Discussion of health literacy should be considered by policymakers

Discussion

According to the literature, access to
antibiotics without prescription, which is usually high in unregulated markets increases
self-medication. For instance, In a research done  in Greece, most of the purchased antibiotics were
not prescribed 18.

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Similarly, in Iran, this study indicated that
56.5% of the respondents could easily access
antibiotics in pharmacies without
physician’s prescription. Although easy access to antibiotics without
prescription logically may lead to self-medication, it was not found any significant
relationship between easy access to antibiotics without prescription and self-medication.

Educated mothers visited a
physician more frequently; however, in line with other studies, those who did not
refer to physicians,  used non-prescribed antibiotics more often than mothers with lower education. This higher rate
of self-medication by higher-educated mothers, which is shown in this study, may be because of better access to medical knowledge by the media 19.

As the literature
indicates, higher-educated parents tend to refer more to media sources for
information 20. Therefore, high-educated
mothers, as well as low-educated ones,
need public health education to provide more information with respect to the
adverse effects of self-medication21. In
other words, although mothers’
education leads to more attention to children’s health and more physician visits
for seasonal cold, it does not sufficiently prevent self-medication. Thus,
improvement of health literacy should be considered by policymakers to decrease self-medication with antibiotics. This means, training
mothers on public health for increasing their
health literacy and their awareness regarding subjects such as antibiotic
resistance and viral infection can be considerably useful to decrease antibiotic
self-medication and to avoid its consequences.

In this study,
it was recognized that   self-medication rate in Iran was 5.9% (22 of 372 responders)  which was an acceptable rate in comparison to the high rate of 50.4 % reported in a Chinese study2. However, sum of refilling the last prescription, 47% (175 of all
372 responders), and self-medication, 5.9% (22 of 372 responders) was 52.9%,
which shows the high level of antibiotics irrational use for children.

Similar to Peng
Bi and Shilu Tong’s study,
we found that  no significant
relationship between self- medication and fathers’ education 2.

Moreover, our study showed a significant
relationship between lack of health insurance
and treatment expenditure. It is shown in
the literature that a patient with health
insurance might be more encouraged to visit a doctor; therefore, they might be
able to store some medicine at home, which may lead to higher self-medication
for their children 2.
Nevertheless, most probably, due to the low price of medicines in Iran, we did not find such a correlation in our study
and insurance coverage is not significantly correlated to self-medication.