ASSESSMENT OF THE UTILIZATION OF HEALTHCARE FACILITY AMONG

WOMEN OF CHILD-BEARING AGE IN OZIOKUTU COMMUNITY ADAVI LOCAL

GOVERNMENT AREA, KOGI STATE.

PRESENTED

BY

USMAN RAHEEMAT OZOHU

INDEX NUMBER: 2023/2250/161050/N

PRESENTED TO:

COLLEGE OF NURSING AND MIDWIFERY OBANGEDE,

KOGI STATE.

IN PARTIAL FULFILMENT OF THE REQUIREMENTS OF NURSING

AND MIDWIFERY COUNCIL OF NIGERIA FOR THE AWARD

OF “REGISTRATED NURSING CERTIFICATE”.

NOVEMBER, 2023

1
 DECLARATION

This is to declare that this research project titled Assessment of the Utilization of Healthcare

Facility among Women of Child Bearing Age in Oziokutu Community Adavi Local

Government Area Kogi State, was carried out by USMAN RAHEEMAT OZOHU is solely the

result of my work except where acknowledged as being derived from other person(s) or

resources.

Examination number: __________________

In Kogi State College of Nursing and Midwifery Obangede

Signature: _________________ Date: _____________________

CERTIFICATION

2
This is to certify that this research project written by USMAN RAHEEMAT OZOHU with

examination number _____________ has been examined and approved for the ward of

General Nursing certificate as a “Registered Nurse."

Signature_______________________ Date________________

MRS. OMEIZA LEAH

BSC (ED), BNSC, RN, RM, FWAPCN

(PROJECT SUPERVISOR)

Signature_______________________ Date__________________

MRS. ABRAHAM H.O

MNSC, BNSC, RMT, RN, RM

(PROVOST)

Signature______________________ Date_________________

CHIEF EXAMINER

ABSTRACT
Utilization of healthcare is an important factor in the effectiveness of national healthcare and
achievement of Health for all. The study is aimed at assessing the utilization of healthcare

3
facilities and factors hindering the utilization of healthcare facilities in Oziokutu community,
Kogi State. A cross-sectional descriptive research design was used, with a target population
440 women of child bearing age and a sample size of 210 using Taro Yemen formula. The
instrument of data collection was a self-developed questionnaire, validity and reliability of the
instrument was ensured. Data gotten was analyzed using frequency and percentage tables.
Findings from the study show that 47.1% of the respondents moderately utilize healthcare
facilities. 40% of the respondents accessiblity to healthcare facility, 35.7% lack of privacy and
confidentiality, 32.9% quality of healthcare services provided and 37.1% felt
judged/stigmatized when seeking healthcare services related to their reproductive health are
some of the primary factors hindering them from utilizing healthcare facility. It was revealed
in the study that all the respondents 100% agreed to the identified solutions proffered by the
researcher for the enhancement of healthcare facility utilization. Therefore, there is need for
sensitization programmes geared towards increasing their knowledge on the importance of
healthcare facility utilization.
Keywords--- Healthcare, child-bearing, perception and utilization

DEDICATION

This project work is dedicated to God Almighty and my ever supporting family Mrs. Sumaila

Hauwa Usman.

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 ACKNOWLEDGMENT

I sincerely show gratitude to the Almighty for his continuous support and direction all through

my life endeavors.

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I appreciate my able supervisor, a mother indeed thank you for taking your time to read,

correct and teach me where necessary in this journey, may Almighty reward you abundantly

Amen.

I also thank the Provost of this great institution Mrs. Abraham H.O and the deputy Provost as

well as the elegant teaching staff and non-teaching staff for all their efforts to bring out the

best for the school may the good Lord reward you all Amen.

My gratitude also goes to my beloved parents Mr. and Mrs. Usman and my beloved siblings

for their support, advice and prayers during my course, May the Almighty Allah bless you all

Amen.

I also appreciate all the support from my friends you guys are just wonderful. May every bit

of your reward locate you Amen

To the dominion set and all members of M.S.S.N, I extend my appreciation to you all and

hoping that the Almighty who saw me through will lift you up beyond your expectations.

TABLE OF CONTENT

Title page i

Declaration ii

Certification iii

Abstract iv

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Dedication v

Acknowledgment vi

CHAPTER ONE

Background of the study 1

Statement of problem 2

Objective of the study 3

Research question 4

Significance of study 4

Scope of study 4

Operational definition of terms 4

CHAPTER TWO

Literature review 6

Conceptual review 6

Level of healthcare system 7

Service provision 10

Concept of childbearing age 11

Factors influencing the utilization o healthcare facilities 15

Theoretical framework 17

Application of the theory 20

Empirical review 21

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CHAPTER THRE

Research design 25

Research setting 25

Target population 26

Sample size 26

Sample technique 26

Instrument for data collection 27

Validity of instrument 27

Reliability of instrument 27

Method of data collection 28

Method of data analysis 28

Ethical consideration 28

CHAPTER FOUR

Bio-demographical data of the respondents 29

Answering the research questions 32

CHAPTER FIVE

Discussion of findings 35

Implication of findings to nursing 37

Limitation of the study 37

Summary of the study 37

Conclusion 38

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Recommendation 39

Suggestions for further study 40

LIST OF TABLES

Table 4.1: showing respondents demographics

Table 4.2 - 4.4: answering research questions

LIST OF APPENDICES

Appendix I: References 41

Appendix II: Questionnaire 43

Appendix III: Letter of permission

CHAPTER ONE

INTRODUCTION

BACKGROUND TO THE STUDY

Childbirth ensures the continuity of human population and is universally celebrated event. Yet

for many thousands of women, childbearing is sometimes experienced not as the joyful event

that it should be, but as a tragedy that may end in death because of inaccessibility to quality

healthcare services by women (Agabi and Main, 2018).

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In Nigeria 40 million women of childbearing age (between 15 and 49 years of age) suffer a

disproportionally high level of health issues surrounding birth. While the country represents

2.4 per cent of the world’s population, it currently contributes 10 per cent of global deaths for

pregnant mothers. Latest figures show a maternal mortality rate of 576 per 100,000 live births

(UNICEF, 2020).

Although many countries have reduced their MMRs, causing a general global decline, efforts

to reduce MMRs of countries in Sub-Saharan Africa have largely stagnated. Nigeria's

maternal and child health indices are among the worst in the world. In 2018 the Nigeria

Demographic Health Survey (NDHS) estimated MMR of 640 per 100,000 life biths. Despite

this reduction, Nigeria still remains one of the countries with the highest MMR globally

(WHO, 2019).

Report from Kogi State Ministry of Health (2018), stated that monthly return from hospitals

and clinics in the state for the years 2014-2019 suggested that utilization of healthcare

facilities in the rural areas including Oziokutu community in Adavi local government of Kogi

State is generally low. However, certain factors are responsible for this ugly situation these

include: Religious beliefs, cultural norms of the people, level of education, financial status,

and poor quality of services and poor attitude of staff are the major contributing factors

responsible for underutilization of healthcare facilities etc.

This project work is directed towards assessing the utilization of healthcare facilities and

affecting change where possible in Oziokutu community in Adavi local government of Kogi

State.

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STATEMENT OF PROBLEM

In 2022, the Nigeria's Maternal Mortality Rate is still among the highest in the world, with an

estimated 512 deaths per 100,000 live births due to low utilization of healthcare facilities.

“This is nowhere near the SDGs target of 70 per 100,000 live births. In fact a Nigerian woman

has 1:22 lifetime risk of dying during pregnancy, childbirth or postpartum/abortion, whereas

the most developed countries, the lifetime risk is 1:4900 (W.H.O, 2022).

According to the National Primary Health Care Development Agency, Abuja, Nigeria Despite

extensive investments, the country still has insufficient healthcare delivery infrastructures,

poor quality health-care services, and unevenly distributed human resource capacity (Adeniyi

2014). These are reflected in its health-care quality ranking of 187 of 200 countries and listing

among countries with some of the worst health indicators in the world. The country has an

estimated 23 640 health facilities, although these facilities serve the majority of the

population, they are unable to provide basic and cost-effective services, especially in rural

areas. These performances are attributed to various factors including poorly equipped health

facilities, insufficient staff, lack of clearly defined roles and responsibilities, inadequate

political commitment, and poor accountability. Quality improvement of utilization of health-

care facilities is critical however, efforts to address the quality of care as a contributory factor

to the country’s poor health outcomes receive less attention.

The issue related to utilization of healthcare facilities among women of childbearing age in

Oziokutu community of Adavi local government of Kogi State is gradually turning into a

serious cause for concern, particularly at the critical time of birth, some women get scared of

having their babies in the hospitals or even seeking help when complications arise. It is in

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light of this that this study seeks to examine the level of utilization of health care facilities

among women of child bearing age in the community.

OBJECTIVE OF THE STUDY

1. To determine the level of utilization of healthcare facility among the respondents

2. To determine the factors hindering the respondents from the utilization of healthcare

facility

3. To identify measures for enhancing the utilization of healthcare facility among the

respondents

RESEARCH QUESTIONS

1. What is the level of utilization of healthcare facilities among the respondents?

2. What are the factors hindering the respondents from utilizing healthcare facilities?

3. What are the identified measures for enhancing the utilization of healthcare facilities

among the respondents?

SIGNIFICANCE OF THE STUDY

At the completion of the study there will be a source for the women to utilize healthcare

facility, create awareness and enlightenment for women on the important of getting quality

healthcare services.

SCOPE OF STUDIES

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This study is aimed at assessing the utilization of healthcare facility among women of

childbearing age in Oziokutu community Adavi local government of Kogi State. Therefore, it

is limited to women of childbearing age (15 - 45).

OPERATIONAL DEFINITION OF TERMS

ASSESSMENT: - the ongoing process of gathering evidence of what each woman actually

knows and understands about healthcare facilities.

HEALTH CARE FACILITY: - They are places that provide health care services for women

which include hospital, clinics, specialized care centers and outpatient care centers.

UTILIZATION: - The act of the respondents using the healthcare facilities.

HEALTH PROFESSIONAL: - They are trained health workers that study, diagnose, treat and

prevent human illness, injury and other physical and mental impairments in accordance with

the needs of the population they serve.

WOMEN OF CHILDBEARING AGE: - Are individual women that have reach the

reproductive age (15 - 45).

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 CHAPTER TWO

LITERATURE REVIEW

This chapter will review related literatures in respect to variables in the topic and objectives of

the study conceptually, empirically and theoretically.

CONCEPTUAL REVIEW

Health facilities are places that provide health care. They include hospitals, clinics, outpatient

care centers, and specialized care centers, such as birthing centers and psychiatric care centers.

When you choose a health facility, you might want to consider how close it is to where you

live or work; whether your health insurance will pay for services there, whether your health

care provider can treat you there, the quality of facility is important. Some facilities do a better

job than others. One way to learn about the quality of a facility is to look at report cards

developed by federal, state, and consumer groups (Medline Plus, 2021).

According to Pharmchoice (2022), most patients fund their Medicare out of their pockets,

unlike in advanced countries, where they are insurance schemes and taxes. The National

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Health Insurance Scheme (NHIS) does not cover the health insurance of most of the

population. Health care system in Nigeria suffers from a lack of proper health funding and

investment, with the government committing only 5% of the budget to health. World Health

Organization (2021), ranked Nigeria as low as 156th out of 191 countries, based on the quality

of medical system and healthcare delivery.

LEVEL OF HEALTHCARE SYSTEM

There are three (3) main levels of healthcare system in Nigeria unlike in some advance

countries, which have 4 tiers of healthcare system, including the quaternary healthcare.

The structures or levels of healthcare system in Nigeria follow the structure of the

government. The federal government handles the tertiary healthcare, the state handle the

secondary healthcare, while the local government takes charge of the primary healthcare.

(W.H.O, 2021).

PRIMARY LEVEL: Facilities at this level serve as the entry point of the community into the

healthcare delivery system. These facilities include the health centers, clinics, dispensaries and

health posts. They provide general preventive, curative, promotive and pre-referral care to the

population.

SECONDARY LEVEL: Secondary care facilities, including general hospital. They provide

general medical and laboratory services, as well as specialized health services, such as

surgery, pediatrics, obstetrics and gynecology to patients referred from the primary healthcare

level.

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TERTIARY LEVEL: Tertiary level facilitates form the highest level of healthcare in the

country. Tertiary health care, consist of highly specialized services, care for specific disease

conditions or specific group of patient. These include specialist and teaching hospitals and

federal medical center (FMCs). They manage patient referred from the primary and secondary

levels and have special expertise and full-fledge technological capacity that enable them to

serve as resource centers for knowledge generation and diffusion. In very small villages, there

are only health sub-centers (HSC) or village clinics that have a trained health worker for

providing basic health care. In bigger district and cities, there are government hospitals that

look after the medical needs of the people of the area. They have many more facilities and are

well equipped to deal with any kind of emergency. They have well qualified staff and latest

Medical equipment.

FUNCTIONS OF HEALTHCARE FACILITIES

 Providing education for community health by teaching the importance of hygiene and

sanitation.

 Looking after the general health of the people and treating them for common diseases

at a nominal cost

 Providing vaccination and inoculation against diseases like tuberculosis, cholera, polio

and other epidemics.

 Running family planning and maternity center

 Organizing drives to give people information about the prevention and causes of

diseases like smallpox, cancer, AIDs, Hepatitis B etc.

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  Providing prompt emergency care in case of natural calamities, epidemics and

accidents. (Deejay Sam, 2021).

TYPE OF HEALTH CARE FACILITY

HOSPITAL: - is an institution for healthcare typically providing specialized treatment for in

patient (overnight) stages. Some hospitals primarily admit patients with a specific disease, or

are reserved for the diagnosis and treatment of conditions affecting a specific age group.

Hospitals are nowadays staffed by professional trained doctors, nurses, paramedical clinicians

etc. whereas historically, this work was usually done by the founding religious orders or by

volunteer. (Syam et al, 2017).

HEALTHCARE CENTER: - This include clinics, doctor’s offices, urgent care centers and

ambulatory surgery centers, serve as first point of contact with a health professional and

provide outpatient medical, nursing, dental and other types of care services. (W.H.O, 2014)

MEDICAL NURSING HOME:- This include residential treatment center, geriatric care

facilities, health care institution which provide short or long term medical treatment of a

general or specialized nature not perform by hospitals to in-patient with any of a wide variety

of medical conditions.

PHARMACIES AND DRUG STORES: - They are establishments engaged in retailing

prescription or nonprescription drugs and other types of medical and orthopedic goods.

Regulated pharmacies maybe based in a hospital or clinic or they may be privately operated

and are usually staffed by pharmacists, pharmacy technician and pharmacy aides.

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MEDICAL LABORATORY AND RESEARCH: - Is a place where tests are done on

biological specimen in order to get information about the health of a patient. Such laboratories

may be divided into categorical department such as microbiology, hematology, clinical

biochemistry, immunology, serology, histology, cytogenetic or virology. (Syam et al, 2017).

SERVICE PROVISION

Health service provision can be defined in terms of who is providing the service and the

setting in which the service is provided. Following the declaration of Alma Ata, the PHC was

pronounced as the key instrument in achieving health-for-all for which reason it is supposed to

be the entry point into the health system, but this is hardly so in Nigeria as in many Sub-

Saharan countries the first point of call in time of ill health is purely an individual choice

based on many factors. (Federal Ministry of Health, 2014).

PUBLIC AND PRIVATE: - Health service provision in Nigeria includes a wide range of

providers in both the public and private sectors, such as public facilities managed by Federal,

State and Local governments, private for profit provider, NGOs, community-based and faith

based organization, religious and traditional care giver. Pharmacists provide healthcare service

in the form of drugs and supplies Federal ministry of Health, (2014). The private sector covers

the entire gamut of tertiary, secondary and primary healthcare facilities, patent medicine

vendor, drug sellers and traditional practitioners, payment for this services can be made in

kind or cash.

The public and private health care can be defined in terms of the fact that one is not for profit

and one is for profit. This has a great impact on utilization pattern of these facilities. Studies

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has shown that the less the cost, the more the usage especially among low income population,

(Ager and Philip, 2015).

FORMAL AND INFORMAL:- Formal health care and treatment is defined in terms of what

is considered conventional medicine in registered setting such as government or private

hospitals, health centers, authorized clinics and dispensaries. (Birung et al, 2016).

Ajilowo and Olujimi (2019), stated that, healthcare relates to self-treatment, self-medication,

traditional healers and remedies, and other non-sanctioned health services. Self-treatment is

extremely common and unfortunately not always appropriate. In many cases, self-medication

is an important initial response to illness before consultation of formal health care facilities.

(World self-medication-industry, 2014). Self-medication and patronage of pharmaceutical

shops (including licensed and unlicensed patent medicine stores and drug peddlers) in place of

clinics and hospitals is a common occurrence in most developing countries including Nigeria,

(Abodunrin et al, 2017).

Informal health workers are found in every health system, and the impact of their role

increases as the strength of the formal sectors weakens. Informal health workers who are not

breaking any regulations can be significant players in some communities and deserve to be

acknowledge, encouraged and supported (Omaswa, 2019).

CONCEPT OF CHILDBEARING AGE

Holly and Stephanie (2018) stated technically, women can get pregnant and bear children

from puberty when they start getting their menstrual period to menopause when they stop

19
getting it. The average woman's reproductive years are between ages of 12-51. Experts say the

best time to get pregnant is between late 20s and early 30s. This range is associated with the

best outcome for both the woman and the baby. One study pin pointed the ideal age to give

birth to first child is at 30 years.

EFFECT OF AGE ON FERTILITY

Women are born with all the eggs they will ever have, about 2millions of them. The number of

women eggs gradually fall over the years. By age 37, you will have about 25000 eggs. By age

51, you will only have 1000 eggs left. That might still sound like a lot of eggs, but the number

of the eggs also goes down as one age. The risk of developing conditions that can negatively

impact fertility, like endometriosis and tubal disease, also increases as you get older. Because

of those factors, fertility begins to gradually decline at around age 32. At 35 and 37, fertility

begins to drop more quickly. The chance of getting pregnant decreases as you get older. 18%

at age 25, 16% at age 30, 12% at age 35 and 7% at age 40. Other factors that may reduce the

woman's chance of getting pregnant include smoking, pelvic infection, cancer treatment such

as radiation and chemotherapy. (Holly and Stephanie, 2018).

IMPORTANCE OF LATE MARRIAGE

Waiting to start a family can have some benefits. You will have more time to save money,

establish your relationship and financially secure the child. Age can bring wisdom and

patience, and there is evidence that children born to older parents achieve higher levels of

20
education. A study 2018, suggested that women who gave birth to their last or only child at

age 40 or older have a lower risk of uterine cancer. (Holly and Stephanie, 2018)

IMPORTANCE OF EARLY CHILD-BEARING

Being a young mother has more benefit to the baby's health. Getting pregnant at late 20s or

early 30s reduces a woman chance of having a pregnancy complication (Holly and Stephanie,

2018).

COMPLICATIONS OF LATE PREGNANCY

Starting at age 35, these pregnancy risks become more common like:

 Gestational diabetes

 High blood pressure

 Pre-eclampsia

 Placenta previa

 Miscarriage

 Premature birth/still birth

 Post-partum hemorrhage

 Infant low birth weight

 Need for cesarean delivery

 Chromosomal abnormality e.g. Down syndrome (Holly and Stephanie, 2018).

CONSULTATION FOR FERTILITY PURPOSE

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Holly and Stephanie (2018), fertility issues are very common, more than 12% of women have

difficulties in getting pregnant. A fertility specialist can conduct certain test’s to see why you

are not conceiving and offer treatment to improve your health. If you have not been able to get

pregnant see a fertility specialist if:

 You are 35years or younger and have been trying to get pregnant for a year.

 You are over age 35 and you have been trying for more than 6months.

 You are over age 40 and you did like to start a family.

 The treatment depends on the cause of your fertility issue, age, preference. Options

includes

 Fertility drugs to stimulate Ovulation.

 Surgery to fix uterine condition e.g. fibroid blocked fallopian tubes.

 Intrauterine insemination, where sperm is placed directly into the uterus during

ovulation.

 In-vitro fertilization, where sperm and ova are placed together in a lab until they form

which is then implanted into the uterus.

 Zygote intrafallopian transfer and gamete intrafallopian transfer, where sperm and ova

or fertilized ova is placed in you fallopian tube.

TIPS FOR CONCEPTIONS

If you are ready to start trying for a baby, here are few things you can do to help make

Parenthood a reality:

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  Get to a healthy weight: being over or underweight can affect the ability to ovulate. An

ideal body mass index is between 19-24.

 Quit smoking; smoking can damage eggs and make a woman more likely to

miscarriage if pregnant.

 Watch for diet; Eating a high fat diet can contribute to weight gain and disrupt

reproductive cycle.

 Take good care of your body, don't drink alcohol, follow a healthy eating pattern,

exercise often and get enough rest and sleep.

 Treat any conditions that could make pregnancy risky e.g. high blood pressure and

diabetes.

 See your obstetrician for preconception visit to make sure you are healthy enough to

get pregnant. Keep up scheduled visit as this will let your doctor monitor you and your

baby's health and address any problem that arises. (Holly and Stephanie, 2018).

UTILIZATION OF HEALTHCARE FACILITY

Health care utilization has been defined by Awoyemi et al (2018), as the use of health care

services by the people. The choice of health care facility among people may vary from person

to person and from place to place depending on various factors predisposed to users.

FACTORS INFLUENCING THE UTILIZATION OF HEALTHCARE FACILITIES

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INDIVIDUAL FACTORS: - these are personal characteristics that influence once decision

and ability to utilize preventive and curative care. Individual factors include:

 PREDISPOSING FACTORS: such as demographic, position within the social

structure and beliefs of health service benefits. Gender, age, marital status,

employment, educational status, family size, ethnicity, attitude towards health and

length of time in the community are examples of such factors. A work carried out in

Kogi State also revealed that household size, distance and total cost of seeking health

affect the utilization of government and private hospitals of both urban and rural

resident. (Awoyemi et al, 2018).

 ENABLING OR IMPENDING FACTORS; such as family and community resources,

family income, motivational benefits, free health care, health insurance status (private,

social and public coverage), occupation, 3rd party influence, basic needs met and

access to source of regular care. Demographic and Health Survey (2018), majority of

men and women have no health insurance coverage (97, 98 and 90 respectively) these

means they pay for health care from their pocket.(W.H.O, 2022)

 NEED FACTORS: such as perceived need and clinically evaluated needs, types of

illness, self-reported number of symptoms, self-perceived health status, number of bed

days, restricted activities, and expected outcome of treatment and activities of daily

living are part of patient’s perceived need of healthcare. (Rubinstein et al 2017).

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HEALTH SYSTEM RELATED FACTORS: - These factors are responsible for the utilization

of health services from the perspective of service provider, at the level of healthcare facility.

The factors include: - health policy, resources and organization.

ACCESSABILITY FACTOR: - Accessibility of health service to the user population was

identified as a crucial factor in the patronage of facilities (Green, 2014). For instance Adavi-

Eba a case study in Kogi state shows that the ratio of household within 10km of a health

center or clinic is 50% higher in urban area compared to rural areas (Onwe, 2017).

AVAILABLE FACTORS: - Availability of modern equipment and materials especially in

public facilities, availability of qualified health staff professional personal, information about

patient health, average cost of service and use of alternative method of treatment.

QUALITY RELATED FACTORS: - Reputation of health facility, cleanliness, tidiness,

internal organization and procedure, staff courtesy and friendliness. The healthcare utilization

of a population has been shown to be related to the availability, quality and cost service, social

economic structure, and personal characteristic of the users. (Sajid & Baig, 2019).

Other studies carried out have shown that utilization of health care facilities is influenced by

physical, social economic, psychological as well as organization factors. These include

proximity, affordability, staff attitude, availability of equipment and qualified personnel’s

(Little et al 2017).

THEORETICAL FRAMEWORK

The Andersen healthcare utilization model is aimed at demonstrating the factors that lead to

the use of health services. According to the model, usage of health services (including

25
inpatient care, physician visits, dental care etc.) is determined by three dynamics: predisposing

factors, enabling factors, and need.

Environment Population characteristics Health behavior Outcomes

Healthcare Perceived health

system Personal health status
practices
Evaluated health
Predisposing Enabling Need status
External characteristics resources Use of health
environment services
Consumer
THE ANDERSEN MODEL OF HEALTHCARE UTILIZATION satisfaction

An individual's access to and use of healthcare facilities is considered to be a function of 3

characteristics.

1. Predisposing factors: the social-cultural characteristics of individuals that exists prior

to their illness.

 Social structure: Education, Occupation, Ethnicity, Social network, Social

interactions and Culture.

 Health belief: Attitudes, values and knowledge that people have concerning and

towards the healthcare system.

 Demographic: Age and gender

2. Enabling factors: the logistics aspects of obtaining care

 Personal/family: The means and know how to access health services, income,

health insurance, a regular source of care, extent and quality of social relationships.

26
  Community: Available healthcare personnel and facilities and also waiting time.

3. Need factors: The most immediate cause of health facilities use, from functional and

health problems that generate the needs for healthcare services. " Perceived need will

help to understand care seeking and adherence to medical regimen, while evaluated

need will be more closely related to the kind and amount of treatment that will be

provided after a patient has presented to a medical care provider."

 Perceived: "How people view their own general health and functional state, as well

as how they experience symptoms of illness, pain and worries about their health

and whether or not they judge their problems to be of sufficient importance and

magnitude to seek professional help."

 Evaluated: “Represents professional judgment about people's health status and

their need for medical care."

APPLICATION OF THE THEORY TO THIS RESEARCH

PREDISPOSING FACTORS: The socio-cultural characteristics of individuals affect their

utilization of healthcare facilities, social structures such as education, occupation, ethnicity,

social networks and social interactions also determine the utilization of healthcare facilities.

Individuals that have appropriate level of education and a very good social interaction with

others will enhance their learning and awareness on the importance of utilization of healthcare

facilities. In an organization where there is health insurance scheme for their workers will

reduces their healthcare services expenses and encourage the workers to utilize healthcare

27
facilities. The tribe of an individual also affects the utilization of healthcare facilities as some

tribes believe in traditional healers. Individual’s health belief, attitude, values and knowledge

that they have towards healthcare system plays a key role on them on the utilization of

healthcare facilities. Demographic factors such as age and gender of individual affect their

utilization of healthcare facilities

ENABLING FACTORS: The means and income of a family, health insurance, a regular

source of care and quality of social relationships can facilitates or impede the utilization of

healthcare facilities. If a family have adequate source of income they will be able to meet up

with the financial aspect of utilizing health care facility when needed, if there is health

insurance scheme for individuals and the quality of social relationships is good the utilization

of healthcare facilities will be sound. In the community availability of healthcare personnel

and facilities will improve their utilization of healthcare facilities and also if the waiting time

at the facilities is delayed this can discourage people of the community from accessing

healthcare facilities.

NEED FACTORS: The need factors talks about “perceived need" and “evaluating need."

Perceived need: Is how a patient views herself if she is in need of healthcare facilities or not.

If the patient feels it's appropriate to seek for treatment she will definitely utilize the

healthcare facility but if she feels she is not in need of medical treatment she would not seek

or utilize healthcare system.

EVALUATED NEED: it is the medical treatment given after evaluating a patient’s medical

needs or after a patient has presented her needs to a healthcare provider.

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EMPIRICAL FRAMEWORK

Yarozever & Seid (2016) conducted a descriptive study on factors that causes underutilization

of healthcare facility and its shows that Nigeria indicates low utilization of public health

facilities by rural residents, 44% of respondents who were ill in the preceding 6months visited

a PHC facility for treatment. While others relied oneself-medications & self-treatment, only

15.6% of the sub urban respondents delivered in the government hospitals, Nwosu et al

(2020), 51.4% of rural dwellers utilizes health facilities and it programs for maternal care,

42.5% of rural dwellers utilizes healthcare facilities in a study, healthcare access and

utilization among rural households in Nigeria, (Titusetal, 2015).

A study done in West Africa by Aye et al (2016) on access and utilization of maternal

healthcare did show that in spite of poverty, many rural poor people in Ivory Coast were able

to access expensive modern healthcare services due to availability of social network. The rural

poor were kin to utilize public health services which are provided free of charge. However,

there were perceptions that healthcare facilities offer low quality care with chronic gaps such

as shortages of essential supplies. (Peterson et al, 2019).

Steven cone (2015), conducted a descriptive survey study on healthcare utilization among

rural women of childbearing age studies revealed that accessibility also contributed to the

underutilization of healthcare facilities as some roads in rural areas especially in the riverine

areas still not motor able and this weakens health services distribution to these area difficult.

In private hospitals, the quality of services, there responsiveness and discipline of the provider

has been questionable. A healthy population is an asset of any society, improving the

29
healthcare delivery system will affect choice making in healthcare facility utilization which

will in the long run improve the quality of life of the people in the state and for effective

management of health and health resources

Adeniyi and Morrow (2015), conducted a similar study which revealed that the availability of

equipment is necessary but not sufficient to guarantee performance of related task. The

perception of some nurses to their patients is said to be poor and in most cases is the reason

why some individuals prefer going to the traditional healers instead of hospitals or primary

health care units. Pregnant woman considered (TBA) traditional birth attendant kind, and

friendly, which attracted their attention more than the midwives. Sources remarked that the

attitude of midwives at the maternity home is very poor, discouraging and it does not reflect

their professional training. It is common saying that female nurses are harsh on their client

than male nurses. This view was generally supported by female client base on their personal

experience.

Sule et al (2018), a descriptive survey study on women's perception on quality and utilization

of healthcare facility study has shown that the presence of health facilities alone is not enough

to guarantee their use as other socio economic factor could influence access and thus

utilization, choice of health care providing facility is an important decision that involves the

interplay of several factors. Ordinarily, a person would not use a product that does not meet

his need unless he has no choice. Meeting this needs go beyond the goods and services alone

but also include environmental characteristics.

A similar study was also carried out by Alade (2015), and it was reported that a midwife

scolded at her during labor pain and was telling her to stop disturbing with her screaming

30
since she wasn’t there with them while they were doing it". This practically demonstrated the

insensitivity on the part of the midwives to the plight of her client. The nurses owe

responsibility of creating a therapeutic environment whatever the case maybe. This implies

that, a cordial relationship should exist between you and the patient. This enhances the

confidence of the patient /client in the use of healthcare facilities.

Green (2014), carried out a cross sectional descriptive survey study on causes of low

patronage of public health facilities in Africa, shows that in some rural communities, some

countries public health care facilities are free, they do suffer from some essential drug

shortages, while moderate payment is required at the private dispensaries, and therefore it

seems patients expects more from the service.

A similar study by Abdul Azeez (2018), however, demonstrated that custom and traditions of

the people sometimes dictate their choice in terms of the means by which they seek for

solution whereby expanded program on immunization that is free still suffer poor attention

and not been taken serious by the people. He concluded that awareness and level of

civilization of the people often determine the degree at which they utilize the available

healthcare facilities in their locality.

A similar study by Irazola et al (2017), In developed countries public Health facilities include

the national and provisional ministries as well as the network of public hospitals and primary

health care centers which provide care to poor and uninsured persons. It is mainly financed by

taxes. Health care in uninsured individuals relies solely on the public network of health care

31
centers and hospitals. The use of public and private hospitals did not differ significantly

between urban and rural areas overall, for either sex.

CHAPTER THREE

RESEARCH METHODOLOGY

This chapter discusses the method that will be employed in conducting and analyzing the data

of this research under the following headings: Study design, setting/area of study, target

population, sample size determination, sample and sampling techniques, instrument for data

collection, validity of instrument, ethical consideration, reliability of instrument, method of

data collection and method of data analysis.

RESEARCH DESIGN

A cross - sectional descriptive research design was used to assess the utilization of healthcare

facility among women of childbearing age in Oziokutu community Adavi local government,

Kogi State.

RESEARCH SETTING

This study was carried out among women of childbearing age in Oziokutu community Adavi

local government, Kogi State. Adavi Local Government Council of Kogi State was created

32
from Okehi Local Government Area on 27th August, 1991 along with the creation of Kogi

State, it is found in the central part of Kogi State and has Ogaminana as its headquarters. The

council is bounded in the North by Okehi LGA, in the west by Okene Council, in the East by

Lokoja LGA and in the south by Ajaokuta LGA. Ebira is the main language spoken in the area

as the area is predominantly dominated by Ebira people. Many non-indigenes live amongst

them, such as Ibo’s, Igalas, Yorubas, Hausas, etc. (Abatemi, 2017).

TARGET POPULATION

The populations to be used for this study are women of childbearing age (15 - 49) in Oziokutu

community, Adavi local government Kogi State, was found to be 440 Adavi secretariat 2016

census populations.

SAMPLE SIZE DETERMINATION

The Taro Yemen (2018) formula, n= N/ 1+N (e) ²

N = total population, e = sample error (0.05) and n = sample size

n = 440/ 1 + 440 (0.05)²

n = 440/ 1+ 440 (0.0025)

n = 440 / 1 + 1.1

= 440 / 2.1

= 209.52

Therefore, n = 210

SAMPLE TECHNIQUE

33
The sampling technique that was used for this study is convenience sampling technique due to

its ease of implementation and accessibility to the target population

INSTRUMENT FOR DATA COLLECTION

The instrument used in the generation and collection of data is a self-developed questionnaire.

The questionnaire comprises of four (4) sections – sections A, B, C and D.

Section A consists of demographic data such as, age, religion, marital status, educational level.

Section B are questions to elicit information about the respondents level of utilization of

healthcare facilities (item 8-10) and answers will be rated on poor (not at all), moderate

(sometimes) and good (always).

Sections C are questions to elicit information about factors hindering the utilization of

healthcare facility among the respondents

Section D consists of questions that identify measures that will help to enhance the utilization

of healthcare facilities among women of childbearing age in Oziokutu community Adavi local

government of Kogi state.

VALIDITY OF INSTRUMENT

The contents of the questionnaire were carefully prepared to reflect the variable in the

research topic which was submitted to the researcher’s supervisor for content validity.

RELIABILITY OF THE INSTRUMENT

34
The research instrument was subjected to reliability test using pilot study. The questionnaire

was administered and interpreted to 10% of the estimated sample size to 8 respondents in

Nagazi Adavi local government of Kogi State in other to assess the consistency of the

instrument before it is used for study sample.

METHOD OF DATA COLLECTION

The researcher obtained an informed consent form the respondents, thereafter the

questionnaires was distributed to the respondents by the researcher and an explanation was

given on how to fill the questionnaires putting those that are not literate into consideration.

The instruments were collected within 4days as it was shared across to various women in their

child bearing age.

METHOD OF DATA ANALYSIS

Data collected was analyzed using percentage and frequency tables based on the responses to

each item on the questionnaire.

ETHICAL CONSIDERATION

Ethical clearance was obtained from the research committee of Kogi State College of nursing

and midwifery, Obangede to the village chief to grant permission to carry out the research.

The respondents consent was soughted, every necessary information was explained including

the right to participate or withdraw. Confidentiality was assured and they were treated with

utmost respect.

35
 CHAPTER FOUR

This chapter is concerned with the presentation of the result or data collected from the

respondents. Responses from the questionnaires were presented according to the objectives of

the study using frequency and percentage in the table below.

Presentation of data

SECTION A

BIO-DEMOGRAPHIC DATA

Table 4.1

n= 210

S/N Characteristics Variables Frequency Percentage

1 AGE 15-24 35 16.5%

25-34 49 23.3%

35-44 68 32%

45 and above 58 27.6%

2 SEX Male

Female 210 100%

3 MARITAL STATUS Single 50 23.8%

Married 88 41.9%

36
 Divorced 41 19.5%

Widow 31 14.8%

4 ETHNICITY Ebira 90 42.9%

Okun 66 31.4%

Igala 30 14.3%

Others 24 11.4%

5 OCCUPATION Student 65 40%

Civil servant 57 27.1%

Trader 67 31.9%

Housewife 21 10%

6 RELIGION Islam 110 52.4%

Christianity 98 46.7%

Traditionalist 2 1%

7 EDUCATIONAL

BACKGROUND Primary 38 18.2%

Secondary 67 31.9%

Tertiary 82 39%

No formal education 23 10.9%

The table for age distribution above shows that 16.5% of the respondents were within the

range of 15-24 years, 23.3% of the respondents were within the age of 25-34 years, 32% of

the respondents were within the age of 35-44 years while 27.6% were 45 and above. The

greatest percentages of the respondents were within the age range of 35-44 years of age.

37
The table for sex above shows that all the respondents were all females which is 100%

The above table for marital status shows that 23.8% of the respondents were single, 41.9% of

the respondents were married, and 19.5% of the respondents were divorced while 14.8% were

widow.

The table for ethnicity above shows that 42.9% of the respondents are Ebira, 31.4% of the

respondents were Okun, 14.3% were Igala while 11.4% belong to others.

The table for occupation above shows that 40% of the respondents were students, 27% of the

respondents was civil servants, 31.9% of the respondents were traders which were majority

and 10% were housewife.

The table for religion above shows that 52.4% of the respondents were Muslims, 46.7% of the

respondents was Christian’s while 1% of the respondents were traditionalist.

The above table for educational background shows that majority of the respondents 39%

attended tertiary institution, 31.9% of the respondents attended secondary school, 18.2% of

the respondents attended primary school while 10.9% of the respondents don't have any

formal education.

SECTION B

RESPONDENTS LEVEL OF UTILIZATION OF HEALTHCARE FACILITIES

Table 4.2

VARIABLES LEVEL OF UTILIZATION FREQUENCY PERCENTAGE

Not at all Poor 35 16.7

38
Sometimes Moderate 99 47.1

Always Good 77 36.7

From the table above 35(16.7%) of the respondents have poor utilization of healthcare

facilities, 99(47.1%) moderately utilize healthcare facilities while 77(36.7%) have good

utilization of healthcare facilities. This indicates that majority of the respondents have

moderate level of utilization of healthcare facilities.

SECTION C

FACTORS HINDERING THE RESPONDENTS FROM THE UTILIZATION OF

HEALTHCARE FACILITIES

Table 4.3

S/N VARIABLES FREQUENCY PERCENTAGE%

1 Quality of healthcare services provided 69 32.9

2 Proximity to your residence 55 26.2

3 Accessibility of healthcare facilities 84 40

4 Affordability of healthcare services 81 38.6

5 Trust in the healthcare system 49 23.3

6 Lack of privacy and confidentiality 75 35.7

7 Not being addressed by healthcare 65 30.9

providers adequately

8 Feeling judged or stigmatized when 78 37.1

seeking healthcare services related

39
 to reproductive system

The table above shows that 84(40%) of the respondents accessibility to healthcare facility is

one of the primary factors hindering them from utilizing healthcare facility, 81(38.6%)

affordability of healthcare facilities, 78(37.1%) felt judged or stigmatized when seeking

healthcare services related to their reproductive health, 75(35.7%) lack of privacy and

confidentiality, 69(32.9%) quality of healthcare services provided, 65(30.9%) felt not being

adequately addressed by healthcare providers, 55(26.2%) proximity of healthcare facilities to

their residence, while 49(23.3%) trust in the healthcare system

SECTION D

Item 20-25 on the questionnaires focused the respondent’s identification on the preferred

solutions to enhance the utilization of healthcare facilities

Table 4.4

S/N Items frequency Percentage

1 Provision of free healthcare services by the 210 100%

government can improve the utilization of

healthcare facilities?

2 Building of more healthcare facilities in the 210 100%

community for easy access is paramount?

3 Healthcare workers should attend to 210 100%

patient in a friendly and polite manner?

4. There should be construction of good roads 210 100%

40
 and provision of transportation to rural areas

by the government?

5. There should be availability of equipment’s 207 98.6%

and essential drugs to ensure good services

in the healthcare facilities?

6. The public should be enlightened on the importance 210 100%

of health information through mass media?

The above table shows that all the respondents 100% accepted provision of free healthcare

services by the government for the improvement on the utilization of healthcare facilities,

100% of the respondents accepted building of more healthcare facilities in the community for

easy access, all the respondents 100% accepted healthcare workers should always attend to

their patients in a friendly and polite manner, 100% of the respondents agreed to the

construction of good roads and provision of transportation to the rural areas by the

government, 98.9% of the respondents agreed on the availability of equipment’s and essential

drugs to ensure good services in the healthcare facilities and 100% agreed there should be

public enlightenment on the importance of health information through mass media.

CHAPTER FIVE

41
This chapter discusses the key findings to the study, discussion of Findings aligning with

literature from previous studies, it also discusses the implication of finding to nursing,

limitation of study, summary, conclusion, recommendation and suggestions for further studies.

KEY FINDINGS

1. The research revealed that 99(47.1%) of the respondents moderately utilize healthcare

facility.

2. The study reveals that there are several factors hindering the respondents from the

utilization of healthcare facilities in the community.

3. It also shows that all the respondents accept the identify measures for enhancing the

utilization of healthcare facilities.

DISCUSSION OF FINDINGS

LEVEL OF UTILIZATION OF HEALTHCARE FACILITY

The finding from the study shows that the respondents 99(47.1%) have moderate level of

utilization of healthcare facilities this in line with the study of Ayee et al (2016), in West

Africa that inspite of poverty the respondents were able to access expensive modern health

services, it was also affirmed by Nwosu et al (2020), that 42.5% of the respondents utilizes

healthcare facility and it program for material care.

FACTORS HINDERING THE RESPONDENTS FROM UTILIZING HEALTHCARE

FACILITY

42
Findings shows that 84(40%) of the respondents accessibility to healthcare facility is one of

the primary factors hindering them from utilizing healthcare facility, 81(38.6%) affordability

of healthcare facilities, 78(37.1%) felt judged or stigmatized when seeking health care

services related to their reproductive health, 75(35.7%) lack of privacy and confidentiality,

69(32.9%) quality of healthcare services provided, 65(30.9%) felt not being adequately

addressed by healthcare providers, 55(26.2%) proximity of healthcare facilities to their

residence, while 49(23.3%) trust in the healthcare system. Steven cone (2015), conducted a

descriptive survey study on health care utilization among rural women of childbearing age

studies revealed that accessibility also contributed to the underutilization of healthcare

facilities as some roads in rural areas especially in the riverine areas still not motor able and

this weakens health services distribution to these area are difficult. Sule et al (2018), a

descriptive survey study on women's perception on quality and utilization of health care

facility study has shown that the presence of health facilities alone is not enough to guarantee

their use as other socio economic factor could influence access and thus utilization, choice of

healthcare providing facility is an important decision that involves the interplay of several

factors.

SOLUTIONS TO ENHANCE THE UTILIZATION OF HEALTHCARE FACILITY

It was revealed in the study that all the respondents 100% agreed to the identified solutions

proffered by the researcher in the enhancement of healthcare facility utilization.

IMPLICATION OF FINDINGS TO NURSING

43
This research will enable the nurses to know the factors hindering women of child-bearing age

from utilizing healthcare facilities. It provides an avenue for nurse to give appropriate health

talk on the importance of healthcare facilities.

Nurses will embark on adequate sensitization of people to know the importance of healthcare

facilities and to patronize them for solutions to their health problems.

LIMITATION OF STUDY

This research work is limited to Oziokutu community only due to financial constraints,

shortage of time and uncooperative attitude of some of the people who were reluctant in

accepting the questionnaire.

SUMMARY

This study assesses the utilization of healthcare facility among women of child bearing age in

Oziokutu community Adavi Local Government, Kogi State. Chapter one dealt with the

introduction of utilization of healthcare facility, statement of problem, objective of the study,

significance of the study, scope of the study and ends with operational definition of terms.

Chapter two revised literature's in respect to variables in the topic and objective of the study

conceptually, empirically and theoretically.

In chapter three across-sectional descriptive research design was used, the study was carried

out in Oziokutu community with a target population 440 women of child bearing age and a

sample size of 210 using Taro Yemen formula. The instrument of data collection was a self-

developed questionnaire which was validated by matching its contents with the research

44
objectives and research questions. Data collection was done by distributing the 210

questionnaires to the respondents.

Chapter four analyses the data gotten from respondents and it was seen that 47.1% moderately

utilize healthcare facilities, factors hindering the respondents from utilizing healthcare facility

was that healthcare facilities does not adequately addresses their healthcare needs, quality of

healthcare services provided, they are dissatisfied with the level of privacy and confidentiality

provided during interactions with healthcare providers, they felt judged and stigmatized when

seeking healthcare services related to their reproductive health/family planning, proximity of

healthcare facilities to their residence and trust in the healthcare system, these factors militates

the use of healthcare facilities in Oziokutu community Adavi Local Government Kogi State.

Chapter five comprises of discussion of findings, implication of findings to nursing, limitation

of study, summary, conclusion, recommendation and suggestions for further studies and

equally contains references.

CONCLUSIONS

The study assessing the utilization of healthcare facility among women of child bearing age in

Oziokutu community, there is need for improvement towards the factors hindering the

utilization of healthcare facilities among the respondents. Since there are dissatisfaction in

level of privacy and confidentiality, quality of healthcare services provided, stigmatization,

and proximity of healthcare facilities to their residence and finally affordability of healthcare

services are some of the factors hindering the utilization of healthcare facility. Therefore a

45
need for sensitization programmes geared towards increasing their knowledge on the

importance of healthcare facility utilization.

RECOMMENDATIONS

Based on the researcher’s findings, the following conclusions and suggestions were made.

1. Special attention should be directed to community health education and workshop.

This will serve as eye opener for people with low or non-formal education in the area.

2. The government should provide basic infrastructures such as accessible roads, stable

power supply, steady water supply, or good source of water and functional ambulances

to aid utilization of these facilities.

3. Health care providers should improve on the quality of their services to encourage

utilization of the facilities periodic evaluation of the quality of care provided by the

health facilities should be conducted where clients of the facilities are asked to rate the

quality of care.

4. The nursing and medical officers in charge of units should be subjected to special

supervision so as to improve their work relationship with patients or clients.

5. There should be establishment of public health centers in rural areas this will increase

the proximity and accessibility of rural people to public health facilities.

46
 6. There is need for sensitization and re-orientation of health workers at the healthcare

facilities on the need for friendly approach to patients, in order to win their confidence.

7. Religious leaders should be made to understand that they can only solve spiritual

problems and therefore direct people to the hospital after rendering there spiritual

assistance.

8. Government should supply drugs to the hospitals and clinics at subsidized rate, as this

will enhance patronage by the people.

9. Efforts should be put in place to improve the working conditions and irregular salaries

experience by workers, in the public facilities as it will in turn improve job satisfaction

and productivity.

SUGGESTION FOR FURTHER STUDY

Causes of under-utilization of healthcare facility

Effect of distance on the utilization of healthcare facility

47
 REFERENCES

Abodunrin L., Bamidele D., Bello A., & Parakoyi B. (2017). Preferred choice of
healthcare facilities for healthcare among adults. Illori Kwara State Nigeria

Adeniyi J., & Morrow O. (2015). Accessibility of the rural dwellers to healthcare
facilities in Nigeria: the Owo experience. Pakistan J. Social Sci, 83(4):44-55

Aye P., Prosser T., & Alade O. (2016). Utilization of health medical services: factors
influencing healthcare seeking behavior and unmet health needs in rural
areas of Nigeria retrieved from http://ro.ecu.edu.au/theses/46

Awoyemi T., Obayelu A., & Opaluwa. (2018). Effect of distance on utilization of
healthcare services in rural kogi State. Nigeria

Ager A., & Philip K. (2015). Pattern of health service utilization and perception of
needs and service. Rural Orissa

Birungi H., Mugisha F., Nsabagasuni X., & Okuonzi S. (2016). The policy on public-
private mix in the Uganda Health sector

48
Federal Ministry of Health. (2014). Revised national health policy FMOH, Abuja

Green M. (2014). Public reform and the privatization of poverty: some institutional
determinants of health seeking behavior. Southern Tanzania

Holly E., & Stephanie W. (2018). What is the childbearing age? Healthline
https://www.healthine.com/health/womens-health/childbearing

Irazola v., Rubinstein A., & Jahangir E. (2017), need, enabling, predisposing and
behavioral determinants of access to preventive care in Argentina: analysis of
the national survey of risk factors. PLoS ONE 7(9): e45053.
Doi:10.1371/journal.pone.00445053

Little R., Sheahan M., & Leggat S. (2017). Performance reporting for consumers:
issues for the Australian private hospital sector Australian and New Zealand
health policy 4:5 doi: 10.1186/1743-8462-4-5

Omaswa F. (2019). Informal health workers to be encouraged condemned? Bulletin

of the world health organization access from
http://www.who.int/bulletin/volumes/84/2/editorial2020html/en/

Onwe (2017). The innovation health research group: the Nigeria health sector and
human resource challenges. The internet journal of health

Sajid M, Baig K. (2019). Quality of healthcare: an absolute necessity for public

satisfaction. International journal of healthcare quality assurance

Syam O., Sam D., & Peterson. (2021). Health care facilities functions, determinants of
health accessed from www.who.int/hia/evidence/doh/en/index/html

Sule S., Ijadunola k., Onyade A., Fatusi O., Soetan R., & Conell F. (2018). Utilization of
primary healthcare facilities: lessons from a rural community in southwest
Nigeria; 17(1):98-106

World health organization (2022) World health statistics. Retrieved from

www.who.int/entity/gho/publications/worldhealth-
Statistics/2022/en/index/html

Zwi A. Private healthcare in developing countries Br Med J, 2001; 323; 4646466

49
 QUESTIONNAIRE

Kogi State College of Nursing and

Midwifery Obangede,

P.M.B. 1030,

Okehi Local Government Area,

Kogi State.

Dear respondents,

I am a final year student of the above mentioned institution conducting a research on

‘Assessment of the Utilization of Healthcare Facility among Women of Childbearing Age in

Oziokutu Community, Adavi Local Government Kogi State’.

50
I hereby solicit your cooperation to give appropriate answers to the questions below as it will

be of great benefit to the community members and the information provided will be strictly

kept confidential.

Yours faithfully,

Usman Raheemat Ozohu (student nurse)

SECTION A

PERSONAL DATA

INSTRUCTION: Please tick (✓) in the space provided

1. Age in years: 15-24 ( ) 23-34 ( ) 35-44 ( ) 45& above( )

2. Marital status: Married ( ) Single ( ) Divorce ( ) Widow ( )

3. Ethnicity: Ebira ( ) Okun ( ) Igala ( ) Others ( )

4. Sex: Male ( ) Female ( )

5. Occupation: Civil servant ( ) Student ( ) Trader ( ) Housewife ( )

6. Religion: Islam ( ) Christianity ( ) Traditionalist ( )

7. Educational status: Primary ( ) Secondary ( ) Tertiary ( )

No formal education ( )

SECTION B

LEVEL OF UTILIZATION OF HEALTHCARE FACILITIES AMONG THE

RESPONDENTS.

51
INSTRUCTIONS: Please tick (✓) appropriately against the given health conditions how you

could classify your visit to the health care facility

S/N ITEMS Not at all Sometimes Always

8. Minor ailments such as headache, back pain,

nasal congestion and nose bleed

9. Moderate aliments such as; fever, typhoid,

cough and injuries

10. Severe aliments/ healthcare conditions such as

delivery and its complications

SECTION C

FACTORS THAT HINDERS THE UTILIZATION OF HEALTHCARE FACILITIES

INSTRUCTION: please tick (✓) appropriately the primary factor that influences your

decision to utilize healthcare facilities? (Select all that applies)

11. Proximity to your residence ( )

12. Quality of healthcare services provided ( )

13. Accessibility of healthcare facilities ( )

14. Affordability of healthcare services ( )

15. Trust in the healthcare system ( )

16. Lack of privacy and confidentiality ( )

52
 17. Not being addressed by healthcare providers adequately ( )

18. Ever felt judged or stigmatized when seeking healthcare services related to

reproductive health/family planning ( )

SECTION D

IDENTIFY THE MEASURES THAT ENHANCES UTILIZATION OF HEALTHCARE

FACILITIES.

Tick (✓) the appropriately

S/N ITEMS YES NO

19 Provision of free healthcare services by the government can improve the

utilization of health care facilities?

20 Building of more healthcare facilities in the community for easy access is

paramount?

21 Healthcare workers should attend to patient in a friendly and polite

manner?

22 There should be construction of good roads and provision of transportation

to rural areas by the government?

23 There should be availability of equipment’s and essential drugs to ensure

good services in the healthcare facilities?

24 The public should be enlightened on the importance of health information

through mass media?

53
54