Self-medication with oral contraceptives in the Urban District of Antananarivo

Julio El-C Rakotonirina, Manitatsoa Razafimahefa, Barbara E.E. Vololonarivelo, Valéry B. Andriantoky, Mamy J-J Razafimahatratra, Jean de Dieu M. Rakotomanga, Henriette Rahantalalao Ratsimbazafimahef, Nantenaina S. Randrianjafisamindrakotrok

Abstract


Background: Oral contraception is the second hormonal contraceptive method most used in the world. Currently, self-medication with oral contraceptives experienced resurgence, most often with no medical supervision. This study aims to estimate the prevalence of self-medication with oral contraceptives, identify the socio-economic status and identify the reasons why women aged 21 to 49 of the Urban District of Antananarivo (UDA) practice self-medication with oral contraceptives.

Methods: A cross-sectional survey was conducted, where an interviewer-administered questionnaire has been used to collect data. Targeted female respondents aged 21-49 were asked about their contraceptive use during the twelve months preceding the survey.

Results: Self-medication prevalence rate is 59.1%, considering oral contraception users. Moreover, it is higher among married women, those aged <36, less educated and having more than two children. Financial problem, affordability of the pills, former use of pills and information by their surroundings are the reasons why women self-medicate. Women who received a medical prescription at the first take of the pills are more likely to presently practice self-medication.

Conclusions: This study demonstrates the evidence of a high prevalence of self-medication in the UDA. Self-medication can be harmful: the fight against its risks should get reinforced.


Keywords


Self-medication, Oral contraceptive, Urban District, Antananarivo

Full Text:

PDF

References


United Nations. Contraceptive prevalence by methods, most recent estimate, World contraceptive use 2009. New York, 2009. Available at http://www.un.org/esa/population/publications/contraceptive2009/contracept2009_wallchart_front.pdf. Accessed 15 February 2012.

Rahelinjanahary V. Importance de l’automédication en milieu urbain et milieu rural à Antananarivo et ses environs. Antananarivo: Thèse Pharmacie, 2011; N° 0012:1-51.

Ministère de la santé et du planning familial. Normes et Procédures en Santé de la Reproduction.

Potter JE, McKinnon S, Hopkins K, Amastae J, Shedlin MG, Powers DA, Grossman D. Continuation of prescribed compared with over-the-counter oral contraceptives. Obstet Gynecol 2011;117:551-7.

Shah MA, Shah NM, Al-Rahmani E, Bebehani J, Radovanovic Z. Over-the-counter use of oral contraceptives in Kuwait. Int J Gynaecol Obstet 2001;73:243-51.

Dembélé RD. Etude descriptive de la vente illicite des médicaments dans les marchés des communes de Kimparana, de Karaba et Kassorola. Bamako. Thèse Pharmacie, 2005; N° 05P42:1-54.

Grossman D, White K, Hopkins K, Amastae J, Shedlin M, Potter JE. Contraindications to combined oral contraceptives among over-the-counter compared with prescription users. Obstet Gynecol 2011;117:558-65.

INSTAT, ICF Macro. Enquête démographique et de santé de Madagascar 2008-2009. Antananarivo, Madagascar: INSTAT et ICF Macro, 4th ed. Antananarivo: INSTAT et ICF Macro; 2010:27.

INSTAT, ICF Macro. Planification familiale. In: Enquête démographique et de santé de Madagascar 2008-2009. 4th ed. Antananarivo: INSTAT et ICF Macro; 2010:63-78.

PSI. Madagascar (2010-2011): MAP Study Evaluating the Availability of Pilplan and Confiance in Madagascar. Baseline. Available at http://www.psi.org/resources/research-metrics/publications/reproductive-health/madagascar-2010-2011-map-study-evaluatin. Accessed 25 April 2012.

Castro-Leal F, Dayton J, Demery L, Mehra K. Public Social Spending in Africa: Do the Poor Benefit? The World Bank Research Observer1999;14:49-72.

Mathieu Lamiaux, François Rouzaud, Wendy Woods. Private Health Sector Assessment in Mali. The Post-Bamako Initiative Reality. In: World Bank Working Paper N°212. Washington, DC: The World Bank. 2011:127.

Grossman D, Fernández L, Hopkins K, Amastae J, Potter JE. Perceptions of the safety of oral contraceptives among a predominantly Latina population in Texas. Contraception 2010;81:254-60.