The Influence of Advertisement on Self-Medication Research Proposal: Case Study of Africa
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Abstract
The concept of self-medication is a global issue that attracts much attention because it can adversely impact people’s health. It is a significant potential for adverse threats for people across all age groups. In developing regions such as Africa, self-medication is a considerable public health concern. As noted in many studies, the utilization of drugs without the approval of health care practitioners and other registered medics is increasing in Africa day by day. Most people that practice self-care are unaware of the safety and rational application of such medications on their health. Besides, self-medication users also seem to overlook the far-reaching consequences that non-prescribed drugs can pose in the long-term. The adverse effects of self-medication must be emphasized to people and communities using advisements in efforts to curb them. Higher usage of antibiotics without doctors or healthcare practitioners’ awareness may result in missed therapies, delays in treatments, and higher mortality rates, among other negative consequences. This research proposal will deal with the rationale, risks, and prevention measures of possible hazards related to self-medication. This proposal will examine the effects of advertisements on self-medication in various African countries. It will use a meta-analysis approach to determine the influence of advisement on self-medication among Africans. The researcher will gather data from the already done studies (secondary sources) in Africa on the effect of advisement in influencing self-medication practices. Findings of the relationship between advertisement as well as self-medication will be reported. Also, the research will establish if adverts as a factor influence the possibility of Africans engaging in self-medication practices.
Acknowledgments
I would like to appreciate my supervisor (give a name) for his/her direction through each of this research proposal process. This work was possible with the support of my friends, family members. I am especially grateful to those I had the pleasure to associate with during this research proposal.
Chapter One
Introduction
- Background of the Study
Self-medication is broadly defined as the utilization of one or more drugs without a doctor’s prescription, diagnosis, supervision, or direction. It also includes the use of medications such as herbal as well as chemical drugs (Asefzadeh, Barkhordari, & Moghadam, 2003). The World Health Organization defines the concept as the practice of humans in selecting and using drugs to treat perceived symptoms and health conditions. According to Jafari, Khatony, and Rahmani (2015), self-medication among people is one of the most significant health concerns affecting both the developed and developing parts of the world today. They say that it is a significant problem that can cause far-reaching effects on people’s health. For them, it adversely affects both the socio-health as well as economies of different nations globally. In some developing countries, they argue that drugs are often available to people without proper prescriptions and appropriate diagnoses to determine their suitability. They equally agree that because of the affordable or lower cost of self-medication drugs, people consider it as an excellent option for those that cannot afford the regular healthcare expenses. For Jafari, Khatony, and Rahmani (2015), the affordability of these drugs explains why most people choose self-medication in many of the developing nations, including Africa. In this sense, they suggest that more than 60 percent of the health issues faced in these developing countries result from self-medication practices. Kumari et al. (2012) also agreed that most people in third-world countries often go for self-medication as an option to other medical services.
They proposed that people also chose self-medication because such drugs were readily available. In their study in Sudan, Awad and Eltayeb (2007) found that 60-80 percent of students decided to use self-medication as an alternative to medical services due to its accessibility. These authors also found that the use of self-medication among the students accounted for most of their health problems. They advised that self-medication among the students was detrimental, and efforts were necessary for averting associated effects. A study by Afolabi (2008) collected data from 205 women in Nigeria and found that patient medication vendors were the common source of self-medication drugs and information. They argued that even with the growing interest in self-medication in Africa, there was little information about the significant causes or factors that contribute to this problem in developing nations. They also argued that self-treatment stimulated people to handle major diseases using simple and effective remedies. Individuals believe that drugs should be utilized during sickness or any discomfort. While people said that they got drug information from medicine dealers, they also agreed that they also depended on other sources for information (Afolabi, 2008). However, Afolabi (2008) found a negative association between respondents’ sources of information through family members, advertisements, and experience from prior illness. They discovered that adverts were not a significant factor in individuals’ self-medication decisions. The determined that knowledge, as well as community health awareness through education, could help to sensitize people on the harmful effects of self-treatment.
In Egypt, a study by Helal and Abou-ElWafa (2017) studied the concept of self-medication among university students. They found that it was a common trend in most of the developing countries. In attempts to investigate the prevalence of this concept, they performed a descriptive cross-sectional analysis and included first and fourth-year students as they sample. They determined that the prevalence of self-medication among these students was 62.9 percent. They also established that some of the factors that influenced students into using self-medication were home pharmacies, marriage, and younger age. They concluded that the pervasiveness of self-medication among the students was higher than in other groups. As such, they said that it constituted a significant health issue that needed immediate intervention. Thus, it is apparent that Helal and Abou-ElWafa (2017) did not find other factors such as advertisement as posing a considerable threat to this population. However, the study by Burak and Damico (2000) revealed that self-medication raised a public health issue among university students in most of the developing countries, mainly in Africa. They found that the practice of self-medication among these students presented a significant problem to this populace because most of them used advertised items, without discussing with doctors or other healthcare practitioners.
- Statement of the Problem
Self-medication as a concept is a pertinent public health concern in both the developed as well as developing worlds. However, it poses a significant challenge in many of the developing countries in Africa. In African countries where universal health coverage has not been attained, the problem of self-medication among people is more prevalent. In these areas, many will often prefer to self-medicate to manage minor and acute conditions, including vomiting, headache, as well as diarrhea, among others. Some of the reasons reported in the literature, from the above discussion, as influencing people to self-medication in Africa are past medical histories, lack of doctors, and advertisements. According to the World Health Organization, having proper medication is highly beneficial for people in treating acute and other conditions (Amin et al., 2019). Thus, self-medication has always raised a medical dilemma for numerous doctors across various countries. When misused, this practice can lead to detrimental effects on users’ health outcomes. However, when used rightly, it can also lighten the need for doctors and make individuals more health mindful. Often, self-medication has been used as an initial intervention before patients see doctors. But, self-medicating before consulting the physician may negatively impact clinical diagnoses and treatment of ailments. On this basis, healthcare professionals must be engaged and have an excellent understanding of this practice in many of the populations they handle.
In most African countries, public adverting materials on drugs are highly regulated by respecting national drug policies. For instance, most states, including Ghana, require that print and electronic advert materials be vetted by relevant bodies before they can be used. In this regard, drug promotional efforts and activities must also be approved before they are released to the public. Hence, whenever a drug brand is used for any promotional reasons, the generic name of such medication must be thoroughly examined. For all adverts, most countries also demand that the generic names of drugs must be given underneath the brands. Moreover, these adverts may not be allowed in public spaces, including parks, markets, and other restricted areas, as provided in each of the respective country’s policies. In different countries around Africa, there have been several drug promotions and adverts in different areas, such as vehicles, parks, and markets. As such, advertising in such restricted areas often leads to the promotion of self-medication in various groups among communities. While it is not clear to what degree each country’s drug policies are enforced, the practice of advertising drugs in several places has continued. It is also not known to what magnitude these adverts influence self-medication in different countries in Africa. Thus, the current proposal seeks to establish the degree to which drug adverts in African countries lead to self-medication among people.
- Objectives of the Study
The general object of undertaking this study is to establish the influence of advertisement on the practice of self-medication among citizens of African states. The specific objectives of this study also comprise the following:
- To find the different types of health conditions that people in African often view as suitable for self-medication.
- To investigate the influence of advertisement on Africans preferring to use self-medication instead of proper medical services.
- To assess the various contributors for self-medication among citizens of different African countries.
- To investigate why people in African settle for self-medication even when health insurance and services exist.
- Study Hypothesis
This study will adopt the following hypothesis in attempts to address the above-state research objectives:
- H0: Drug promotion and advertisement do not influence individuals’ self-medication decisions.
- HA: Drug promotion and advertisement do influence individuals’ self-medication decisions.
- Study Justification
The problem of self-medication has become an increasing concern in many African countries in the world today. However, while it is cited as presenting a vital dilemma to the provision of care to people, it also helps to move individuals towards higher independence in managing and treating diseases. One benefit of self-medication given in the study by Soroush et al. (2018) is fostering empowerment among people. The other advantages for healthcare systems include promoting enhanced use of clinical knowledge, increased access to drugs, and low prescription expenses. However, it often contributes to various health risks, including drug misuse, long duration of use, overdose, and other detrimental effects. Usually, drug interactions, as well as concurrent use of drugs, might be mainly problematic for children and older people. As such, proper education on drug use, frequent monitoring, and partnership between families, patients, and doctors help to maximize benefits while reducing associated risks (Helal and Abou-ElWafa, 2017).
Even informal sectors in most countries, drugs are often sold without correct prescriptions and labeling. Besides, drugs are sold in different places such as kiosks, shops, drug stores, as well as markets in many African settings. Equally, numerous drug peddlers bring a variety of medications to people living in remote areas in most of these settings. Also, the patients’ purchasing powers determine the type and quality of drugs they obtain from the readily available dispensers. It is regularly hard to differentiate whether it is customers or pharmacologists who decide the medicine to be bought by patients. In attempts to regulate and minimize harmful effects from self-medication, governments and policy-makers should take appropriate measures and encourage their people to use the right medications. Apart from highlighting the influence of drug advertising on self-medication, this study will also inform leaders on how to manage drug use. This study will also play a poignant role in helping leaders and states how to curb the adverse effects that originate from self-medication.
- Methodology and Data Analysis
This study will use a meta-analysis approach to determine the influence of advisement on self-medication among Africans. According to Davis et al. (2014), this approach is a statistical method of merging results from various studies to evaluate, compare, and recognize patterns, trends, as well as relationships that exist in multiple studies on the given topic. With this approach, the researcher will abstract each of the primary research, code, and calculate the overall effect.
- The Study’s Scope
This study will be limited to the African continent. Thus, the study will use primary studies to determine the impact of drug advertisements on self-medication. As noted early, most of the African countries lack sufficient healthcare coverage, poor infrastructure, and remote healthcare systems, which make patients go for self-medications. Many of these people are equally exposed to numerous print and electronic drug advertisements. The African region has been selected because it one of the affected by self-medication in the world. In total, a sample of 15 primary studies will be used in this study. While the researcher will like to adopt a large number of studies, time, and resource constraints place significant limitations.
- Study’s Organization
This given study is organized into three chapters, including chapters one, two, and three. The first chapter, labeled as chapter one, will present a complete introduction of the research topic. In chapter 2, the researcher will present relevant studies on this topic and associate methodology. The third chapter will have a summary of the methods that the researcher intends to utilize to complete this study.
Chapter Two
Review of the Literature
2.0 Introduction
The concept of self-medication has become a topic of interest globally because of the effects it inflicts on people. Individuals often have the notion that medicine should be taken in the experience of an ailment. World health agencies such as the World Health Organization advocate for the inclusion of community stakeholders in prime health care. The practice of self-medication cuts across all social, economic, political as well as demographic factors. The practice has become rampant, thus drawing the attention of medical practitioners, especially the dispensers. According to Vacca et al. (2005), distributors are required to appropriately dispense medicine to achieve rational use, thus ensuring they remain up to date regarding the information, tools, and skills. Hence, this chapter will review the theoretical and empirical studies on the selected topic.
2.1 Defining Self-Medication
Montastruc et al. (1997) say that self-medication is defined as acquiring and consuming a medicine without a prescription from a physician either for diagnosis or monitoring for treatment. It includes purchasing medication without a doctor’s advice, use of a previous order to buy drugs, using unused medicines at home, or even sharing medicine with a family member or relative. It mainly involves buying Over-The-Counter (OTC) medicines, as well as Prescription Only Medicines (POM) (Pereira et al., 2007). Self-medication is assumed to be part of self-care among individuals ailing and assume duties of medical practitioners to offer treatment or prevent sickness by use of POMs (Hughes et al., 2001). The ailments may include indigestion problems, fever, cold, headache, backache, and diarrhea. Many people may get advice from family members, relatives, and patent medicine sellers on the kind of drugs to take as treatment. The drugs can be herbal or conventional and can be bought from chemists and pharmaceutical stores. This aspect constitutes self-medication (Costa et al., 2004). The use of herbal drugs for self-medication is widespread in developing countries, as most people think that it is safer than conventional medicine (Mitri, 1987).
According to the World Self-Medication Industry (WSMI), self-medication is defined as the treatment of common health problems with drugs labeled to be used, not necessarily with physician’s advice and approved for safe and effective use. Self-medication has severe risks, including overdosage, poly-pharmacy, incorrect drug usage, misdiagnosis, among others. Acquiring Over-The-Counter medication has proved to be a global challenge in the public health sector both in developed and developing countries. The World Health Organization emphasizes the need to create awareness regarding self-medication and controlling this practice (WHO, 1998). According to the WHO (1998), drugs used through self-prescription can either treat well or even cause adverse effects. I n this case, a pharmacist play a significant role by ensuring that the consumer is provided with sufficient information regarding the use of such drugs and when to see a doctor (Hughes et al., 2002). Self-medication is popular because of drug advertisements by manufacturing pharmaceuticals. Other reasons for this popularity include feelings of independence to treat among people, inadequate doctors (Biduki, 2013). An individual can also be prompted by dispensing health workers and previous excellent experience of managing the same sickness (Afolabi, 2008). If practiced correctly, self-medication saves on time spent on waiting to consult a physician, reduces the cost of consultation and purchase of medicine, especially in developing countries, in addition to lowering medical services load (WHO, 2005).
2.2 Theoretical review
As reported in the study by Chang and Trivendi (2003), while medical services constitute normal goods, self-medication is regarded as an inferior commodity. The law of supply and demand will require the level of self-treatment to decrease when income rises and vice-versa. It means that whenever people’s disposable incomes increase beyond certain levels, they start consulting doctors and other medical professionals for assistance. This model equally implies that the demand for goods is relative to their prices in the market. It is also evident that when people have sufficient health insurance coverage, the cost of medical care becomes relatively affordable, leading to increased medical services use and decreased self-medication preference among individuals. This framework also suggests that the choice to use self-medication among people depends of product prices in the market. In other words, individuals would often switch between self-medication and professional care depending on the cost of treatment. Similarly, the perceived efficiency and value for money could also determine if patients choose self-medication or medical care services. Likewise, self-medication could also be a normal good for individuals using it. Thus, a rise in people’s incomes could also increase the demand for self-medication. Hence, a maximum subsidy in expert services could discourage people from going for self-medication.
2.3 Empirical review
Consumers of specified health products can get information from different sources, including advertisements and websites. These sources enable them to make decisions regarding health products to use. Adverts involve transmitting simple, clear, and concise information. However, research shows that advertisement is the least used source of information concerning the use of certain drugs. Most people trust information and advice from healthcare practitioners. Nevertheless, ads play a significant role in creating awareness concerning a given medication at the same time, providing detailed information that is useful for appropriate decision making on drug use. In their study, Blinn et al. (1999) found that television advertisement creates awareness regarding product choice and emphasize its primary importance to many viewers. They stressed that ads must be simple and consumer attractive for it to be effective.
Scholars have failed to agree on the use of direct-to-client marketing of pharmaceuticals strategy. Holmer (1999) found that advertising acted as an educational resource, mainly in helping patients find drugs. However, Rados (2004) found that ads increase self-medication resulting in over usage and misuse of such health products. Evaluating the role played by African Pharmacies in the health care provision system in South Africa, Cocks and Dold (2000) found that there were more female than male consumers. It also revealed that most of the individuals who went for OTC medication in pharmacies had a low level of education. Self-medication had a key influence on treating diseases in African chemists at the early stages. In his study, Andualem (2002) established that the common reasons for self-medication are previous experience about the use of the drug and mildness of the disease. While people might be given the right drugs after attending consultations with care practitioners, it does not imply that they cannot consume them improperly. There have been many cases where patients have misused drugs and failed to follow doctors’ instructions. According to Martin et al. (2002), drug use often varies significantly among certain groups of people due to factors such as adverts and the nature of diseases.
Chapter Three
Research Methodology
3.0 Introduction
This chapter will deal with data collection, analysis, and presentation. When performing a research study, the most critical aspect one has to bear in mind is the study’s design because it informs the nature of the research. In this regard, the correctness, effectiveness, and suitability of a given study are determined by its design. As such, this study will employ a meta-analysis of 15 previous primary researches on the topic to answer the provided research hypothesis. Whereas the chosen sample is not large enough, it will help to inform the research process and analysis. The reason for the selected sample size is due to time and resource constraints.
3.1 Study Area and Population
The African continent is among the world’s largest continent, with almost 54 countries. It is regarded as a developing world because most of its countries continue struggling on significant economic indicators, including health. It also comes second in both size and populace after Asia. It covers nearly 30 million square kilometers and 6 percent of the earth’s surface area. This area is also projected to house about 1.3 billion people going by the 2018 statistics. It also hosts a vast diversity of cultures, languages, as well as ethnicities than any other continent on earth. While the people of Africa aspire for a great future of outstanding health and wellbeing, the current state of health in this region is disheartening. Even with numbers of facilities and care professionals, Africa’s health systems perform minimally when compared to those in other continents. The prevalence of self-care is considerably high among African countries. Many factors have also been studied in the past to find causes for self-care and health-seeking behaviors among people. Thus, using the repertoire of existing primary researches, this study will establish whether drug ads do influence people to self-medication in African states.
3.2 Sampling Methods and Sample Size
In this study, the researcher will select a total of 15 primary studies that have been conducted in Africa on the research topic to inform its hypothesis and objectives. The examiner will combine the fifteen studies’ results to weigh, compare, and identify patterns and associations that can accurately address the given guess. In particular, he will thoroughly abstract each of the studies, code them, and transform their findings into a standard metric that will determine the influence of drug ads on self-medication. Davis et al. (2014) argue that even when it might be challenging to perform this analysis due to differences in methodologies, they advise researchers to compile studies that use similar methods. They also recommend that a meta-analysis approach is advantageous because the examiner can establish whether an effect is common across studies and identity what future studies can do.
3.3 Methodology used by other Studies
From the above literature, different scholars have used various methodologies in their studies. For instance, the research by Afolabi (2008) has used semi-structured surveys to study the influence of self-medication among Nigeria’s adults. The one by Robit and colleagues has also used a similar approach in studying the prevalence of self-medication among students in India. It is also worth noting that other researchers have used descriptive and logistic regression methods to undertake their studies. In all these studies, the advertising element has been one of the contributors of self-medication among people. However, this study will use advertising as a significant factor in analyzing people’s health-seeking behaviors. In this sense, the researcher will use a meta-analysis approach to study the relationship between drug ads and self-medication among people.
3.4 Expected Results
The researcher expects drug ads to predict the possibility of self-medication positively after people have watched different promotions. In particular, he anticipates that this study will prove that medicine ads do influence people into using self-medication as an alternative option to professional medical services from physicians. It is expected that this study will also demonstrate the myriad of reasons why people engage in self-medication after seeing ads. For instance, it is anticipated that income will be a significant predictor that will positively influence individuals into choosing self-medication rather than professional medical services. In other words, it will show that when people have higher incomes at their disposal, they often tend to seek specialized services and vice-versa.
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