Self-medication is very common especially in developing countries and is documented to be associated with many health risks including antibiotic resistance. Antibiotic resistance is shrinking the range of effective antibiotics and is currently listed as a global health problem. This study investigated the perceptions of self-medication with antimicrobials (SMWA) after community mobilization intervention among the households in Nyalenda B, an informal settlement, within Kisumu County, Kenya. This enabled the study to establish the magnitude of SMWA and the perceptions that persist given such intervention within the region. Data was collected through structured questionnaires administered to 380 households. Focus group discussions (FGDs) were also facilitated and targeted purposively-selected 30 CHVs.  Descriptive and binary logistic regression analyses were used to determine the association between socio-demographic characteristics and the perceptions influencing SMWA. The study established that 316 households had used antimicrobials of which 20.9% were self-medicating with antimicrobials. Age (OR=0.647, 95% CI=0.431, 0.973, P=0.037) is significantly related to SMWA, use of NHIF for outpatient services (OR=1.772, 95% CI=0.652, 2.887, P=0.133) and use of Universal Healthcare Services (OR=1.165, 95% CI=0.922, 1.472, P=0.201) may have contributed to SMWA reduction but not significantly as compared to other socio-demographic factors. Likewise, sources of information or advice on self-medication (OR=0.732, 95% CI=0.613, 0.873, P=0.001) and illness or symptoms of illness (OR=1.324, 95% CI=1.129, 1.554, P=0.001) may significantly influence SMWA as compared to other SMWA perceptions. Community mobilization using empowerment as a strategy and implemented through participatory learning and action is a successful method for reduction of SMWA level and development of SMWA perceptions with an experiential value especially when strengthened with structural modification. SMWA is a serious problem in developing countries and so such intervention should be prolonged and continuous to offer sustained changes in public perception and attitudes towards the misuse of antimicrobials.

Self-medication with antimicrobials (SMWA) is a common global practice. Studies in Nyalenda B Ward, an informal settlement in western Kenya, found that significant households (76.6%) perceived the practice of SMWA as convenient and appropriate. The rationale of the current study was in response to unsolved self-mediation practice through functional health literacy in such setups. This study used Participatory Learning and Action (PLA) as a tool and assessed its role on strengthening the different domains of empowerment on SMWA. The study adopted a descriptive Owuor et al.; JAMPS, 21(3): 1-12, 2019; Article no.JAMPS.50537 2 survey design and data was collected from 1531 PLA trainees through focused group discussions and structured questionnaires. Results revealed that reasons for SMWA are ignorance and easier accessibility. Logistic regression analyses with a statistical significance tested at p≤0.05 established the association between PLA domains and all empowerment domains revealed that flexible learning and listening increase power within by 5 times (OR=5.361, 95% CI=3.101-9.268, P<0.0001), power with by 6 times (OR=6.160, 95% CI=3.437-11.39, P<0.00010) and power over by 2 times (OR=2.261, 95% CI=1.293-3.954, P<0.0001). Participatory evaluation may increase power within by almost 8 times (OR=7.711, 95% CI=5.184-11.459, P<0.0001), power with by 5 times (OR=5.012, 95% CI=3.375-7.443, P<0.0001), and power over by more than 3 times (OR=3.618, 95% CI=2,375-5,509, P<0.0001). Participatory interaction may increase power within by almost 8 times (OR=7.823, 95% CI=4.798-12.763, P<0.0001), power with by over 8 times (OR=8.610, 95% CI=4.987-14.866, P<0.0001.), power over by 4 times (OR=4.003, 95%CI=2.325-6.693, P<0.0001). PLA proved to be a useful tool for strengthening all domains of empowerment and integrated functions that prompted broader social connections. Original Research Article