Determinants of Choice of Health Care Services Among Pregnant Women in Etche Local Government Area of River State
Chapter One
Purpose of the Study
The primary purpose of this study is to investigate the determinants influencing the choice of healthcare services among pregnant women in Etche Local Government Area of Rivers State, Nigeria. The specific objectives are:
- To identify the socio-economic factors influencing the choice of healthcare services among pregnant women.
- To assess the influence of cultural beliefs and practices on the utilization of healthcare services during pregnancy.
- To examine the impact of healthcare infrastructure and accessibility on pregnant women’s choice of healthcare services.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Review
Healthcare Service Utilization
Healthcare service utilization during pregnancy encompasses the use of various healthcare services by pregnant women to ensure their well-being and that of their unborn child. It involves accessing prenatal care, delivery services, postnatal care, and other medical interventions aimed at promoting a healthy pregnancy and childbirth experience (Babalola & Adesegun, 2019). Several factors influence healthcare service utilization among pregnant women, including socio-economic status, cultural beliefs, and healthcare infrastructure.
Socioeconomic status plays a significant role in determining the extent of healthcare service utilization during pregnancy. Research has shown that women from higher socio-economic backgrounds tend to access healthcare services more frequently and at earlier stages of pregnancy compared to those from lower socio-economic strata (Ikeako et al., 2020). Factors such as income level, education, employment status, and access to health insurance can influence a woman’s ability to afford and access quality maternal healthcare services.
Cultural beliefs and practices also impact healthcare service utilization among pregnant women. Cultural norms, traditions, and beliefs related to pregnancy, childbirth, and healthcare can either facilitate or hinder women’s engagement with healthcare services (Akowuah & Danquah, 2019). For instance, certain cultures may encourage women to seek traditional healing methods or rely on family members for pregnancy-related advice, which can delay or deter them from accessing formal healthcare services.
Furthermore, healthcare infrastructure plays a crucial role in determining the availability, accessibility, and quality of healthcare services for pregnant women. Inadequate healthcare infrastructure, including limited healthcare facilities, shortage of skilled healthcare providers, lack of essential medical equipment and supplies, and poor transportation systems, can hinder pregnant women’s access to timely and appropriate healthcare services (Hazemba & Siziya, year). Rural areas like Etche LGA often face challenges in healthcare infrastructure, exacerbating the barriers to healthcare service utilization among pregnant women.
The interaction of these factors underscores the complex nature of healthcare service utilization during pregnancy. Women from lower socio-economic backgrounds or marginalized communities with strong cultural beliefs may face multiple barriers to accessing healthcare services, leading to disparities in maternal and child health outcomes. Understanding these factors and their interplay is essential for designing targeted interventions and policies that address the specific needs and challenges faced by pregnant women in rural areas like Etche LGA (Gopal et al., 2020).
Efforts to improve healthcare service utilization during pregnancy should focus on addressing socio-economic inequalities, promoting culturally sensitive healthcare practices, and strengthening healthcare infrastructure in underserved areas. Community-based interventions, health education programs, and collaborations between healthcare providers, policymakers, and local communities can contribute to overcoming barriers and improving access to maternal healthcare services for all women, regardless of their socio-economic status or cultural background.
CHAPTER THREE
RESEARCH METHODOLOGY
Research Design
The research design employed for this study was a quantitative cross-sectional survey design (Saunders et al., 2019). This design allowed for the collection of data at a single point in time from a large sample of pregnant women in Etche Local Government Area (LGA) of Rivers State, Nigeria. It facilitated the investigation of various factors influencing the choice of healthcare services among pregnant women, providing a snapshot of their attitudes, beliefs, and experiences related to maternal healthcare.
Area of Study
The study focused specifically on Etche Local Government Area (LGA) of Rivers State, Nigeria, as the area of study. Etche LGA represents a rural area with distinct socio-economic and cultural characteristics that may influence pregnant women’s decisions regarding healthcare service utilization during pregnancy.
Population of the Study
The target population for this study included pregnant women residing in Etche LGA who were accessing or had accessed healthcare services during their pregnancy. This population encompassed women from diverse socio-economic backgrounds, cultural beliefs, and geographical locations within Etche LGA. A target population of 1200 respondents was adopted for this study.
CHAPTER FOUR
DATA PRESENTATION, ANALYSIS AND DISCUSSION OF FINDINGS
Data Presentation
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary of Findings
The study focused on investigating the determinants influencing pregnant women’s healthcare service choices in Etche LGA, highlighting various socio-economic, cultural, and infrastructural factors that impact decision-making during pregnancy. The findings offer valuable insights into the complex dynamics shaping women’s preferences and utilization of maternal healthcare services in the region.
One of the key findings of the study relates to the significant relationship between socio-economic status and healthcare service preferences among pregnant women. The analysis revealed a strong association, indicating that the financial capabilities of women play a crucial role in determining where they seek healthcare services. Women with higher socio-economic status are more likely to access better-quality care or opt for private healthcare facilities, reflecting their enhanced resources and choices. Conversely, those with lower socio-economic status may face barriers such as financial constraints, limiting their options and access to quality care. This finding underscores the importance of addressing socio-economic disparities in healthcare access to ensure equitable service provision for all pregnant women, regardless of their economic background.
Cultural beliefs and practices emerged as another significant determinant influencing healthcare utilization among pregnant women in Etche LGA. The study highlighted a substantial relationship between cultural factors and healthcare service preferences, indicating that women’s cultural norms, beliefs, and practices significantly shape their perceptions and decision-making regarding pregnancy-related care. For instance, traditional birthing practices, cultural preferences for specific healthcare providers or types of care, and beliefs surrounding pregnancy and childbirth can influence where women seek antenatal and delivery services. Recognizing and understanding these cultural nuances is crucial for healthcare providers to deliver culturally sensitive and appropriate care that aligns with women’s values and preferences.
Furthermore, the study emphasized the critical role of healthcare infrastructure and accessibility in determining pregnant women’s service choices during pregnancy. The findings revealed a significant association between infrastructure/accessibility and healthcare service preferences, indicating that the availability, proximity, and quality of healthcare facilities influence women’s decisions regarding where to seek care. Factors such as the distance to facilities, transportation options, and the quality of services offered play a vital role in shaping accessibility and utilization patterns. Improving healthcare infrastructure, enhancing service quality, and addressing geographical barriers are essential strategies to enhance access to maternal health services, particularly in underserved or remote areas like Etche LGA.
Overall, the study’s findings underscore the multifaceted nature of factors influencing pregnant women’s healthcare service choices. Addressing disparities and improving access to maternal healthcare requires a comprehensive approach that considers socio-economic, cultural, and infrastructural determinants. Collaborative efforts between policymakers, healthcare providers, community stakeholders, and relevant organizations are crucial to developing and implementing context-specific interventions that promote equitable access, improve service quality, and enhance maternal health outcomes in Etche LGA. By addressing these determinants holistically, stakeholders can contribute to the well-being of pregnant women, improve pregnancy outcomes, and support overall maternal and child health in the region.
Conclusion
Based on the results obtained from the hypotheses tested in this study using one-sample t-tests, several conclusions can be drawn regarding the determinants influencing pregnant women’s healthcare service choices in Etche LGA.
Firstly, the hypothesis testing revealed a significant relationship between the socio-economic status of pregnant women and their choice of healthcare services. The findings indicated that socio-economic factors such as income, education level, and employment status significantly influence where women seek maternal healthcare services. This highlights the importance of addressing socio-economic disparities to ensure equitable access to quality healthcare services for all pregnant women, regardless of their financial background.
Secondly, cultural beliefs and practices were found to have a significant impact on the utilization of healthcare services among pregnant women in the study area. Cultural norms, preferences, and beliefs surrounding pregnancy and childbirth play a crucial role in shaping women’s perceptions and decision-making regarding healthcare. Recognizing and understanding these cultural factors is essential for healthcare providers to deliver culturally sensitive and effective care that meets women’s needs and preferences.
Lastly, the study revealed that healthcare infrastructure and accessibility significantly influence pregnant women’s choice of healthcare services during pregnancy. Factors such as the availability, proximity, and quality of healthcare facilities impact women’s decisions on where to seek antenatal and delivery care. Improving healthcare infrastructure, enhancing service quality, and addressing geographical barriers are essential steps to enhance access to maternal health services and improve maternal health outcomes in the region.
In conclusion, the findings highlight the multidimensional nature of factors influencing pregnant women’s healthcare service choices in Etche LGA. Addressing socio-economic disparities, understanding cultural contexts, and improving healthcare infrastructure are key strategies to promote equitable access to maternal healthcare and support positive pregnancy outcomes. Collaborative efforts involving policymakers, healthcare providers, communities, and relevant stakeholders are crucial in implementing effective interventions that address these determinants and improve maternal health services in the region.
Recommendations
Based on the findings and conclusions drawn from this study regarding the determinants influencing pregnant women’s healthcare service choices in Etche LGA, the following recommendations are suggested:
- Enhance Socio-Economic Support: Implement programs and policies aimed at improving the socio-economic status of pregnant women in Etche LGA. This includes initiatives to increase income opportunities, provide educational support, and promote employment opportunities for women. By addressing socio-economic disparities, more women will have the financial means to access quality maternal healthcare services.
- Promote Cultural Sensitivity in Healthcare: Healthcare providers and facilities should adopt culturally sensitive practices that respect and accommodate the diverse cultural beliefs and practices of pregnant women in the study area. This involves training healthcare personnel to understand and navigate different cultural contexts, providing language-appropriate services, and incorporating cultural competence into service delivery.
- Invest in Healthcare Infrastructure: Allocate resources and investments to improve healthcare infrastructure in Etche LGA, particularly in rural and underserved areas. This includes building and equipping healthcare facilities, ensuring the availability of essential medical supplies and equipment, and enhancing transportation networks to improve accessibility to healthcare services, especially for pregnant women living in remote areas.
- Expand Community-Based Healthcare Services: Implement community-based maternal health programs and outreach initiatives that bring healthcare services closer to communities. This can involve mobile clinics, community health workers, and awareness campaigns aimed at promoting antenatal care, family planning, and safe delivery practices within local communities.
- Strengthen Health Education and Promotion: Develop and implement health education programs focused on maternal health, targeting both women and their families. These programs should emphasize the importance of antenatal care, skilled birth attendance, postnatal care, family planning, and healthy lifestyle practices during pregnancy. Educating communities can lead to improved health-seeking behaviors among pregnant women.
- Collaborative Stakeholder Engagement: Foster collaboration and partnerships among government agencies, healthcare providers, non-governmental organizations (NGOs), community leaders, and other stakeholders involved in maternal healthcare. By working together, stakeholders can pool resources, share best practices, and coordinate efforts to address the multifaceted determinants of maternal health and improve healthcare service delivery for pregnant women in Etche LGA.
References
- Adeyemi, E. O. (2020). Socio-economic differentials in health care choices: implications for maternal mortality in Nigeria (PhD Thesis, Department of Sociology, Lagos State University, Nigeria).
- Akeju, D. O., Olufemi, T. O., Marianne, V., Adepoju, A. A., Sawchuk, D., Qureshi, R., Muftaut, S., Olalekan, O. A., Peter von, D., & CLIP Nigeria. (2020). Determinants of health care seeking behaviour during pregnancy in Ogun State, Nigeria. Reproductive Health, 1(32), 67-97. DOI: 10.1186/s12978-016-0139-7.
- Akowuah, J. A., & Danquah, B. A. (2019). Determinants of women’s perceived satisfaction on Antenatal care in urban Ghana: A cross-sectional study. Clinical Journal of Obstetrics and Gynecology,(2), 038-053. https://doi.org/10.29328/journal.cjog.1001022
- Almeida, L. M., & José, C. (2020). Social Determinants of health in pregnancy, postpartum and early motherhood: the impact of migration. methaodos.revista de ciencias sociales, 2(1), 154-160.
- Anya, S. B. N., & Yene, A. (2022). The determinants of the choice of treatment of pregnant women in Cameroon. Health Economics Review, 6(48), 1-9. http://dx.doi.org/10.1186/s13561-016-0127-1
- Atahigwa, C., Damazo, T. K., Samuel, I., Steven, A., & Annelies, V. R. (2020). Trends and determinants of health facility childbirth service utilization among mothers in urban slums of Nairobi, Kenya. Global Epidemiology, 2, 100029. Available at https://www.journals.elsevier.com/globalepidemiology.
- Azuh, D., Ogundipe, A., & Ogundipe, O. (2019). Determinants of women’s access to healthcare services in Sub-Saharan Africa. The Open Public Health Journal, 12, 504-514. DOI: 10.2174/1874944501912010504.
- Babalola, S., & Adesegun, F. (2019). Determinants of use of maternal health services in Nigeria – looking beyond individual and household factors. BMC Pregnancy and Childbirth, 9(43). doi: 10.1186/1471-2393-9-43.
