Factors Affecting Utilization of Public Health Facilities by Rural Dwellers in Abia State

ABSTRACT BACKGROUND: Utilization of public health services is an important factor in the effectiveness of national health care and achievement of Health for All. Nigeria’s population is predominantly rural and the health needs of rural areas are numerous. For one to be able to maintain a healthy state, the choice of health care facilities/services and predictors of the choice are important. An individual’s choice of health facilities for healthcare is largely determined by patient-related factors and provider-related factors and these affect patient’s health outcomes. These choices of health care provider may also give an insight into how these health facilities can improve on their service delivery, improve client satisfaction and by extension ensure a healthier population. OBJECTIVES: To determine factors (both patient-related and provider-related ) affecting the utilization of Public health facilities by rural dwellers in Abia state south east Nigeria. Also to elicit their health related activities and level of satisfaction with Public health facilities. METHODOLOGY: It was a population based cross-sectional, descriptive study, carried out in selected rural areas of Abia state in south east geopolitical zone of Nigeria. 447 household heads or caregivers adults permanently residing in the selected rural areas were randomly selected and then interviewed using a pretested, semi structured questionnaire. Frequencies, percentages and mean were calculated, tables were created and comparisons of categorical data were done using descriptive methods. Chi square test was used to determine factors that were significant at a p- value of 0.05 and logistic regression was used to determine the predictors for choice of health care facility. RESULTS: The results indicated that 282 out of 447 0f the rural study population utilized public healthcare facilities. The patient related factors that encourage the utilization of public health facilities included age (31-40yrs), gender (male), marital status (married) and employment status (Government employed) There were no significant relationship between educational level, family income, household size and duration of stay in community at pvales of 0.05. The provider-related variables influencing the choice of public health facility for respondents included factors like internal organization and procedures, availability of health information, working hours, cost of service, waiting time and availability of ancillary services matters. This study also reported that users of government facilities were just somewhat satisfied with services rendered, location of the facility, overall cleanliness of the center, Staff courtesy and friendliness, skill and competency of the staff the health services they received. They are very satisfied with the efficiency of nursing care and work schedule of care in the clinic. CONCLUSION: This study highlighted that the utilization of public health facilities by uralurban dweller in Abia state is high. Choice of health care providing facility is an important decision that involves the interplay of several factors. Understanding these factors by health policy makers is important in the provision and the utilisation of health care services . Also satisfaction with services provided is a perception by the clients and must be considered by managers of health institutions when decisions to improve health facility services are to be made. A healthy population is an asset to any society. Consequently, improving the healthcare delivery system in the public setting will in the long run improve the quality of life of the people in the study area.