SOCIOCULTURAL FACTORS AFFECTING UTILIZATION OF HEALTH CARE SERVICES IN ESSIEN UDIM LOCAL GOVERNMENT AREA, AKWA IBOM STATE, NIGERIA

TABLES OF CONTENTS
Title page
Certification
Declaration
Acknowledgement
Abstract
Table of contents
List of tables
List of figure
List of abbreviation



INTRODUCTION
1.1     Background of the Study
Good health is essential to socio-economic development given that it enables people to participate in economic, social and political development. Good health is a vital indicator of quality of life and a major contributor to human capital. Health is a state of complete physical, mental and social wellbeing of an individual not merely the absence of disease or infirmity (WHO, 2000). The overriding importance of an effective health care delivery system is understood as it represents one of the drivers of development sound Health of the citizenry ensures greater human development. The wealth of any country can be measured by the inhabitants’ health status.
Health status of members of the society can be seen as part of an interrated set of conditions which has to do with one’s capacity to adjust to the immediate environment and to utilize it to the optimum advantage. Health care services are known to be provided, at different levels by different agencies and specialists.
Nigerian government taken care of healthcare services at the federal, state and local government. These healthcare services are also supported by organizations, and private individuals, who established and own private medical services. Addressing health issues in rural communities has been prioritize  in policy agenda in most developing nations primary health care delivery system has been implemented  in Nigeria. “ Primary, Health care delivery services is an essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community can afford to maintain at every stage of their development in the spirit of self determination” (Ekwuruke, 2005:1).  The affirmation by the Alma-Ata declaration of 1978 by World Health Assembly (WHA) states the access fundamental right and responsibility of all.
However, after over three decades, the reality is that many, particularly in rural  areas are still not adequately utilizing basic healthcare services (Jegede, 20002) . the challenges of utilizing bare healthcare services in Essien Udim local government area, a rural area in Akwa Ibom State are essential problems to sustainable health care. The larger percentage of illness and diseases putting burden on Essien  Udim rural populace and other places in centred around the utilization of primary health care services.
Jegede (2002), observes that various governments in Nigeria have tried to take health facilities to the rural areas in its health care delivery system. However, inadequate utilization of healthcare services in rural villages such as Essien Udim has highly contributed to the increase in mortality r ate amongst children and pregnant women. United Nations population fund (UNPF) 2005 states that there is higher tendency for a child born in a developing country to die within the early age mostly before five years than those born in the developed countries even when the diseases leading to these deaths are preventable through vaccinations and basic health services.
The issue of non-utilization of health care services in rural areas is critical setback to the health status of rural dwellers. According to United Nations Development  Programme (UNDP, 2005) thirty thousand children die each day in rural areas from diseases t hat are preventable, more than five hundred thousand women die during child birth and complications in pregnancy over one million under five years old children die of malaria every year, approximately twenty million people have died of HIV/AIDs while over thrity eight million are living with the disease eight million people develop active tuberculosis. Elaborating further, Lawal (2009) asserts that the non utilization of health care services in rural areas may not be disassociated from socio-cultural factors. The factors affecting health care  are varied and far reaching. Having high quality accessible health care and utilization is important. Lawal (2009) argues that socio-cultural factors are important to consider when it comes to proper health care services.
Although efforts have been made to ensure availability of health care services in rural area there seem to be little positive results in the area of utilization. This is traceable to socio-cultural factors like cultural belief.
Educational status
Marital status
Employment rate and religious affiliations.
Based on this reason, the researcher was motivated to find out if utilization of health care services in Essien Udim Local Government Area of Akwa Ibom State is influenced by socio-cultural factors.
1.2     Statement of Problem
The basic health care services utilization rate in our rural areas has been recent times passed a serious concern to medical sociologists and health policy makers health care delivery institutions appear less patronized by rural dwellers, this may perhaps explain the high maternal and infant mortality rate, high fertility rate and increase in sexually transmitted infections in rural areas (UNDP, 2005).
Health care services has undergone a lot of transformation in order to improve  health care utilization. There have been policies to make health care services in rural areas accessible and affordable through various agencies such as primary health care services. Efforts have been made to promote healthy behaviour to help mobilize communities for action on health related issues and to target outreach communities for health service. Also, measures such as free pre-natal and neo-natal care have been put in place. Equally, enlightenment programme and health education have been provide (Anam & Antai, 2010).
Practically, primary health care system has been setup in the local government area for easy access and affordability to individuals and families with their full participation and the overall goals is to render basic health care services to all in the rural areas. Regrettably, despite all these ongoing efforts the health of rural dwellers in Essien Udim Local Government area appears not to have improved over the years. Observations revealed inadequate access and utilization of health care services from available health care facilities by the people. This, perhaps accounts for the noticeable healthcare problems such as increase ion maternal and child morbidity rate, ravaging pandemics of HIV/AIDS, Malaria and other life threatening diseases such as undiagnosed hypertension which may result in unconsciousness and death may be inevitable.
It is in response to this situation that the researcher was motivated to identify socio-cultural variables that may be relevant in explaining the utilization of health care services in Essien Udim Local Government Area. The issue is; to what extent is utilization of health care services influence by cultural belief, marital status, educational status and religious affiliations?
1.3     RESEARCH QUESTIONS
The following research questions were used to guide the study:
  1. To what extent does cultural belief influence utilization of health care services in Essien Udim Local Government Area?
  2. What influence has marital status of the utilization of health care services in Essien Udim Local Government Area of Akwa Ibom State?
  • How does educational status influence utilization of health care services in Essien Udim Local Government Area of Akwa Ibom State?
  1. How does religious affiliation influence utilization of health care services in Essien Udim Local Government of Akwa Ibom State?

1.4     Objectives of the Study
The purpose of this study is to determine the socio-cultural factors that influence the utilization of health care services in Essien Udim Local Government Area. Specific objectives includes:
  1. To determine the relationship between cultural belief and utilization of health care services in Essien Udim Local Government Area.
  2. To find out if marital status has any influence on utilization of health care services.
  3. To find out if educational status has any influence on utilization of health care services in Essien Udim Local Government Area of Akwa Ibom State.
  4. To find out if religious affiliation has influence on utilization of health care services in Essien Udim Local Government Area.

1.5     Statement of Hypotheses
The following hypotheses were formulated to guide the study:
  1. Cultural belief has no relationship with utilization of health care services in Essien Udim Local Government of Akwa Ibom State.
  2. Marital status does not exert any influence on the utilization of health care services.
  3. Educational status of the people has no influence on utilization of health care services in Essien Udim Local Government Area of Akwa Ibom State in Nigeria.
  4. There is no influence of religious affiliations on the utilization of health care services in Essien Udim of Akwa Ibom State.

1.6     Significance of the Study
The findings of this study will be of great benefit to government, health care providers, medical sociologists and researchers. To government, it will help them be aware of factors that influence the utilization of health care services and work out modalities to ensure the promotion of good health amongst rural dwellers. To health care providers, the findings will help them to consider the views and belief system of the people while rendering health care services to the people.
To medical, sociologists, the study is likely to help them identify the barriers to utilization of health care services by rural dwellers. In other words, the influence of factors such as cultural belief, educational status, marital status and religious affiliations on the utilization of health care services will be understood. This will make room for recommendations to the authorities concern. They will also realize that the health of rural dwellers in developing countries is challenged by socio-cultural factors and proper solutions to them as social scientists. To the public, it will eliminate and promote health consciousness in them. Finally, the findings of this study will add to the body of already existing literature.

1.7     Operational definition of terms
Socio-Cultural Factors: These refers to the social and cultural variables that influence health care utilization and they are:
  • Cultural belief: Refers to the practice of using herbs, performing sacrifices and patronizing traditional medical practitioners for treatment of ailment instead of western medical practitioners.
  • Educational status: It is repeated to level of knowledge acquired that may promote the desire or willingness to use health care services
  • Marital status: it is used in the study to refer to married or unmarried people who constitute the population of study
  • Religious affiliation: It refers to one’s religious belief Christianity, Islam or African traditional practice that may influence an individual’s decision on health care issues.
Utilization of Health Care Services
This refers to the ability of the rural populace to use health care services during ill-health
  • Health care services: They are facilities provided by government to care for the sick or well in order to promote wellbeing of the people.
  • Health Care Delivery: Implementation of care to the rural dwellers or rendering health care to rural dwellers.





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