Asking people directly about preferred health-seeking behaviour yields invalid response: an experiment in south-east Nigeria

Onwujekwe, Obinna; Chukwuogo, Ogoamaka; Ezeoke, Uchechukwu Enuma; Uzochukwu, Benjamin; Eze, Soludo

doi:10.1093/pubmed/fdq065

Cited by 20 publications

(19 citation statements)

References 9 publications

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“…For example, many reported recognition of traditional healers as the best to treat cases of convulsions or illnesses with spiritual causes. Patients were reported to attend biomedical health facilities because they believed that these facilities 'Cheap' Kenya [14], Tanzania [15], Uganda [16][17][18] Nigeria [19], [20] Ghana [21], Ethiopia [22], Tanzania [23], Malawi [24], Nigeria [25,26] 'Cheap'Burkina Faso [33] 'Cheap' Uganda [16] Free services Malawi [36]South Africa [37] Kenya [38], Tanzania [31] Ethiopia [39] 'Free services' Kenya [35] 'Free or cheap drugs' Uganda [45,46] Tanzania [47] 'No charge' Uganda [12,13] 'Affordable' drug vendors Nigeria [27,28]Ghana [29] 'For those who find it difficult to pay' Tanzania [23], Uganda [32] 'Reduced cost' Kenya [35] 'Free if unable to pay' Tanzania [34] 'Low cost' Uganda [41] 'Inexpensive services' Nigeria [48] Ghana [21], Nigeria [20], Kenya [14], [38,49,50], Mozambique [51] Ethiopia [52] 'Charge less th...…”

Section: Factors Important Across All Provider Typesmentioning

confidence: 99%

“…'Close by'Ethiopia [52]Sudan [64], Nigeria [20,48], Ghana [21] Tanzania [47,4]Uganda [46], Kenya [38] 'Easy access' Uganda [17] (traditional birth attendants)…”

Section: Factors Important Across All Provider Typesmentioning

confidence: 99%

“…'Less travel' Ghana [43], Tanzania [15] Malawi [36] 'Easy access' Uganda [32] 'Easy access' Uganda [41] Kenya [63] 'Easy access' Mozambique [51], Tanzania [53], Kenya [49] 'Save on transport cost' Nigeria [27] Ghana [21] Kenya [30] Save on transport cost' Kenya [38], Mozambique [51], Ghana [21] Provider timeliness of services (opening hours and waiting times) (n = 21) 'Short waiting time' Nigeria [56] 'Available 24 hrs' Kenya [14], Nigeria [19] 'Available at convenient hours' Tanzania [34] 'Operate for longer hours' Ghana [65] 'Fast services for malaria cases' Nigeria [66] 'Short waiting time' Ethiopia [52], Ghana [21], Kenya [38,49] Uganda [46] Nigeria [48] 'Longer opening hours' Nigeria [20], Uganda [18] 'Short waiting time' Kenya [14], Nigeria [28] 'Short waiting time' Ethiopia [39] 'Convenient treatment times' Ghana [43] 'Provide faster services' Kenya [35] 'Short waiting time' Ghana [21,43], Ethiopia [22], Tanzania [31] Malawi [36], Uganda [18] 'Provide fast services' Uganda [18] Note: Papers providing a rich description of attracting factors are marked in bold; findings from me...…”

Section: Factors Important Across All Provider Typesmentioning

confidence: 99%

“…'Drug availability' Ethiopia [95] Tanzania [91] 'Drug availability' Kenya [35] Ethiopia [13] 'Drug availability' Zambia [60]Uganda [102] 'Drug availability' Zambia [93,78] Uganda [41], Nigeria [25] 'Availability of drugs' Nigeria [20,48] 'Drug availability' Nigeria [28,26]Tanzania [53,101] Uganda [32], [102,18]Ethiopia [13] 'Well equipped' Kenya [49,38]Tanzania [34] Uganda [16] 'Drips available' Tanzania [101] 'Wide range of drugs' Tanzania [101] Malawi [24] 'Ward for in-patients' Tanzania [47] 'Diagnostic facilities' Zambia [93] Tanzania [101] 'Presence of laboratory' Tanzania [47] 'Staff availability' Zambia [93] 'Medical staff' Kenya [38] Better 'quality of services' (as a general statement) (n = 15) Uganda [18] Uganda [32] Kenya [14], Ethiopia [10], Uganda [41], Ghana [21] Ethiopia [39] Nigeria [62] Uganda [41], Nigeria [62] Kenya [50,…”

Section: Attracting Factormentioning

confidence: 99%

See 3 more Smart Citations

Improving access to health care for malaria in Africa: a review of literature on what attracts patients

Kizito

Kayendeke

Nabirye

et al. 2012

Malar J

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BackgroundIncreasing access to health care services is considered central to improving the health of populations. Existing reviews to understand factors affecting access to health care have focused on attributes of patients and their communities that act as 'barriers' to access, such as education level, financial and cultural factors. This review addresses the need to learn about provider characteristics that encourage patients to attend their health services.MethodsThis literature review aims to describe research that has identified characteristics that clients are looking for in the providers they approach for their health care needs, specifically for malaria in Africa. Keywords of 'malaria' and 'treatment seek*' or 'health seek*' and 'Africa' were searched for in the following databases: Web of Science, IBSS and Medline. Reviews of each paper were undertaken by two members of the team. Factors attracting patients according to each paper were listed and the strength of evidence was assessed by evaluating the methods used and the richness of descriptions of findings.ResultsA total of 97 papers fulfilled the inclusion criteria and were included in the review. The review of these papers identified several characteristics that were reported to attract patients to providers of all types, including lower cost of services, close proximity to patients, positive manner of providers, medicines that patients believe will cure them, and timeliness of services. Additional categories of factors were noted to attract patients to either higher or lower-level providers. The strength of evidence reviewed varied, with limitations observed in the use of methods utilizing pre-defined questions and the uncritical use of concepts such as 'quality', 'costs' and 'access'. Although most papers (90%) were published since the year 2000, most categories of attributes had been described in earlier papers.ConclusionThis paper argues that improving access to services requires attention to factors that will attract patients, and recommends that public services are improved in the specific aspects identified in this review. It also argues that research into access should expand its lens to consider provider characteristics more broadly, especially using methods that enable open responses. Access must be reconceptualized beyond the notion of barriers to consider attributes of attraction if patients are to receive quality care quickly.

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Section: Factors Important Across All Provider Typesmentioning

confidence: 99%

“…'Close by'Ethiopia [52]Sudan [64], Nigeria [20,48], Ghana [21] Tanzania [47,4]Uganda [46], Kenya [38] 'Easy access' Uganda [17] (traditional birth attendants)…”

Section: Factors Important Across All Provider Typesmentioning

confidence: 99%

Section: Factors Important Across All Provider Typesmentioning

confidence: 99%

Section: Attracting Factormentioning

confidence: 99%

See 2 more Smart Citations

Improving access to health care for malaria in Africa: a review of literature on what attracts patients

Kizito

Kayendeke

Nabirye

et al. 2012

Malar J

View full text Add to dashboard Cite

show abstract

“…The estimated 200,000 PPMVs operating in Nigeria [11] are the first source of care for up to 55 % of under-five child illnesses, such as malaria and diarrhea, and 35 % to 55 % of adult malaria treatment [12–16]. In addition to selling drugs, PPMVs can be a source of advice about illness and drug therapy [17] in place of more formal care at health facilities, even if they are relatively accessible.…”

Section: Introductionmentioning

confidence: 99%

Care-seeking at patent and proprietary medicine vendors in Nigeria

Prach

Treleaven

Isiguzo

et al. 2015

BMC Health Serv Res

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BackgroundTo achieve health development goals, policymakers are increasingly focused on improving primary care in low- and middle-income countries, and private sector drug retailers offer one channel through which basic services may be delivered. In Nigeria, patent and proprietary medicine vendors (PPMVs) serve as a main source of medications, but little is known about their clientele or how care is sought at PPMVs for common illnesses. We explore differences in care-seeking at PPMV shops based on the most commonly reported symptoms.MethodsIn Kogi and Kwara states, Nigeria, 250 PPMV shop workers and 2,359 customers purchasing drugs were surveyed, and each worker-customer interaction was observed. Multivariate regression analysis was used to assess the association of commonly reported symptoms with care-seeking behavior prior to attending the shop and while interacting with the provider at the shop.ResultsMost customers sought care for headache (30.5 %), fever (22.9 %), cough/cold (18.1 %), or diarrhea (8.4 %). Customers with fever were more likely to report being diagnosed by a formally trained person, to have discussed the illness with and be examined by the shop worker, and have more difficulty paying. In contrast, customers with headache symptoms were less likely to experience these outcomes and spent less money purchasing drugs. Those reporting cough or cold symptoms were less likely to have been diagnosed by a formally trained person, waited longer before visiting the PPMV shop, and were more likely to discuss the illness with the shop worker, but were less likely to be examined or to recommend the purchased drug themselves. If a sick child was brought to the shop, a discussion of the illness and an exam were more likely and more money was spent on drugs.ConclusionsBecause care-seeking behaviors vary by symptoms and the sick person’s age, PPMVs should be trained to treat common illnesses for which customers are unlikely to seek a formal medical consultation. Interventions aimed at improving primary care need to target the places where most people access care, and equip PPMV workers with knowledge and tools to provide basic services.

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Profile of practitioners, and factors influencing home care physiotherapy model of practice in Nigeria

Onyeso

Umunnah

Ezema

et al. 2020

Home Health Care Services Quarterly

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Asking people directly about preferred health-seeking behaviour yields invalid response: an experiment in south-east Nigeria

Cited by 20 publications

References 9 publications

Improving access to health care for malaria in Africa: a review of literature on what attracts patients

Improving access to health care for malaria in Africa: a review of literature on what attracts patients

Care-seeking at patent and proprietary medicine vendors in Nigeria

Profile of practitioners, and factors influencing home care physiotherapy model of practice in Nigeria

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