Factors Influencing Reluctance to Seek Hospital Care Among Adults in Nigeria

Introduction

Health seeking behaviour (HSB) can be described as steps or actions undertaken by individuals who have health related issues with the goal of achieving solution to these issues or improving their health.¹ Good HSB is important as it aids in the early diagnosis of diseases, enables individuals to receive appropriate and timely care and overall improves health outcomes.² Decision-making regarding health is not the same among individuals as it is influenced by socioeconomic, socio-demographic, and cultural factors.² Individuals in the older age group are particularly vulnerable to disparities in their HSB including overutilization and underutilization of healthcare services.³ A study carried out n Nigeria has also shown that as many as 71% of rural dwellers have reported inappropriate HSB during their last illness episode while only 53% of urban dwellers reported inappropriate HSB during theirs.⁴ This article aims to identify the factors that influences health seeking behaviour among adults in Nigeria.

Factors

Health seeking practices of a community are influenced by several factors such as financial constraints, preference of herbal medication, self-management and use of over the counter medication, communication barrier, and promptness of care; to mention a few.

Financial Constraints

According to Okojie and Lane, the cost of healthcare is a major factor influencing health-seeking behaviour especially in a low-income country like Nigeria.⁶ Healthcare expenses which includes consultation fees, cost of medication and cost of transportation. As a result, many people delay or avoid seeking medical care.

Preference of Herbal Medications

Herbal medications are mostly rooted in tradition and passed through several generations. Many people believe that herbal medications are natural, hence safer and more effective than orthodox medicines. Previous positive experiences with herbal medications also reinforces this belief. But there are factors to be considered such as lack of standardization, toxicity, drug interactions in the human body.

Self-Medication and Over-The-Counter (OTC) Medication

A recent study showed self-medication as the first response to managing symptoms in many patients.⁷ In a country like Nigeria where OTC medications are easily accessible, patients would self-prescribe. Once they temporarily feel better, it gives a false sense of control and they feel they no longer need the services of a health practitioner nor need to visit the hospital.

Communication Barrier

In a multilingual country like Nigeria, healthcare providers might not share the same first language with the patient leading to difficulty in communication, frustration from the patient and unwillingness to come to the hospital in case of another illness.

Accessibility and Timeliness of Care

A major influence in reluctance of persons to seek medical care is accessibility to care.⁶ Delays in seeking treatment may arise due to factors that impedes logistics to healthcare facilities.

Recommendations

1. Healthcare should be made affordable for the Nigerian public. In the 2014 Presidential Summit on Universal Health Coverage (UHC), the implementation of health insurance for the formal sector, community-based health insurance (CBHI) for the informal sector and free healthcare for vulnerable groups were emphasized.⁷ These should be properly implemented.

2. There is a need to sensitize the public on risks associated with unregulated herbal use, particularly on kidney and liver function. Acute renal failure from use of herbal remedies is said to account for about 30-35% of all cases of acute renal failure in Africa.⁸ Traditional Medicine Practitioners (TMPs) should be trained to recognize warning signs and refer patients to hospitals when necessary.

3. Patients who frequently purchase OTC medications instead of proper consultation are at high risk of long-term health complications.⁹ People should be encouraged through targeted outreaches to invest in preventive medicine and avoid self-medication. Functional primary healthcare centres should be provided in communities and prescription-only policy should be enforced in pharmacies except in cases of visible emergency.

4. Communication gaps directly affect treatment outcomes and health system trust.¹⁰ Therefore, the usage of local languages and interpreters, when necessary, should be encouraged. There should also be development of simple health education materials using images and illustrations.

5. Improving prompt access to care leads to earlier diagnosis and better outcomes. In order to achieve this, primary healthcare centres in strategic locations closer to underprivileged populations should be provided. Routine health screenings in communities should also be conducted from time to time for early detection of diseases. Telemedicine should be explored.¹¹

Conclusion

Good health seeking behaviour is critical in the overall improvement of health and though influenced by several factors ranging from socioeconomic, socio-demographic, and cultural factors. It is therefore imperative to address these factors to improve health care services utilization.

References

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