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AN INDEPT ANALYSIS ON THE FACTORS INFLUENCING THE PATRONAGE OF PRIMARY HEALTHCARE AMONG RURAL DWELLERS
CHAPTER ONE
INTRODUCTION
Background of the study
The use of healthcare services is influenced by several factors, including the presence of healthcare facilities (Cueto, 2014). Availability encompasses proximity, ease of access, knowledge, transportation, language, cultural differences, and personal choice. Other factors include the cost of healthcare services and the quality of care provided by healthcare professionals. The utilization of healthcare services varies significantly between urban and rural areas due to disparities in the availability of essential medical equipment and trained medical personnel. Urban areas tend to have a higher concentration of these resources, whereas rural areas, home to over 60% of the population, face a limited supply.
Nigeria’s health indices have seen a significant slowdown in growth, particularly regarding the maternal mortality ratio, where the country ranks among the highest. The 2018 NDHS estimated the maternal mortality ratio at 512 maternal deaths per 100,000 live births for the seven years preceding the survey (Gillam, 2018). In rural areas, where access to modern health facilities is limited, the situation is even more dire. Most residents rely on local traditional birth attendants for healthcare needs. The distribution of health facilities and the presence of healthcare workers significantly influence the utilization of health services in both rural and urban populations. Recurring gaps in healthcare provision are attributed to factors such as inadequate equipment, insufficient infrastructure, poor communication services, and lack of access roads (Gillam, 2018).
Rural residents face challenges accessing healthcare due to the need to travel long distances and spend more time reaching health centers, which hinders their ability to make repeat visits. This lack of access has led to a decrease in life expectancy among rural residents and urban slum dwellers and an increase in newborn mortality rates (Gillam, 2018). Therefore, this study aims to examine the factors influencing the patronage of primary healthcare among rural dwellers in Ikole-Ekiti.
Statement of the problem
Access to high-quality healthcare is a basic entitlement for all individuals worldwide, and Nigeria is no exception. The objective of primary health care was to provide universal and readily available healthcare services for all individuals. Undoubtedly, this is yet to be accomplished in Nigeria. Primary health care facilities were built in both urban and rural regions in Nigeria to promote equity and provide convenient accessibility. The majority of individuals living in underdeveloped nations, particularly in Africa, possess little knowledge of their national health systems and programmes, resulting in a propensity to underutilize healthcare services. Furthermore, several studies conducted in Nigeria since the establishment of PHC in 1992 have consistently revealed low rates of utilization, which in turn contribute to the poor health condition of the population (Jaro and Ibrahim, 2015; Galadanchi, 2017; Cueto, 2014). Considering that the primary goal of primary health care (PHC) in developing nations is to enhance the health of individuals and communities by promoting health and increasing the use of preventive, curative, and rehabilitative health services, it is important to comprehend the factors that lead to the low patronage of health care facilities, particularly at the primary level. Rural populations continue to have ongoing difficulties in accessing sufficient healthcare services, leading to discrepancies in health outcomes when compared to metropolitan regions. Although attempts have been made to enhance primary healthcare delivery systems, there is still a lack of comprehension of the elements that influence the behaviour of rural residents in seeking and using these services. Hence, the study examine the factors influencing the patronage of primary healthcare among rural dwellers in Ikole-Ekiti.
Objective of the study
The broad objective of the study is to examine the factors influencing the patronage of primary healthcare among rural dwellers in Ikole-Ekiti. Specifically, the study will;
Ascertain whether affordability of healthcare services influences patronage of primary healthcare in Ikole-Ekiti.
Examine whether educational level of rural dwellers influence their patronage of primary healthcare in Ikole-Ekiti
Determine whether distance and transportation barriers influence patronage of primary healthcare in Ikole-Ekiti.
Identify potential strategies aimed to improve the patronage of primary healthcare services among rural dwellers in Ikole-Ekiti.
Research questions
The following questions have been prepared to guide the study
Does affordability of healthcare services influence the patronage of primary healthcare in Ikole-Ekiti?
Does educational level of rural dwellers influence their patronage of primary healthcare in Ikole-Ekiti?
Does distance and transportation barriers influence patronage of primary healthcare in Ikole-Ekiti?
What are the potential strategies aimed to improve the patronage of primary healthcare services among rural dwellers in Ikole-Ekiti?
Significance of the study
The findings of this study will aid the local governments in charge of service delivery at these facilities in focusing their education and community communications on the core aspects that operate as obstacles to health-care utilization. It will also assist service providers at the facility level in developing strategies and action plans to encourage increased use of the services available. These efforts will help to start the process of enhancing access to health care services, which will eventually improve the overall health of everyone in the state.
The findings of the study will further be of benefit to the academic community as it will contribute to the existing literature.
1.6 Scope of the study
The study focuses on the factors influencing the patronage of primary healthcare among rural dwellers in Ikole-Ekiti. Geographically, residents in Ikole local government area, Ekiti State.
1.7 Limitation of the study
Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection (internet, questionnaire, and interview), which is why the researcher resorted to a moderate choice of sample size. More so, the researcher will simultaneously engage in this study with other academic work. As a result, the amount of time spent on research will be reduced.
1.8 Definition of terms
Patronage Behavior: The actions and decisions made by individuals or communities regarding their utilization of goods or services, particularly in the context of healthcare, encompassing factors such as choice of healthcare provider, frequency of visits, and adherence to treatment plans.
Rural Dwellers: Individuals residing in sparsely populated areas characterized by agricultural or natural landscapes, typically located outside urban centers and cities.
Primary Healthcare Delivery System: The network of healthcare facilities, professionals, and services focused on providing essential and preventive care to individuals and communities, typically serving as the first point of contact within the healthcare system.