Utilization of primary health care facilities: lessons from a rural community in southwest Nigeria

Niger J Med. 2008 Jan-Mar;17(1):98-106. doi: 10.4314/njm.v17i1.37366.


Background: This study assessed service/organisational factors and clients' perceptions that influenced utilisation of Primary Health Care (PHC) facilities in a rural community in Nigeria.

Method: A cross-sectional household survey in the community as well as key-informant interviews of opinion leaders and health care providers and participant observations of health facilities and utilisation pattern was used to collect data.

Results: Forty-four percent of respondents to the survey who were ill in the preceding six months visited a PHC facility for treatment, while others relied on self-medication/self-treatment. Education was positively associated with utilisation of PHC services (P<0.05). Maternal and child health (45.4%), prompt attention (23.0%), and appropriate outpatient (20.5%) services attracted respondents to use PHC services. Poor education about when to seek care, poverty, perceived high cost of PHC services, lack of drugs and basic laboratory services, and a regular physician on site at the facility were identified as barriers to utilisation.

Conclusion: We conclude that community perceptions of poor quality and inadequacy of available services was responsible for low use of PHC services.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Attitude to Health*
  • Child
  • Child Welfare
  • Community Health Services / statistics & numerical data
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Care Surveys
  • Humans
  • Interviews as Topic
  • Male
  • Maternal Welfare
  • Middle Aged
  • Nigeria
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Pregnancy
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data*
  • Qualitative Research
  • Rural Health Services / standards
  • Rural Health Services / statistics & numerical data*
  • Social Perception*
  • Surveys and Questionnaires