Kanayo Umeh

Liverpool John Moores University
United Kingdom

Abstract Title: Self-medicating on antibiotics during pregnancy in Sub-Saharan Africa: perspectives of local obstetric gynaecologists

Biography:

Dr Umeh is a senior lecturer at the School of Psychology at Liverpool John Moores University, UK. He completed his PhD at the University of Leicester UK and manages a UK-registered charity that supports womens careers in health. He has published 48 papers in peer review journals, including at least five publications in 2025, and is the author of a textbook on adolescent health behaviours, published by Cambridge University Press.

Research Interest:

Antibiotic use during pregnancy has been implicated in congenital abnormalities. In 1987 the World Bank, in collaboration with WHO and UNFPA, launched the Safe Motherhood Initiative (SMI). Although the SMI has been a global priority in recent years, the implications of antibiotic misuse during pregnancy on meeting SDG-3 initiatives in sub-Saharan Africa have yet to be addressed. Nigeria has one of the highest rates of antibiotic misuse during pregnancy. Since obstetric gynaecologists in the region are influential stakeholders who can help develop policy guidance to reduce antibiotic self-medication in pregnant women, this study explored their perspectives regarding antibiotic misuse during pregnancy. Semi-structured interviews were conducted with 24 medical doctors working in three Nigerian tertiary hospitals. Thematic analysis was used to analyse the data. Checks for methodological rigour were performed. The doctors cited several distinct issues: prescribing antibiotics; easy availability of antibiotics; self-medication with antibiotics; use of medicinal herbs; detecting self-medication; lack of policy guidelines on antibiotic self-medication; and side effects. Antibiotics are easily available without prescription, and there is a lack of policy guidelines on how to manage antibiotic misuse in pregnant women. History taking and side effects alone cannot detect antimicrobial self-medication, and herbal medications are frequently used. Overall, the data suggests antibiotic misuse in pregnancy, especially the use of herbal medicines, is a significant clinical challenge. The project highlights a need for policy guidance on antibiotic stewardship, including point-of-care testing to detect antibiotic self-medication in pregnant women. Implications for antibiotic-related congenital abnormalities in sub-Saharan Africa are considered.