Abstract
Utilization of healthcare is influenced by numerous factors. Although many of the factors are similar across geographical boundaries, their interactions and effects on people’s behavior are frequently unique to a population in the context of the environment in which they reside. This study’s main objective was to evaluate the variables influencing the use of healthcare services at the Lagos State University Teaching Hospital in Lagos, Nigeria.
This study’s goal was to evaluate the variables influencing the use of healthcare services at the Lagos State University Teaching Hospital in Lagos, Nigeria. In particular, it attempted to identify the various types of healthcare services families utilized when unwell and gauge the percentage of households that utilized formal healthcare when ill.
Data collection was done using a mixed technique approach. For the quantitative analysis, a descriptive cross-sectional study with a straightforward random sample technique was used. Adults who resided at the Lagos State University Teaching Hospital made up the study population. 169 people made up the sample size. To get quantitative data, a standardized questionnaire was used. Microsoft Excel was used to prepare the data before being exported to STATA version 15 for analysis. The qualitative investigation made use of a semi-structured interviewing guide.
According to the study, women do not have the autonomy to seek medical attention on their own when they are ill because they must obtain permission from the heads of their households, and some respondents continued to hold the view that not all illnesses can be treated by conventional medicine.
The results of this study show that the Lagos State University Teaching Hospital makes adequate use of its medical resources. Utilization rate of 77.8% was greater than that seen in the literature (50%). We found some similarities and differences in the contributing elements. The NHIS requires investment to be improved.
CHAPTER ONE
INTRODUCTION
- Background to the study
The health and survival of a society’s citizens, especially its women and children, are crucial to that society’s well-being. Therefore, it is widely understood that cultures advance when women and children can survive (WHO, 2016). Being a vital human right (health) most governments worldwide agree to provide health systems that provide fair access to care for all residents. Universal access to primary healthcare is an intermediate goal in and of itself. As the study’s focus country, Nigeria is no exception. In accordance with Nigeria’s National Health Policy, “every citizen has the fundamental right to sufficient health care” (2017).
The use of a healthcare facility or system may be influenced by sociodemographic variables, social structures, education, cultural and religious beliefs and practices, gender, the empowerment of women, political and economic systems, environmental conditions, disease morphology and pattern, and the healthcare system itself. This makes it possible to learn about how people engage with the healthcare system, how they use it, and how they exercise their freedom of choice to decide whether or not to consult various types of healers in the interests of their families (M. Saeed Siddiqui, M. Khalid Siddiqui, 2011).
Despite this, health systems in Nigeria and many other countries throughout the world are ineffective at ensuring access to healthcare, which leads to disparities in health and healthcare usage among various social groups (Karim, Buse, Vaughan, Karim, & Buse, 2000; Syed Masud Ahmed, Alayne M. Adams & Bhuiya, 2000). This study used a community in the Upper West Region of Nigeria as an example to try to identify characteristics that affect and/or influence health service access and utilization among the rural poor.
According to earlier studies, increasing the supply through initiatives like expanded service delivery does not always result in higher service utilization (Hjortsberg, 2003; Syed Masud Ahmed, Alayne M. Adams & Bhuiya, 2000). Instead, it is suggested that policies intended to improve access and use should combine supply- and demand-side thinking. According to empirical study, a number of factors can affect a person’s decision to seek medical attention when they are ill. These variables include socioeconomic status, cultural and religious preferences, geographic accessibility, disease patterns, wait times, access to care, and appropriate treatment, as well as shortages in the health care system that affect the availability, accessibility, or quality of care, sexually transmitted infections like HIV and AIDs, as well as other opportunistic infections (UNDP, 2012).
However, the Nigeria Health Service, which is responsible for expanding access to high-quality healthcare, has made great efforts to reverse this disastrous trend in Nigeria. By examining past outcomes and data available in the health sector, it is possible to conclude that the progress made can be linked to increased access to and use of healthcare services as well as to practical social reforms such the Health Insurance Scheme, which was adopted in 2004.
Despite this, the poorer areas account for a higher proportion of mortality caused by insufficient use of healthcare services. Although significant research has been done in the past, the Upper West Region continues to fall behind since there are still daily deaths of women and children from preventable causes because of issues with access to medical treatment. According to reports, Lagos State’s crude death rate is 5.0 per 1000 people. 7.4% of deaths in the Municipality are due to accidents, violence, homicide, and suicide, while 92.6% of deaths are due to other causes (GSS, 2014).
One of these villages with high rates of diseases and fatalities reported each year is LUTH, a community in Lagos State. Therefore, the purpose of this study was to identify the variables influencing the use of healthcare services in Lagos State, using LUTH as a case study.
Problem Statement
The foundation of universal health coverage is financial security and universal access to high-quality care. In many nations, including Nigeria, the emphasis has been on ensuring financial security while utilizing healthcare services. To use health services, however, removing financial obstacles does not often remove other access barriers (Lépine, Lagarde, & Le Nestour, 2018). In truth, a population’s ability to receive healthcare depends on a variety of societal and medical conditions. Therefore, investing in equitable and accessible health care service consumption is a crucial building component of any health development strategy.
Some villages in Lagos State, Nigeria, lack a healthcare facility to offer adequate and high-quality healthcare services, hence the locals turn to other types of healthcare when they become ill. To meet their medical needs, they include over-the-counter pharmaceuticals, self-medications, traditional or herbal remedies that have not undergone scientific testing. Additionally, community members must travel roughly 8 kilometers to the Wa Municipal Hospital or a neighbouring village called Bamahu in order to get proper health care services. Fetal distress, maternal and/or newborn deaths, impairments, and general mortalities are likely to be reported in emergency situations like labor or accidents (Garenne, 2015).
This neighborhood is primarily made up of impoverished peasant farmers. According to studies, poor individuals are less likely than wealthier people to use health services (D. Boateng & Awunyor-Vitor, 2013; Jehu-Appiah et al., 2011; Oxfam, 2013). Poor communities typically find themselves in a never-ending cycle of poverty and health-related problems as their disease burden rises as a result of growing distance from the closest services, which are often underutilized (Billi, Pai, & Spahlinger, 2007). Although evidence regarding utilization rates and the factors influencing them in the general population exists, little is known about them in peri-urban areas of Lagos. Additionally, research has shown that disadvantaged people rarely use services (Good & Kimani, 1980; Wang, Yip, Zhang, Wang, & Hsiao, 2005)
This study thus determined factors affecting utilization levels among peri-urban dwellers in Nigeria using LUTH as a case study.
Objectives of the study
General objective
The main aim of the study was to assess the factors affecting utilization of health care services in Lagos State University Teaching Hospital, Lagos state Nigeria.
Specific objectives
The specific objectives of the study were to:
- To assess the different forms of health care services that households use when ill
- To assess the proportion of households that use formal health care services when ill
- To determine how socio-demographic/economic factors influence utilization
- To explore how socio-cultural practices/factors influence healthcare
- To assess how geographical/health facility factors influence healthcare
1.4 Research Questions
The main research question of the study is:
Whatarethefactors affectingutilizationofhealthcareservicesinthe Lagos State University Teaching Hospital?
Specifically, the study sought to address the following questions:
- What are the different forms of health care services that households use when ill?
- What proportion of households use formal health care services when ill?
- Do household’s socio-demographic/economic status have influence on healthcare utilization?
- How does socio-cultural practices/factors influence utilization of healthcare service in Lagos State University Teaching Hospital?
- What are some of the geographic/facility factors that influence utilization of healthcare services in Lagos State?
Significance of the study
Despite varying degrees of government and development partner efforts and initiatives, Nigeria’s maternity and under-five mortality statistics remain unacceptably high. Pregnancy complications and issues include severe hemorrhage, eclampsia, pregnancy-induced hypertension, infections, and incomplete or septic abortions continue to kill a significant number of women every year (Bustreo et al., 2013). Therefore, there must be coordinated efforts to enhance and preserve the recent sensitive and targeted initiatives for mother and child survival that helped to improve goal 4 and goal 5 of the Millennium Development Goals. For the purpose of providing effective NHIS coverage, some of these interventions include separating parents from their children or dependents; increasing the use of insecticide-treated nets (ITNs); implementing free maternal health services; and implementing emergency obstetric and neonatal care (EmONC) (UNDP, 2012).
The ability of new mothers and their infants to receive timely, high-quality medical treatment is essential for all of these interventions to produce the desired benefits. However, access to and use of health care services in rural communities remain serious concerns (UNDP, 2012).
Therefore, with a focus on rural residents, the study aimed to highlight any potential causes or factors that may affect the use of healthcare services in Lagos State.
The results of this study will help decision-makers in the nation decide whether or not to expand the implementation of cutting-edge programs to other regions of the nation in order to enhance the health of the rural population, particularly the delivery of maternal and child health care services. It will also fill a gap in the literature and further empirical investigations on the topic.
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