Factors associated with health seeking behaviours and practice of antibiotics self-medication among adults in Abakaliki Metropolis, Ebonyi State, Nigeria

One of the inappropriate health seeking behaviours (HSBs) people express when they feel ill is self-medication (SM) with antibiotics. The consequence of SM with antibiotics is the increase in antimicrobial resistance (AMR). Therefore, this study aimed to assess HSBs and the practice of SM with antibiotics among adults in Abakaliki, Nigeria. The study was undertaken using community-based cross-sectional study design. Multi-stage sampling technique was used to select 448 study respondents. Data were collected with interviewer-administered questionnaire in May 2021 and analysed using SPSS version 26. Frequency tables were used to present the descriptive statistics. Bivariate and multivariate analyses of HSB and practice of SM with antibiotics against socio-demographic characteristics were done and statistically significant findings were considered with the alpha level of significance set at 5%. Only 161 (35.9%) of the respondents had appropriate HSB (consulting a doctor) as their first action when experiencing a health problem. Factors reported by majority of respondents to influence HSBs were perceived severity of illness 321 (71.7%), knowledge/past experience of illness 306 (68.3%), and cost of treatment 304 (67.9%). The predictors of HSB were being single (AOR = 0.349, 95%CI = 0.172-0.709), privately/self-employed (AOR = 0.337, 95%CI = 0.158-0.720), unemployed (AOR = 0.219, 95%CI = 0.074-0.645), living with family members (AOR = 0.549, 95%CI = 0.307-0.981), and earning ≥ 100,000 naira (AOR = 3.619, 95%CI = 1.271-10.303). Many respondents 431 (96.2%) had ever practiced antibiotics SM. Over half 252 (58.5%) had practiced antibiotics SM in the previous three months before the study. Factors reported to influence antibiotics SM were successful treatment from previous use of prescribed antibiotics 366 (84.9%), easy access to antibiotics from drug stores 357 (82.8%), knowledge/past experience of illness 326 (75.6%), and affordable cost of care in drug stores 325 (75.4%). The predictors of antibiotics SM were being single (AOR = 0.578, 95%CI = 0.351-0.953) and earning 30,000-49,999 naira (AOR = 0.463, 95%CI = 0.268-0.802). Most of the respondents had inappropriate HSBs and almost all had practiced antibiotics SM previously. There is need for mass sensitisations and enforcement of antibiotic dispensing laws in Nigeria. Also, scaling up health insurance in communities may address some identified factors influencing HSBs and SM, such as insufficient funds to visit a health facility.