FACTORS AFFECTING UTILIZATION OF HEALTH CARE SERVICES

CHAPTER ONE

INTRODUCTION

1.1 Background of study

Differences in health status between industrialized and developing countries, as measured by indices such as newborn mortality, young and child mortality, and maternal mortality, have been documented throughout history. As we go from urban to rural areas in developing countries, the situation has gotten worse. Unfortunately, the causes of this distressing reality include illnesses that can be cured and fatalities that may be avoided with modest actions, but for which ineffective structures have served as a roadblock. To justify the amount of money spent on health and the number of workers employed, serious attention must be paid to improving the quality of healthcare services while keeping costs in check, as well as planning health-care activities and performing effective management functions related to health-care delivery systems (HCDS).

This is impossible to achieve outside of the constraints of use. This is due to the fact that usage is the most activity-related problem, as it is consumer-oriented and has multiple dimensions in terms of demands, perceptions, and knowledge. The scale of the problem is crystallized to the extent that usage includes the collaboration and invitation of people outside the health system. Indeed, history and current situations around the world have justified utilization as a fundamental aspect of planning any health-care delivery system. WHO had warned at the outset of HFA/2000 that if its aims, support activities, administration, and execution were not tailored toward optimal usage, it could become obsolete. In the United States, hospitals and affiliated health facilities are required to have formal usage review procedures as a requirement for participating in health plans, and any institution seeking accreditation must have some kind of utilization review mechanism. The comprehensive National Health Scheme (NHS) of the United Kingdom is designed to ensure equity and encourage all citizens to seek out treatments. Even during the apartheid era in South Africa, health care was reconstructed under the ideas of accessibility, affordability, acceptability, equity, and efficacy, resulting in desegregation. Attempts have been made in developing nations to promote utilization, particularly among rural communities, but success has been limited. The provision of free medical treatments as a strategy to increase utilization by removing financial obstacles has become a major political issue. Inadequate structures have hampered progress in this direction, resulting from a failure to tune planning and management operations toward utilization, a scenario exacerbated by other issues like as

1. Population is increasing at a breakneck pace.

2. Demand for health services is rising, while resources are shrinking.

3. Inadequate use of limited resources

4. Inefficiency of government health-care systems and services on the inside.

5. Private health-care services are of poor quality.

6. Inadequate support infrastructure, such as water, electricity, and well-maintained roads.

These issues have resulted in ineffective architecture, inefficient resource allocation, and incongruent staff scheduling, which would not have occurred if potential utilization had been the foundation upon which the facilities were built. This situation necessitates restructuring, which can only be aided by examining the relationship between resource distribution, health concerns, and use patterns, where identified factors would indicate the services to be supplied to the rising population as well as their magnitude.

The real coverage is classified as ambulatory medical care services (outpatient and home), inpatient medical care services (hospital), and preventive services. To attain optimal use levels, all three groups must engage the population's participation and initiative, as well as that of health care providers. Previously, it was assumed that the Health Ministry and other health-care providers recognized the demand for their resources, on which planning was based, based on the number of people who needed services. There is growing evidence that many more people are attempting to acquire such services but are unable to do so for a variety of reasons, particularly in poor countries. The disparity between what levels of health care utilization are and what they should be in Nigeria, particularly in Kwara State, is plainly visible. This highlights current initiatives to link resource utilization to utilization, as well as past and current planning efforts. It has been suggested that planning efforts and their appropriateness be reviewed, particularly when evaluated from the perspective of health-care utilization.

1.2 Statement of problem

Nigeria has a three-tiered health-care delivery system, with primary care accounting for the majority of health-care delivery. The government has maintained its attempts to decentralize health-care services so that they are more accessible to the public and more economical. This is intended to improve a wide range of health indices that affect the quantity and quality of residents' lives in the long run. Low consumption of health services at these places of delivery, however, has undermined the core goal of decentralization; evidence of low utilization has been established by various studies in other parts of the country, such as Adeyemo, 2005; Katung, 2001; and Kabiru, 2005. As a result, the purpose of this study is to investigate the factors that affect the utilization of healthcare services.

1.3 Objective of study

The following are primary objectives of this study:

1.   To investigate the extent to which health care services are available in Guma Local Government Area.

2.   To examine the factors affecting the utilization of healthcare services in Guma Local Government Area.

3.   Identify the underlying causes for health facility inefficiencies in Guma Local Government.

4.   To proffer implementable recommendations to the challenges identified.

1.4 Research question

The following research question guides this study

1. To what extent is health care services available in Guma Local Government Area?

2. What are the factors affecting the utilization of health care services in Guma Local Government Area?

3. What are the causes for health facility inefficiencies in Guma Local Government?

1.5 Significance of study

The goal of this research was to learn more about the underlying elements that influence how people use health-care services. These aspects will be examined from the perspectives of a variety of stakeholders, including clinic attendees, non-clinic attendees, and service providers. The findings of this study will aid the local governments in charge of service delivery at these facilities in focusing their education and community communications on the core aspects that operate as obstacles to health-care utilization. It will also assist service providers at the facility level in developing strategies and action plans to encourage increased use of the services available. These efforts will help to start the process of enhancing access to health care services, which will eventually improve the overall health of everyone in the state.

This study will contribute to the current literature in this field and will also serve as a resource for academics, researchers, and students who may want to do future research on this or a comparable topic.

1.6 Scope of study

This study focuses on assessing the factors affecting the utilization of health care service in Nigeria. This study is limited to Guma Local Government Area in Benue state.

1.7 Limitation of study

Finance, inadequate materials and time constraint were the challenges the researchers encountered during the course of the study.

1.8 Definition of terms

Healthcare Service : This is the timely use of personal health services to achieve the best possible health outcomes.