Socio – economic Factors Influencing Utilization of Healthcare Services in Sokoto, North-Western Nigeria

Abstract

The objective of equity in health care system is “equal access for equal needs” and there should be no barriers to healthcare utilization. The objective of the study was to assess the socio – economic factors influencing utilization of healthcare services in Sokoto, Northern Nigeria. A descriptive cross – sectional study among 360 randomly selected (using multi – stage sampling technique) household heads in Sokoto, Nigeria was conducted in August 2015. Informed consent was obtained and information was collected using a pre – tested semi – structured interviewer administered questionnaire. Data was cleaned, manually entered and analysed using SPSS statistics version 22. Most of the households 221 (61.4%) belonged to upper social class (class I – III) and 139 (38.6%) belonged to lower social class (class IV – V). Majority of the households 337 (93.6%) paid for their healthcare through user – fees out – of – pocket payment (OOPP). About half of those that were ill suffered from Malaria and PMDs were the most visited for healthcare. Social class, user – fees and educational status were the three predictors of utilization of healthcare services at the health facilities as households in the lower social class were 2 times the odds to find it difficult in paying for the services utilized at the health facilities (OR = 2.20, p = 0.003, 95% CI [1.31 – 3.77]). Similarly, households that paid for healthcare with user – fees were 8 times the odds to find it difficult in paying for the services utilized at the health facility (OR = 8.02, p = 0.045, 95% CI [1.05 – 61.17]) and households with informal education were 2 times the odds to find it difficult in paying for the services utilized at the health facility (OR = 2.23, p = 0.008, 95% CI [1.24 – 4.16]). Free healthcare services, increased coverage of pre – payment options (NHIS, CBHIS), regulations of PMDs and creation of more job opportunities to address unemployment thereby upholding the social class of the citizens of Nigeria were suggested.