Prevalence and Determinants of Self‑Medication Among Adult Outpatients in a Rural Health Facility in Northern Uganda: A Cross‑Sectional Study

Peter Philip Watuwa,1 Ronald Opito,1 Samuel Okello,2 Rachael Mercy Asapo,1 Innocent Baguma,1 Jorem Okello,1 Oscar Onap,1 Emmanuel Tiyo Ayikobua,3 Tonny Odung,4 Patrick Lubogo5 1Department of Public Health, Soroti University, Soroti, Uganda; 2Department of Nursing, Soroti University, Soroti, Uganda; 3Department of Physiology, Soroti University, Soroti, Uganda; 4Department of Health, Alebtong District Local Government, Alebtong, Uganda; 5Department of Pharmacology, Soroti University, Soroti, UgandaCorrespondence: Patrick Lubogo, Email [email protected]: Self-medication, defined as the use of medicines without prescription or supervision from a qualified healthcare provider, is common in low-resource settings. Rural communities may be disproportionately affected due to limited healthcare access, yet empirical data from Uganda remain scarce. This study aimed to fill this gap by assessing the prevalence, patterns, and factors associated with self-medication among outpatients in a rural health facility in Northern Uganda.Methods: A cross-sectional study was conducted among 248 adult outpatients at Alebtong Health Center IV using systematic random sampling. Data were collected via a structured interviewer-administered questionnaire capturing sociodemographic characteristics, patient-related factors, and health facility-related factors. Modified Poisson regression with robust standard errors was used to determine factors associated with self-medication, with significance set at p < 0.05.Results: Of 248 participants, 182 (73.4%) reported self-medication. The most frequently used drug classes were analgesics (36.3%), antibiotics (22.0%), and antimalarials (15.4%). Factors significantly associated with self-medication included tertiary education (aPR: 1.48; 95% CI: 1.04– 2.09), being self-employed (aPR: 1.62; 95% CI: 1.21– 2.18) or a student (aPR: 1.46; 95% CI: 1.07– 2.00), inability to obtain an appointment with a health worker (aPR: 1.36; 95% CI: 1.20– 1.55), and the lack of privacy during consultations (aPR: 1.21; 95% CI: 1.08– 1.36).Conclusion: Self-medication was highly prevalent among outpatients, particularly among individuals with tertiary education, the self-employed, and students. Limited access to health workers and the lack of privacy during consultations were also associated with this practice. Findings highlight the need for improved healthcare access, enhanced patient privacy, and greater involvement of frontline health workers in community education to promote responsible medicine use. As a cross-sectional study, causal relationships cannot be inferred.Keywords: self-medication, prevalence, rural health facility, Uganda, outpatients, associated factors