Self-medication has become a growing norm in Nigeria, as many people continue to seek quick fixes outside the hospital system. In this report, YETUNDE AJANAKU explored the implications of seeking medical assistance outside the regulated health system.
FOR millions of Nigerians facing devastating socio-economic challenges, visiting the clinic when in a mild or serious medical emergency has become a luxury, as they have now turned to pharmacy counters, roadside stalls, or herbal concoctions as their first point of call.
But for many of them, who rely heavily on out-of-pocket health spending, they can’t afford consultation fees, lab tests, hospital charges, or transportation.
When such treatment remains expensive, self-diagnosis and self-treatment become the fallback. People often reuse old prescriptions or rely on what previously worked for them. As such, leftover pills find their way back into households.
However, what usually begins as a shortcut often leads to a dangerous end with many facing misdiagnosis, complications, drug resistance or worse.
Experts have, however, cautioned that self-medication is no harmless shortcut as it carries risks such as misdiagnosis, excessive dosing and dangerous drug interactions. Yet, in a system under strain with rising costs, inadequate infrastructure, and weak regulation, many ordinary Nigerians feel they have no other option.
A woman named Bimbo told Sunday Tribune she whatever the treatment she would opt for depends on the kind of illness she is faced with.
“I use everything, it depends on what I want to treat,” she said. “If it’s a headache, I may reach for paracetamol. If it’s fever, that may lead me to anti-malarial sachets. For chronic pains, I probably just take herbs. It depends on my pocket most times.”
An elderly woman, who sells vegetables along Molete road in Ibadan, disclosed that she has never used any form of medication in her life because her body has adapted to the use of herbs, adding that it was what her forefathers brought her up with
“I never use medication before because it won’t work and I never visited hospital,” she said.
While casually dismissing and describing medication as chalk, the 85-year-old woman noted that the herbal concoctions work better, adding that she is hale and hearty at her age.
But such view was not entertained by Deji, a young man, who was resolute in putting his trust in medications carefully conceived and produced by experts.
“I can’t use herbs or do self-medication. I prefer to go to hospital regardless,” he said while describing medicine as a profession that is beyond his understanding.
Why self-medication in Nigeria is more than an individual health choice, it remains a mirror that reflects the gaps in the country’s healthcare system and the struggles of daily survival.
To those who engage in self-medication, patronise roadside pharmacies and seek traditional remedies, their reasons, including limited access to affordable hospitals, long waiting times, inadequate facilities, and economic hardship are clear.
‘We are not quacks’
One of those who operate a roadside and equally mobile pharmaceutical store in Ibadan, Mrs Bisola Oyetunde, was arranging small boxes of medications on a table lined with sachets, small bottles and pills when Sunday Tribune met her at Akilapa area in Ogunpa, Ibadan.
She disclosed that practitioners like her do not worry about selling wrong medication without tests, saying: “Whenever most of them complain, we already know what to give.”
Such prognosis is not based on laboratory findings but on what she described as years of practice, hearsay, and customer feedback.
“I don’t have to run laboratory test to treat headache or body pain,” she added.
She also challenged the perception of illegitimacy because they don’t operate in physical stalls.
“The reason why most people prefer to buy from us is because ours is cheaper, and it doesn’t mean they are fake,” Mrs Oyetunde said. “Because of the high cost of rent, we stay on the roadside. It is not that most of us are quacks.”
While saying that many in her business learned from others, observed symptoms, and built semi-intuition, she admitted that some have made some mistakes in deciding the prognosis for some of their customers with some of them coming back with other complaints.
“There is risk in selling on the roadside, but many people have no other affordable alternatives,” she added.
‘We treat root causes, not just symptoms’
A trader, who deals in herbal products at Oja Bode, Mrs Idowu Akande, popularly known as Iya Musibau, described herself not just as a herb seller but also a healer.
“Most people prefer to use herbs to cure the root of their sickness than just buying medication because they believe it will only relieve them without curing it completely,” she said while arranging dried leaves, roots, powders, and glass bottles of tincture.
She linked the practice to tradition, saying, “That is what our forefathers have been using. People have used herbs to cure different ailments and to give birth among others.”
Akande, however, warned that not all herbs are cheap, adding that good herbs cost money, care, and knowledge.
“Many herb sellers are professionals with deep knowledge of plant medicine,” she added.
She also warned against mixing herbs with medicine, as doing such will complicate the issues, but quickly added that though she relies solely on herbal products, people’s body systems react differently and they should stick to what works for them.
Despite admitting that there is usually risk in dosage and misuse, she believes the advantages lie in holistic healing, fewer synthetic side effects, and cultural trust.
She also stated that herbal products are not in competition with medications, adding that they are simply an alternative worldview.
Medical experts weigh in
While patronising roadside pharmacies and herbal sellers may appear as a quick solution amid hard economic realities, the risks, as medical experts have said, are grave. Such risks include drug resistance, misdiagnosis, overdose, and worsening of untreated conditions.
A Consultant Gynaecologist at the University College Hospital, Ibadan, Dr Timothy Olusesan, while recounting the patterns he experiences in the clinic, said: “The situation of the country makes people run away from the clinic. At the end, their situation always becomes worse than how it started. Patients prevent themselves in the hospitals late, after trying home remedies or local drugs.”
He further explained that what might have been a treatable condition becomes complicated as he has seen simple fever turn into severe infections, with wounds festering.
“You skip lab tests, skip diagnosis, take something you saw before or someone recommended, then you come with two or three ailments,” he said. “Once you mix drugs without supervision, you may damage kidneys, liver, or exacerbate side effects.”
He warns that self-medication also undermines trust, adding that when people feel clinics are inaccessible or unaffordable, they invest themselves in partial cures and become reluctant to consult professionals until it’s too late.
Another pharmacist, Martins Ozour, who decried the practice of self-medication, lamented that without regulation, the pharmacy trade has becomes a free market where price and convenience outweigh prescription protocols. This is because whenever they refuse to make a sale, they risk losing such customer to a competitor.
“When people say they want to buy drugs, the best thing is to sell it because everyone has access to different pharmacies,” Ozour said.
“If government can regulate the way people have free access to chemists and pharmacies, the idea of self-medication will reduce,” he said.
He listed the issues contributing to the practice to include lax enforcement, availability of prescription-only drugs over the counter, patchy oversight and drug vendors without proper credentials.
Ozour lamented such practices work for a lucky few, they often lead to moral hazards for many others because people demand powerful antibiotics or injections when they only need analgesics.
He also expressed deep worry about the consequences of drug resistance, side effects and masked diseases.
To these experts, the cycle of unsafe medication practices not only endangers lives but also burdens the already fragile healthcare sector with preventable complications.
To break this cycle and overdependence on self-medication, experts believe that the government and health stakeholders must prioritise policies that make healthcare affordable, accessible and trustworthy. They added that education and awareness campaigns are equally vital to change attitudes toward drug use.
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