Behavioral Risk Pathways and Socioeconomic Determinants of Self-Medication: Evidence from Urban Households in Bangladesh

Self-medication remains a significant public health concern worldwide, particularly in low- and middle-income countries such as Bangladesh, where regulatory enforcement is often weak. This study examines the prevalence, behavioral risk pathways, and socio-economic determinants of self-medication in an urban municipal context. A cross-sectional household survey was conducted in Monsurabad, Pabna Municipality, from July to September 2025, involving 125 randomly selected respondents. Data were analyzed using descriptive statistics, chi-square tests, exploratory factor analysis (EFA), and binary logistic regression. All respondents reported engaging in self-medication in the past year, with 57.6% belonging to the 18–30 age group. Frequent self-medication (≥5 times annually) was observed among 44.8% of respondents. Lower educational attainment and unemployment were significantly associated with higher self-medication frequency (P < 0.05), while gender differences were not statistically significant (P > 0.05). Medications for cough, cold, and fever were the most commonly used. EFA identified three behavioral domains—household medicine sharing/substitution, healthcare friction, and reliance on traditional remedies—that accounted for 46.5% of the total variance. Logistic regression analysis revealed that larger household size (AOR = 8.22), use of old prescriptions (AOR = 6.96), reliance on non-professional advice (AOR = 3.32), and traditional remedy use (AOR = 3.31) significantly increased the likelihood of frequent self-medication, whereas higher household income reduced the odds (AOR = 0.23). The findings suggest that self-medication in this urban setting is shaped by an interplay between socio-economic vulnerability and behavioral risk pathways, with important implications for pharmaceutical regulation, health education, and the strengthening of primary healthcare in Bangladesh.