SPATIAL VARIATION IN MATERNAL HEALTH-SEEKING BEHAVIOUR IN IBARAPA REGION, OYO STATE, NIGERIA

Abstract

Maternal health seeking behaviour is influenced by availability and access to health-care facilities. Previous studies on maternal health-seeking behaviour have focused on the effects of the cost of services, accessibiity, availability and the utilisation with little or no attempt to investigate the spatial dimensions. This study therefore, was designed to investigate spatial variation in health-seeking behaviour of women of child bearing age in Ibarapa Region, a rural district in Oyo State with a view to improving the provision and accessibility of maternal health facilities.

Anderson model and Attitude, Social Influence and Self Efficacy model provided the framework while a survey design was adopted. A structured questionnaire which focused on demographic and socio-economic characteristics (age, monthly income, and educational qualification), spatial variation and barriers in the utilisation of Maternal Health care Services (MHS) was administered at the maternity centres on randomly selected consenting women of child bearing age in Ibarapa East 227, in Ibarapa Central 239 and in Ibarapa North 241 Local Government Areas. Also, one tertiary, three secondary and five primary health care facilities were purposively selected. Descriptive statistics, Nearest Neighbour Analysis (Rn), Analysis of variance, Stepwise multiple regression and Logistic regression were used to analyse quantitative data at p≤0.05 while qualitative data collected through fifteen in-depth interviews (IDIs) and six key informant interviews (KIIs) were content analysed.

Respondents’ age was 26.8±5.3years. Over 85.0% earned less than ₦20,000 per month while 34.4% had secondary education. Over 98% had knowledge of (MHS). This varied from 32.0% in Ibarapa East, 32.8% in Ibarapa North and 33.5% in Ibarapa Central. Eighty per cent had preference for utilisation of orthodox facilities and this varied from 23.3% in Ibarapa East, 26.3% in Ibarapa North and 30.4% in Ibarapa Central. Whereas, 20.0% had preference for non-orthodox MHS. Over 58.0% of the women indicated that distance to nearest MHS was less than 5km, attitude of health workers (62.0%), physical accessibility (49.5%) and location of facility (31.1%), were barriers to utilization of MHS. The distribution of health care facilities in Ibarapa Region was clustered (Rn=0.451). There were significant differences in the utilisation of MHS by women of child bearing age F(29, 677)=2.424. Utilisation of MHS was influenced by cultural beliefs (acceptance or rejection of MHS) in Ibarapa Central (β=0.279), marital status in Ibarapa North (β=0.115) and cultural beliefs, wife’s ethnicity and education in Ibarapa East (β=0.121). Facility accessibility (OR:4.386;CI:1.446-13.297), quality of service (OR:0.360;CI:0.144-0.898) and belief system (OR:0.245; CI:0.102-0.587) were significant barriers to the utilisation of MHS. Non-challant attitude of nurses and inadequate health professionals in government hospitals, unkempt environment of traditional birth attendants and inability of the health workers to handle complications during delivery were the perceived major challenges to maternal health seeking behavior in Ibarapa Region.

Maternal health seeking behaviour varied among child bearing women in Ibarapa Region due to the clustered nature of health care facilities. There is the need to mainstream improved provision and utilisation of maternal healthcare services in the region.

Keywords: Maternal health-seeking behavior, Health care facilities, Ibarapa Region, Nigeria Word count: 489