Rising healthcare costs and worsening economic pressures are pushing many Nigerians away from formal medical care towards self-medication, herbal remedies and other alternative treatment options.

Across homes, pharmacies and informal treatment spaces, many Nigerians now rely on symptom descriptions, recommendations from friends and relatives, online health advice, roadside mixtures and spiritual interventions before eventually seeking hospital care, especially for conditions they initially consider manageable.

Concerns over self-medication and informal treatment practices have continued to grow nationwide, with antibiotics, malaria drugs and painkillers among the most purchased medications without prescriptions, raising concerns about delayed diagnosis, drug misuse and treatment complications.

For many patients, accessing medical care has become a financial decision as hospital visits often involve consultation fees, laboratory tests, scans, medications and follow-up procedures that are increasingly difficult for low- and middle-income households already struggling with food inflation, transportation costs, rent and other expenses.

The growing dependence on self-treatment has coincided with sharp increases in medicine prices. A 2024 study on drug affordability in Nigeria linked rising pharmaceutical costs to inflation, foreign exchange instability and broader economic challenges affecting access to healthcare.

Beyond the cost of treatment, some patients are increasingly hesitant to seek hospital care because of fears that routine complaints may lead to prolonged treatment, repeated investigations and prescriptions without clear explanations or visible improvement.

For instance, an Enugu-based woman, Gladis Ezeugwu, told The Guardian that she stopped returning to the hospital after months of consultations, medications and laboratory investigations failed to provide clear answers to her persistent skin condition.

She said she now manages the condition mainly with ointments and medications previously prescribed during treatment. The frustration is further worsened when medications fail to produce expected results or when changing prescriptions and repeated hospital visits continue without reassurance about recovery.

In some communities, individuals increasingly focus on immediate relief from symptoms such as stomach pain, itching, swelling, diarrhoea, cough or body weakness without understanding the underlying cause.

Self-treatment practices, including the use of ginger mixtures, onion preparations and herbal remedies marketed for infections and fertility challenges, continue to influence healthcare decisions, with temporary relief often reinforcing dependence on informal treatment pathways.

The spread of health advice through social networks and online platforms has also expanded the influence of informal treatment choices. The post-COVID-19 period further accelerated reliance on home remedies and non-hospital approaches to managing illnesses.

In many cases, individuals experiencing infections, wounds or reproductive health concerns are advised by friends, relatives or non-medical contacts to try herbal mixtures, local preparations or over-the-counter medicines before seeking professional care.

For some patients, alternative treatment centres appear more reassuring because they offer quick answers, direct promises of healing and fewer financial uncertainties compared with hospitals.

Health workers, however, warn that many locally prepared herbal mixtures are used without dosage control or medical supervision, increasing the risk of misuse, delayed diagnosis and prolonged illness.

According to The Guardian’s findings, many patients only visit hospitals after symptoms worsen significantly, pain becomes severe or previous treatment attempts fail. Community pharmacies have increasingly become the first point of consultation, with many customers seeking medicines based on symptoms rather than professional diagnosis.

A pharmacist, Uchechi Ukachi, said only a small number of customers now arrive with hospital prescriptions, estimating that nearly 80 per cent of pharmacy visitors describe symptoms or request medications based on personal assumptions, past experiences or recommendations.

She said many customers come convinced about the medicines they need based on advice from friends, relatives, social media platforms or previous illnesses.

According to her, some patients try herbal remedies, online recommendations and self-prescribed drugs before seeking medical attention, often returning only when symptoms persist or worsen.

Several studies have also highlighted the growing prevalence of self-medication across different population groups in Nigeria, linking the trend to healthcare costs, long waiting times, previous treatment experiences and recommendations from social networks.

A 2024 study published in the Journal of the College of Basic and Clinical Research among non-health workers in two tertiary institutions in Lagos found that 62.8 per cent of respondents practised self-medication.

The study identified analgesics, antimalarials and antibiotics as some of the most used drugs, while more than 70 per cent reported using herbal remedies obtained from herb sellers.

A community health nurse, Christabel Nwokedi, described antibiotic misuse and self-diagnosis as increasingly common, especially among patients who believe they already understand recurring symptoms.

She warned that repeated purchase of antibiotics and malaria drugs without proper diagnosis could contribute to drug resistance and reduce treatment effectiveness.

For Lagos-based worker, Esther Anozie, treating fibroid-related complications became a prolonged search involving herbal treatment, pharmacies, injections and repeated hospital visits as costs continued to rise. She said some herbal treatments cost between N30,000 and N100,000 per round, while scans, consultations, injections and surgery expenses accumulated over time.

According to her, after months of moving between different treatment options, she spent hundreds of thousands of naira without fully resolving the condition. She added that after eventually undergoing breast surgery, complications later required further tests and treatment, leading to additional medical expenses.

Health workers warned that delayed diagnosis, prolonged self-medication and increasing dependence on informal treatment pathways could worsen health outcomes as high medical costs and weak insurance coverage continue to limit access to formal care.

A Community Health Practitioner and Founder of Goodness and Mercy Care Hub, Adebisi Kehinde, called for responsible use of medicines amid growing concerns over self-medication.

She said one of the major dangers of the practice is misdiagnosis, explaining that symptoms such as fever, headache, fatigue and abdominal pain may indicate different underlying conditions.

Kehinde warned that treating symptoms without proper diagnosis could worsen illnesses, delay appropriate treatment and contribute to antimicrobial resistance. She also highlighted the risk of harmful drug interactions and adverse reactions, particularly among children, pregnant women, older adults and people living with chronic conditions.

According to her, factors driving self-medication include high healthcare costs, limited access to health facilities, long waiting times and inadequate public awareness.

To address the challenge, Kehinde called for stronger health education, stricter enforcement of regulations on prescription medicines and improved access to affordable healthcare services. She also recommended community outreach programmes, media campaigns and school-based health education initiatives to promote responsible health-seeking behaviour among Nigerians.