Factors affecting maternal initiated medication practices among Sinhala speaking mothers for preschool children in Godakanda (East) and Uluvitike areas, Galle, Sri Lanka

Abstract

Introduction: Maternal initiated medication practices for children frequently involve over-the counter, traditional and herbal medicines that may be inappropriate and not evidence-based. Objectives: To identify factors affecting self-medication practices among Sinhala speaking mothers of preschool children in Godakanda (East) and Uluvitike areas, Galle, Sri Lanka. Methodology: The study consisted of a survey questionnaire, a qualitative study, and a contrived observational study. Two public health midwifery (PHM) areas were selected to conduct the study. Stratified random sampling was used to select 400 mothers from two PHM areas for both questionnaire survey and contrived observational study. Purposive sampling was used to select mothers for the qualitative study. Results: The prevalence of maternal initiated medication of the children aged between 1 to 5 years of age in the study area was 77.4%. The age of the index child is significantly higher in the group of mothers who have not done maternal initiated medication than the group of mothers who have medicated the index child by themselves (p=0.01). The frequency of maternal initiated medication was significantly higher for younger children than older children (p=0.01). Types of medicine used for maternal initiated medication were independent of socio demographic factors. Most of the mothers obtained medicines from a pharmacy without prescriptions (68.6%). Mothers with a higher level of education (p=0.008) and higher income (p<0.001) were significantly more likely to follow professional information sources than autonomous sources when they practice maternal initiated medication. The qualitative study reported that factors affecting mothers‟ perceptions and attitudes towards mother initiated medication included: previous experiences, perceived idea of formal health care services, perceived impact of illness on the child and family, external influences, understanding of benefits and risks of maternal initiated medication, perceived impact of illness on the child and family. Perceptions assessed include adverse events of pharmaceuticals, toxicity of pharmaceuticals to child‟s body which contributed to noncompliance with the drug therapy and influenced the mother to use traditional or herbal medicines widely for their children. The contrived observational study suggested, only 26.9% of mothers could correctly decide and measure doses of paracetamol within the acceptable range. The rest of the mothers made at least one error in either dose determining or measurement. Only 35.4% of mothers made actual measured doses in acceptable dose range and 55.8% of mothers made small errors. Of all 353 mothers, significantly higher percentage of mothers measured acceptable doses by using 10 ml syringe (88.4%) with compared to measuring cup (60 .6%) (p<0.0001, CI=21.5 - 33.7) and calibrated spoon (26.1%) (p<0.0001, CI=56.1 - 67.5). Conclusions: The prevalence of mother initiated medication for children aged 1 to 5 years of age was higher among the study area. Mothers require healthcare professionals‟ guidance when recognizing illnesses, selecting treatment options and correctly determine and measuring doses of over the counter medicines for young children.