Introduction

Self-medication refers to the method of acquiring the drug in the absence of a particular healthcare provider and the source of the medication [1]. Antibiotic resistance may develop and spread faster due to this improper use of drugs [2]. It can be extended to the act of sharing and lending medications as types of self-medication, along with other intriguing ideas like self-care, disregarding a prescription, reusing stored medications, and not taking them as directed by health professionals [1]. People rely on their own experience and information from trustworthy sources such as chemists, pharmacists, and other health professsionals are not considered [3].

Self-medication can have detrimental effects on society and healthcare systems in the short- and long-term, costing nations a tremendous amount of money [4]. It is a source for a worldwide expanding phenomenon that poses a threat to public health due to currently existing problems like antibiotic resistance, the potential for harmful side effects, drug interactions, and disease masking [1]. Furthermore, it has a cumbersome contribution to increasing the up growth and expansion of antibiotic resistance [2]. Nearly half of the Ethiopian university students practiced self-medication, which is very high given the current global health problem of anti-microbial resistance increment [5–7]. Self-medication was also reported to be commonly practiced among the adult population [8] and pregnant women [9,10].

Self-medication practice varies widely because of different factors such as where people live, their cultural background, how easy it is to get health care, and accessibility of the pharmacy [11]. Self-medication is mostly used for affordability, speed of relief, and reduced time commitment [3]. In addition, factors, like its affordability [11], a previous history and the minor nature of the disease were significantly associated for self-medication practice [4]. Furthermore, it is highly related to self-care. Self-care is the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and cope with illness and disability with or without the support of a health worker [12]. Although self-medication can be considered a kind of self-care, there are some situations where this definition cannot be limited to the realm of health [1]. Currently, 3.6 billion people lack access to essential health services [13]. WHO recommends self-care interventions for every country and economic setting, as a critical path to reaching universal health coverage, promoting health, keeping the world safe, and serving the vulnerable [14].

Self-medication has piqued the curiosity of public health experts worldwide. Most of the drugs commonly used for self-medication in Africa are anti-malaria, antibacterial, and analgesics. Improper drug usage could contribute to the rise in drug resistance (antibacterial& antimalarial) [15]. People do not trust commercial sources such as health magazines and advertisements for self-medication. Self-medication is also not influenced by the patients’ education level. The main reasons why people practice self-medication are affordability, quick relief and saving time [3].

It is very crucial to control the supply of antibiotics by enforcing the current regulations strictly and/or adopting new ones, and by training and educating pharmacy staff (such as pharmacists and pharmacy assistants) on how to use antibiotics responsibly and the significance of antimicrobial stewardship [16].

Even though the positive aspects of self-medication related to primary healthcare should be recognized in low-income countries, the risk may outweigh the benefit if the current trend continues [17]. People in developing countries like Ethiopia not only use drugs they aren’t prescribed but also prescribed drugs without being supervised [18,19]. One of the major challenges in addressing self-medication is the failure of pharmacies to adhere to their professional commitments. Their practices significantly contribute to the expansion of self-medication [20].

Self-medication has positive effects on individuals and healthcare systems when practiced correctly. However, its promotion needs a policy direction supported by scientific evidence specific to the local socio-economic and cultural contexts. Currently, systematic reviews and the recommendations or clinical practice guidelines (CPGs) provide the cornerstone of evidence-based medicine [21,22]. In Ethiopia, there are different systematic reviews considering self-medication practice. However, it is very difficult to provide the national self-medication status of the country from the general population so that this umbrella review will provide possibility to address a broad scope of issues related self-medication [22]. Therefore, this umbrella review is proposed to examine self-medication practice in Ethiopia to produce the best available evidence in the context of Ethiopia and help evidence-informed policymaking.

At present, based on our preliminary screening of the literature in PubMed and Google Scholar, and a search of registered systematic review databases such as PROSPERO, there are currently no umbrella reviews or published protocols examining the self-medication practices in Ethiopia.

Methods

The planned review of umbrella review will be carried out using the JBI Umbrella review methodology [22,23]. The title for this review was registered on PROSPERO and obtained registration ID CRD42023182552.

Discussion

Antimicrobial resistance (AMR) is a global health threat closely linked to the inappropriate use of medications, including self-medication, which can diminish the effectiveness of antibiotics. The misuse and overuse of antimicrobials, particularly in humans, are among the primary drivers of drug-resistant pathogens. In recent years, the number of facilities providing medications has significantly increased in low-income countries like Ethiopia. Drug vendors, pharmacies, and wholesalers are now widespread in towns and cities, despite occasional shortages of essential medicines. However, reports frequently highlight that these facilities often sell medications without requiring prescriptions from authorized healthcare professionals, treating them like ordinary consumer goods. This practice exacerbates the global threat of antimicrobial resistance, as self-medication often leads to poor adherence to prescribed treatment regimens and incomplete courses of antibiotics, further exacerbating the development and spread of resistant pathogens.

As far as researchers’ knowledge is concerned this umbrella review is of its first kind in Ethiopia on self-medication practice. The review will focus to identify the overall pooled estimate of self-medication practices and contributing factors in Ethiopia. The result will give rich information to the evidence-based decisions making on self-medication practices in Ethiopia, which might be base to design policies and strategies to fight against anti-microbial and irrational use of medications like self-medication of different population segments within the country.

Any systematic review and/or Meta-analysis in Ethiopian context found both in published and unpublished form will be considered for better estimating the pooled magnitude of self-medication practices and its associated factors in Ethiopia. Thus, this umbrella review is needed to negotiate the result from systematic review and meta-analysis of self-medications found in Ethiopia. It is also crucial opportunity with study to state the status of self-medication practice and associated factors within Ethiopia. The study will also significantly important to embrace the factors that contribute to self-medication practice within Ethiopia, so that targeted intervention will be designed for each factor.

The result from this umbrella review will attract the attentions of government and partners for intervention of self-medication practices which is serving as driving engine to fight against anti-microbial resistance. Furthermore, it serves for policy makers by providing evidence on self-medication practices to design context specific intervention to halt self-medication practices. Parallel to this, it will supplement evidence for government to develop guidelines, policies and proclamations for use of self-medication practices which will play pivotal role in preventing anti-microbial resistance. The result form this review will essential for appropriate implementation of drug distribution and sells across all drug distrusting store, venders or whole sellers in Ethiopia, so that regulation of medication/drugs to augment effort to fight against global issue of AMR. It can be taken as a benchmark for future researchers undertaking their interventional and other high standard studies to reduce self-medication practices and anti-microbial resistances.

All efforts will be made to disseminate the evidence to scientific community through different means like present the work on different workshops, conference and publication on internationally reputable scientific journal. However, the two might be limitation of the review like related with language, and limitation of study area. This can cause bias on the outcome. Therefore, the finding of this review should use with caution to the other areas than within Ethiopia.

Conclusion

The finding will used as a basic information for understanding the burden of self-medication in low-income countries like Ethiopia. Furthermore, this review will aid for design prevention of self-medication practice in Ethiopia as well as other country as antimicrobial resistance is one of the global concerns currently. In addition, the result will explore importance of self-medication in prevention of Global concerns like anti-microbial resistance.

Supporting information

Acknowledgments

This review will contribute toward a Doctor of Evidence Based Health Care (EBHC).