Factors Influencing Health Seeking Behaviour Among Women Of Reproductive Age

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Factors Influencing Health Seeking Behaviour Among Women Of Reproductive Age


Abstract


This study explored factors influencing Health Seeking Behaviour among women of reproductive age with a case of Women of Orlu Community. The study was guided by three specific objectives: to explore socio-cultural aspects of Health Seeking Behaviour among Women of reproductive age; to examine the economic aspects of Health Seeking Behaviour among Women of reproductive age and to evaluate the political factors of Health Seeking Behaviour among Women of reproductive age.

In the methodology, the study used a mixed approach, where both qualitative and quantitative methods of data collection and analysis were applied. The study used three methods in primary data collection, which were social survey, in-depth interview and focus group discussion. Purposive sampling method was used for attaining key informants for in-depth interview, whereas stratified and simple random sampling were used to obtain social survey and focus group discussion respondents. Sample size for social survey was obtained by the use of an online software (Calculator.net) for sample calculation that resulted to 73 respondents, whereby the qualitative part depended on the saturation point in gathering information. Quantitative data was analyzed by using Social Science Statistical Package (SPSS) Version 20. Findings from this study have revealed that social-cultural, economic and political aspects have influenced women Health Seeking Behaviour. Religion and wealth influenced Health Seeking Behaviour of Women of reproductive age in varied manner. In addition, delay in attainment of Health Insurance Identity Cards was seen to be a factor that led some women not to visit hospitals.

It was recommended that women need to use the adequate biomedical healthcare facilities as well as ensure timely attainment of health insurance membership cards. Healthcare practitioners and Student Welfare Officers were encouraged to ensure women are aware and use the available healthcare services. ORLU COMMUNITY management and the government of Nigeria should play well their part by ensuring good healthcare services to women.


Chapter One


Introduction

1.1 Chapter Overview

This study intended to explore factors influencing Health Seeking Behaviour among Women of reproductive age. Chapter one covered the introductory part of the study. The chapter introduced the research problem by providing it with a relevant background information and a clear statement of the problem. Further, this chapter contains the focus of the study through main and specific objectives which subsequently addressed specific questions. At the end, the chapter shows the worthiness and rationale of the study.


1.2 Background to the Research Problem

Health is one of the ever mentioned important aspects that cause and sustain life of any nation. It is the duty of the entire community to ensure good and quality health of all members. All modern governments have tried to include maintenance, promotion and restoration of health to be among their fore agenda in maintaining good and quality health of a community. The issue of Health Seeking Behaviour lies at the demand side of health systems development, which addresses the issue of users‟ attitude towards the existing healthcare facilities.

Health Seeking Behaviour (HSB) is the “sequence of remedial actions that individuals undertake to rectify perceived ill-health” (Hakmaosa et al., 2017). Health Seeking Behaviour is normally “described with data collected from information such as time difference between the onset of an illness and getting in contact with a healthcare, the type of healthcare provider patients seek help from and how compliant a patient is with the recommended treatment” (Champlin et al., 2017). Others include, “reasons for choice of healthcare professional and reasons for not seeking help from healthcare professionals” (Ibid). In other literatures (Latunji & Akinyemi, 2018).

Literatures on HSB (MacKian, 2003; Grundy, 2010; Latunji & Akinyemi, 2018) reveal that studies on HSB may be classified into two classes, namely, those emphasizing the “utilization of the formal system or Health Care Seeking Behaviour” (HCSB) “and those which emphasize the process of illness response or Health Seeking Behaviour” (HSB) (Latunji & Akinyemi, 2018). HCSB normally “involves identification of pathways” specific “to the formal health care system”, that in many time starts “with home care or traditional healers” and then extends to formal healthcare system with “pathways differing according” to the revealing condition (Edwards, 2016). In this aspect, Segall (1995, in Grundy 2010) showed “the decision to engage with a particular medical channel” may be subject to various factor, such as “sex, age, the social status of women, the type of illness, access to services and perceived quality of the service”.

In the developed world, studies have shown that women of reproductive age generally differed in their HSBs in accordance to demographic and contextual factors. “A cross-sectional multicenter” conducted in Germany and Hungary by Riemenschneide, et al., (2016) examined whether “socio-cultural factors” influenced “medical women‟ health-status and heath promoting Behaviour”. It was noticed, “The health status distributions were comparable between the study sites” and significant predicting factors that were mentioned included gender, financial situation and nationality. The study concluded by asserting that gender and study year were seen to have “minor role in the health status and health promotion”, while “structural (study site) and somewhat socio-cultural factors (nationality, financial situation) explained the differences regarding health promoting Behaviours” among the studied women.
Studies on HSB in Least and Middle Income Countries (LMICs) suggest several factors that influence the HSB of a population segment, whereas certain sections of the population are more likely to have appropriate HSB than others; such factors have included type and severity of ailment, accessibility as well as obtainability of services, social determinants, which are conditions that people are born with (WHO, 2016; Sharma, Pinto & Kumagai, 2018), social-economic status (SES), gender, and culture (Latunji & Akinyemi, 2018).

In operationalizing the study, HSB was classified “formal (when professional help was sought), informal relational (help sought from friends/family) and informal personal self-help (Ibid). The research scrutinized the following health issues, “physical, psychological, social and relational, sexual, drug, alcohol and smoking”. In the results, it showed that when women faced health-related matters inclined to seek informal health care, and the identified factors explained such situation were categorized into two groups, accessibility and relational factors. In that way it was advised that women should be encouraged to use the formal healthcare and there must be assured aspects of confidentiality and understanding on the part of service providers.

In Sub-Saharan Africa, a study by Ajaegbu and Ubochi (2016), in Nigeria begun by asserting that “young people have specific health problems and developmental needs” differing greatly with youngsters and adults; and reasons for health problems were found to be mostly psychosocial rather than biological. The study further exposed that common ailments amongst women were fever and headache, and women went “to buy drugs from the patent medicine stores when sick”. Also, it was found that women wouldn‟t visit a hospital till they experience acute pain. The main observed factors influencing women HSB were “mostly related to accessibility, effectiveness and none delay”.

Also, the Ajaegbu and Ubochi (2016), study showed how “seeking health help when sick by women” was a problem (Ajaegbu & Ubochi, 2016). Furthermore, in the findings it was revealed that the patients attendance record in the community health center obtained at the records department, indicated that despite the presence of several illness episodes, less than twenty five percent (25%) of women sought health help at the community clinic for issues related to health.

In Nigeria, like many other developing countries, The Nigeria National Health Policy (2007 & the new 2017), have several issues and specific objectives that focus “to reduce morbidity and mortality and increase life expectance” to citizens and ensures deliverance of quality health service especially to vulnerable groups such as “infants, under-fives, pre and school children, youths, people with disability, women of reproductive age and elderly people” (Health Policy, 2007). The new Health Policy (2017) mentions HSB under the “Cross Cutting Health Sector Issue”, where harmful gender norms is said to negatively influence HSB and encourage risky healthy Behaviours among people.
This study therefore, intended to explore the most important factors that influence health seeking Behaviour among women of reproductive age


1.3 Statement of the Problem

In both developed and developing countries, researchers have tried to explain factors influencing HSB among different population subgroups such as school children, women of reproductive age, pregnant women, etc. though in varying contexts and with specific health conditions. Mendoza, et al., (2018) identified factors influencing HSB among women of reproductive age, which included perception of illness and stigma, sociodemographic variable such as gender, religion and cultural backgrounds and practices. Other mentioned factors were knowledge about the availability of health facilities and access to those facilities, effectiveness of the health channel chosen as well as attitude of healthcare providers (Erkan, et al., 2012; Mendoza, et al, 2018).

Also, Ajaegbu and Ubochi (2016), held that factors that were found to affect choice of health care during illness among Enugu Women of reproductive age, were those connected “to accessibility, effectiveness and none delay”. A previous study by Afolabi, (2013) in Obafemi Awolowo Community in Nigeria had indicated that HSB was influenced by factors such as perception of health, knowledge, socioeconomic limits, adequacy of health facilities and “attitude of healthcare providers” (Ibid).

Among the available literatures looking for factors influencing HSB among women of reproductive age, very few focus on such factors of HSB for Women of reproductive age as a population subgroup instead, the focus has been on looking HSB within specific diseases contexts. However, disease specific studies like the Astrom and Masalu, (2001) study on “HSB among MUHAS women in terms of Oral Health” revealed the most important factors influencing HSB to be the place of origin either rural or urban, time consumed for service, and the community environment.

This study explored factors influencing Health-seeking Behaviour among women of reproductive age as a population subgroup with a case of Orlu Community women. Factors influencing women HSB in many Communities around the globe have varied according to social, economic and cultural, as well as the political atmosphere of a country. The varied nature gave reasons for researching on HSB among women of reproductive age specifically at Orlu Community, since Orlu Communityis distanced by other Communities outside Nigeria in terms of social, economic, political and cultural environments. Factors influencing women‟ HSB in other countries may or may not explain HSB among Women of reproductive age due to the existing social, political, economic, cultural, and geographical differences. It was therefore, expected that Women of reproductive age would respond to illness experience differently due to differences in presenting contextual factors. From this situation, it was found worthy to carry out this study at Orlu Community.


1.4 Research Objectives

The research was guided by both general and specific objectives concerning Health Seeking among women of reproductive age.

1.4.1 General Objective

The general objective of the study was to explore factors influencing Health-Seeking Behaviour among women of reproductive age.

1.4.2 Specific Objectives

Specifically, the study aimed;

  1. To assess the influence of social cultural factors on women HSB among Women of reproductive age.
  2. To examine the economic influence for Women of reproductive age HSB.
  3. To explore the political factors of Health Seeking Behaviour among Women of reproductive age.

1.5 Study Questions

The study was guided by the following queries that were to be answered in this research activity:

  1. How do socio-cultural factors influence HSB among Women of reproductive age?
  2. How are the economic aspects influencing HSB among Women of reproductive age?
  3. What are the political aspects of HSB among Women of reproductive age?

1.6 Significance of the Study

Health Seeking Behaviour studies are known to have contributed in much understanding the reasons and practices engaged in times of needing health services (Metta, 2016). Health Seeking Behaviour (HSB) is one of the important aspects in developing people centered healthcare system. It was therefore important to have this study so that there is a proper understanding of factors influencing women HSB among Community population group for improving health care provision to this important group that is fountain of elite working class. Above all, the study is of great help for health stakeholders in women‟ among Community managements, health policy makers, women and student welfare stakeholders.


1.7 Scope of the Study

According to Khant, et al (2018), scope of a research is about the content level which is “covered by the means of the research in order to come to more logical conclusions and give conclusive and satisfactory answers to the research”. Scope of a research implies all aspects covered in a research project, excluding all that is left behind. In this study, the scope featured women of reproductive age of Orlu Community.


1.8 Organization of the Study

This study contains five chapters.

  • Chapter one contains the background information to the problem, statement of the problem, research objectives, and the research questions. Also, chapter one provides the significance and scope of the study.
  • Chapter two is about review of literatures, both theoretical and empirical. It begins with definition of key terms used in the study, the theoretical basis of the study as well as review of empirical literatures on HSB.
  • Chapter two ends up with analysis of the research gap and the conceptual framework.
  • Chapter three provides a discussion on how the research was accomplished. The chapter shows the research design used, the methods of data collection, presentation and analysis as well as techniques to ensure data credibility.
  • Chapter four is all about presentation and discussion of findings; while chapter five provides summary, conclusion, recommendations and areas for further study.

Chapter Five


Conclusion and Recommendations

5.1 Conclusion

From the findings, it is plausible to conclude that health is an important aspect for individual, social and economic progress of a country. Health Seeking Behaviour is an important concept to be explored when checking on the demand side of healthcare service delivery since it unveils people’s readiness to use the available healthcare facilities. Nevertheless, in developing countries like Nigeria, the issue of Health Seeking Behaviour seems to be ignored when planning for improving quality healthcare service to population subgroups. Although all statistical tests could not establish significant association between social, cultural, and political factors, the factors have varied impacts in health seeking Behaviours among women of reproductive age. Exploring Health Seeking Behaviour for women of reproductive age as a population subgroup is very important. It should be underpinned that HSB supplements the supply side of health systems development.


5.2 Recommendations

Based on the objectives of this study on the factors influencing Health Seeking Behaviour some recommendations are suggested. The recommendations are suggested to women, to the health service practitionersas well as to the government of Nigeria.

Recommendation to Women

Women of reproductive age need to understand that biomedical healthcare service is adequate and need to be used effectively. No ailment should be ignored and left unattended. Women must use all available health services in promoting, maintaining and restoring health.

Also, women must fulfill their obligations of making close follow up on the attainment of health insurance membership cards earlier in advance instead of waiting until when feeling ill. Apart from the duty and obligation of the Community management, women need to make prompt follow up before the card is highly needed for use during illness.

Recommendation to the Health Service Practitioners

Health service practitioners include Medical Doctors (MDs), Medical Assistant Officer (MAOs), Nurses, Pharmacologists, and Health Records and System Administrators. All these officials should play their part and fulfil their duties so as to ensure women are aware of the available healthcare facilities. Knowledge on the available services was mentioned as one of the issues women minded, it is high time for all staff working in the provision of health service to work hard so that users of the service access the service timely. Also the issue of good customer care should be addressed.

Recommendations to the Government of Nigeria

From the study findings, the ministry responsible for health should establish a mechanism through policy implementation that would ensure adequate availability of healthcare services to women by increasing the number of workers in health facilities at orlu community so as to reduce the time patients spend. Also the government should keep on modernizing the facilities by purchasing modern testing equipment which will improve confidence users and thus improve utilization the facilities by women.


5.3 Areas for Further Research

This research only concentrated exploring factors influencing Health Seeking Behaviours among Women of reproductive age. It provides basic information on the issue. However, the issue of Health Seeking Behaviour is broad thus, other study activities may be done by widening the scope to include other community as well as focusing on population subgroups other than women of reproductive age.


Factors Influencing Health Seeking Behaviour Among Women Of Reproductive Age


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