Barriers to accessing health care in Nigeria: implications for child survival

Abstract

BackgroundExisting studies indicate that about one in every six children dies before age five in Nigeria. While evidence suggests that improved access to adequate health care holds great potential for improved child survival, previous studies indicate that there are substantial barriers to accessing health care in Nigeria. There has not been a systematic attempt to examine the effects of barriers to health care on under-five mortality in Nigeria. This study is designed to address this knowledge gap.Data and methodData came from a nationally representative sample of 18,028 women (aged 15–49) who had a total of 28,647 live births within the 5 years preceding the 2008 Nigeria Demographic and Health Survey. The risk of death in children below age five was estimated using Cox proportional hazard models and results are presented as hazards ratios (HR) with 95% confidence intervals (CI).ResultsResults indicate higher under-five mortality risks for children whose mothers had cultural barriers and children whose mothers had resource-related barriers to health care (HR: 1.44, CI: 1.32–1.57, p<0.001), and those whose mothers had physical barriers (HR: 1.13, CI: 1.04–1.24, p<0.001), relative to children whose mothers reported no barriers. Barriers to health care remained an important predictor of child survival even after adjusting for the effects of possible confounders.ConclusionFindings of this study stressed the need for improved access to adequate health care in Nigeria through the elimination of barriers to access. This would enable the country to achieve a significant reduction in childhood mortality.

Intra-demographic birth risk assessment scheme and infant mortality in Nigeria

“…Consequently, diverse quantitative and qualitative research has been conducted to investigate factors influencing mortality among children in Nigeria [14,15,17,19,29]. Despite the existing interesting findings from these studies and their impact on mortality and its associated causes through policies, a more scholarly approach is obligatory to enhance the survival chances of newborn babies.…”

“…Though several scientific investigations have improved understanding of the causes of childhood mortality in Nigeria [14,15,17], a new approach as incorporated in the current study is clearly necessary. The method discussed here classifies maternal demographic childbirth risks into low or medium or high.…”

Maternal Health Care Services Access Index and Infant Survival in Nigeria

“…In spite of this achievement, Nigeria was unable to achieve the Millennium Development Goal (MDG) target of a two-thirds reduction in 1990 childhood mortality levels in year 2015. Nigeria, the most populous black nation where physical barriers constitute challenge to accessing care within the health system is still among nations having the highest infant mortality worldwide (4,5,6).…”

Pediatric out-of-hospital deaths following hospital discharge: a mixed-methods study

“…2 Barriers to seeking care in Sub-Saharan Africa are complex and can include financial constraints, distance to health facilities, cultural practices, gender dynamics, limited knowledge or information, and health facility disincentives. 5,6 These barriers are thought to contribute to increased child mortality, for instance long distance from a health facility increased mortality risk by 17% in Tanzania. 7 Malnutrition, previous hospitalizations and HIV are often identified as key risk factors for post-discharge mortality.…”