u003eOsemene KP, Lamikanra A. A Study of the Prevalence of Self-Medication Practice among University Students in Southwestern Nigeria. Trop J Pharm Res. 2012;11(4):683\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eEsan DT, Fasoro AA, Odesanya OE, Esan TO, Ojo EF, Faeji CO. Assessment of Self-Medication Practices and Its Associated Factors among Undergraduates of a Private University in Nigeria. J Environ Public Health. 2018;2018:5439079.\u003c/li\u003e\n\u003cli\u003eEyisi IG, Njelita IA, Akabuike J, Nwachukwu C, Eyisi CS. Knowledge, Attitude and Practice of Self Medication amongst Medical Students in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka. Med Pub Health Res J. 2022;3(3):1\u0026ndash;18.\u003c/li\u003e\n\u003cli\u003eMusa Y, Awosan KJ, Ibrahim MTO, Abdullahi Z, Jafaar M, Peter G, et al. Knowledge and Practice of Self-Medication among Undergraduates Students of Usmanu Danfodiyo University, Sokoto. Ann Int Med Den Res. 2016;2(1):83\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eBanda O, Vlahakis PA, Daka V, Matafwali SK. Self-medication among medical students at the Copperbelt University, Zambia: A cross-sectional study. Saudi Pharm J. 2021;29(11):1233\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003ePopoola OO, Adebisi IA, Adeyemi AS, Adepitan DS, Oladeru OF. Assessing ethical practices among community pharmacists in Nigeria: prevalence, drivers, challenges, and implications\u0026mdash;a mixed methods study. Front Public Health. 2025;13:1495328. doi:10.3389/fpubh.2025.1495328.\u003c/li\u003e\n\u003cli\u003eShitindi L, Issa O, Poyongo BP, Horumpende PG, Kagashe GA, Sangeda RZ. Comparison of knowledge, attitude, practice and predictors of self-medication with antibiotics among medical and non-medical students in Tanzania. Front Pharmacol. 2024;14:1301561.\u003c/li\u003e\n\u003cli\u003ePark H, Lee KS. The association of family structure with health behaviour, mental health, and perceived academic achievement among adolescents: a 2018 Korean national representative survey. BMC Public Health. 2020;20:510.\u003c/li\u003e\n\u003cli\u003eVahedi S, Jalali FS, Bayati M, Delavari S. Predictors of Self-Medication in Iran: A Notional Survey Study. Iran J Pharm Res. 2021;20(1):e124479.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Self-Medication, Public Health, Health Knowledge, Attitudes, Practice, Nigeria, Health Personnel, Students, Drug Utilization","lastPublishedDoi":"10.21203/rs.3.rs-8070985/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8070985/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eSelf-medication (SM) is a significant public health concern, particularly in low- and middle-income countries with weak drug regulatory frameworks. Alarmingly, healthcare professionals, including future public health leaders, are often frequent practitioners. This study assessed the knowledge, attitude, practice, and associated factors of SM among Master of Public Health (MPH) students at a Nigerian university.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was conducted among MPH students at Ahmadu Bello University's Distance Learning Centre from July to August 2025. A Google Forms questionnaire was distributed via WhatsApp, employing a convenience sampling technique. Data on socio-demographics, knowledge, attitudes, and practices of SM were collected. Descriptive statistics, chi-square tests, and logistic regression were performed using SPSS version 27, with a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOut of 357 participants (mean age 31.2\u0026thinsp;\u0026plusmn;\u0026thinsp;5.8 years; 64.2% female), the vast majority were healthcare professionals. A high proportion (82.0%) had good knowledge of SM. Paradoxically, the prevalence of SM practice in the preceding six months was 82.7%. The most common reasons for SM were easy access to pharmacies (75.5%), self-perceived knowledge of correct drugs (72.0%), expensive hospital bills (68.3%), and prior experience with the illness (68.2%). Analgesics (63.8%) and antimalarials (49.6%) were the most frequently used drugs, primarily for headaches (86.0%) and cough/flu (47.2%). SM was significantly associated with younger age (\u0026lt;\u0026thinsp;30 years), being single, lower educational level (BSc/MSc vs. PhD), monogamous family structure, and, notably, a higher knowledge score (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for all).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eDespite high knowledge levels regarding SM risks, its practice remains pervasive among future public health professionals in Nigeria. Confidence in personal medical knowledge and easy drug access appear to override risk awareness. These findings highlight an urgent need for targeted educational interventions and stricter enforcement of drug dispensing policies within this key demographic to curb this dangerous trend and align their practices with their public health advocacy roles.\u003c/p\u003e","manuscriptTitle":"The Paradox of Self-Medication among Future Public Health Leaders: Evidence from MPH Students in Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-17 16:55:00","doi":"10.21203/rs.3.rs-8070985/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-12-29T20:30:39+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-23T09:04:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"285937355960443839111661250125970091376","date":"2025-12-21T20:15:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"191576207539376869972704945686288632746","date":"2025-12-21T17:15:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"56614641865831257784208555036690088668","date":"2025-12-12T22:07:11+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-12T07:20:41+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-08T13:39:41+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-12T18:07:49+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-12T12:54:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-11-12T12:51:20+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b2166e46-cd01-4d48-8d5b-d0170d11f9dc","owner":[],"postedDate":"December 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-17T16:55:00+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-17 16:55:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8070985","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8070985","identity":"rs-8070985","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}