Determinants of health care seeking behaviour during pregnancy in Ogun State, Nigeria

• Published in: Reproductive health Vol. 13 Suppl 1; no. Suppl 1; p. 32
• Main Authors: Akeju, David O, Oladapo, Olufemi T, Vidler, Marianne, Akinmade, Adepoju A, Sawchuck, Diane, Qureshi, Rahat, Solarin, Muftaut, Adetoro, Olalekan O, von Dadelszen, Peter
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.06.2016; BioMed Central
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Decision Making; Female; Health aspects; Health behavior; Health Facilities - statistics & numerical data; Health Knowledge, Attitudes, Practice; Health Services Accessibility; Humans; Male; Middle Aged; Nigeria; Patient Acceptance of Health Care - psychology; Pregnancy; Pregnant women; Prenatal care; Social aspects; Socioeconomic Factors; Young Adult; Nigeria; Health care; Pregnancy complications
• ISSN: 1742-4755; 1742-4755
• DOI: 10.1186/s12978-016-0139-7

In Nigeria, women too often suffer the consequences of serious obstetric complications that may lead to death. Delay in seeking care (phase I delay) is a recognized contributor to adverse pregnancy outcomes. This qualitative study aimed to describe the health care seeking practices in pregnancy, as well as the socio-cultural factors that influence these actions. The study was conducted in Ogun State, in south-western Nigeria. Data were collected through focus group discussions with pregnant women, recently pregnant mothers, male decision-makers, opinion leaders, traditional birth attendants, health workers, and health administrators. A thematic analysis approach was used with QSR NVivo version 10. Findings show that women utilized multiple care givers during pregnancy, with a preference for traditional providers. There was a strong sense of trust in traditional medicine, particularly that provided by traditional birth attendants who are long-term residents in the community. The patriarchal c influenced health-seeking behaviour in pregnancy. Economic factors contributed to the delay in access to appropriate services. There was a consistent concern regarding the cost barrier in accessing health services. The challenges of accessing services were well recognised and these were greater when referral was to a higher level of care which in most cases attracted unaffordable costs. While the high cost of care is a deterrent to health seeking behaviour, the cost of death of a woman or a child to the family and community is immeasurable. The use of innovative mechanisms for health care financing may be beneficial for women in these communities to reduce the barrier of high cost services. To reduce maternal deaths all stakeholders must be engaged in the process including policy makers, opinion leaders, health care consumers and providers. Underlying socio-cultural factors, such as structure of patriarchy, must also be addressed to sustainably improve maternal health. NCT01911494.