Parent-initiated self-medication practices for children and associated factors in Adet town, Northwest Ethiopia: a mixed methods study

Self-medication—the use of medications without a professional prescription to treat recognized illnesses or symptoms—is a critical global public health concern. While prevalent in both industrialized and developing nations, it leads to resource wastage, accelerated antimicrobial resistance, and severe clinical complications in pediatric populations. In Ethiopia, there remains a critical gap in research comprehensively examining the driving mechanisms and parental experiences behind non-prescription treatment for children. This study aimed to investigate the prevalence, associated factors, and parental experiences regarding self-medication practices for children under five in Adet Town, Northwest Ethiopia. A community-based cross-sectional study using a concurrent mixed-methods design was conducted from March 15 to April 30, 2023. For the quantitative component, structured, interviewer-administered questionnaires were completed by 423 systematically sampled parents. Concurrently, qualitative data were gathered via in-depth interviews with eight purposively selected parents who practiced self-medication. Quantitative analysis was performed using Epi Data version 4.6 and SPSS version 26, utilizing multivariable logistic regression to identify independent predictors. Qualitative data were transcribed verbatim and analyzed thematically using ATLAS.ti 8 software. The prevalence of parent-led self-medication practices for children was 47.61% (95% CI: 42.10%–52.40%). Multivariable logistic regression revealed that parent-led self-medication was significantly associated with female parents [AOR = 3.14], having more than one child [AOR = 2.22], maternal lack of formal education [AOR = 2.20], and living less than 30 min away from health institutions [AOR = 2.98]. The qualitative thematic analysis enriched these findings, revealing deep parental misconceptions regarding drug safety, where antibiotics and antipyretic were viewed as harmless, low-risk options. This lack of risk awareness directly explains why closer proximity to health facilities paradoxically increased self-medication odds, as parents heavily utilized nearby informal medicine retail channels for rapid, unprescribed access fueled by financial constraints and peer advice. Nearly half of the parents self-medicate their young children, heavily driven by maternal educational gaps, household size, and structural proximity to medicine retail channels. The qualitative insights underscore that proximity, when combined with low drug-safety literacy and economic barriers, accelerates this unsafe practice. Consequently, the Ethiopian Food and Drug Authority and regional health bureaus must enforce strict regulatory penalties on the unauthorized over-the-counter sale of prescription-only antibiotics at local pharmacies, while implementing community-level behavioral change campaigns led by health extension workers to correct drug safety misconceptions.