1.1 Introduction
Health care utilization is defined as the consumption of services or supplies such as the number of office visit a person makes per year with a health care provider, the number of prescription made or the number of days a person is hospitalized. Health Care Utilization according to Carrasquillo (2013) is the quantification or description of the use of services by persons for the purpose of preventing and curing health problems, promoting maintenance of health and well- being, or obtaining information about one’s health status and prognosis. It refers to the use of health care services. Utilization can be described as the use or amount usage per unit population of health services.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
Over the past health workers have been contributing immensely to the primary prevention of disease in both community and health facilities with emphasis on the front-line health workers, these are the health care providers that are available to cater for the immediate health need of the patients, according to (Agyeponget al. 2001) the Interventions to improve quality and responsiveness in healthcare have centered on professionals and frontline workers without recourse to a total system reform.
The world health education (WHO) considered the institution of health care services as the vehicle that will convey the declaration of health for all by the year 2000 and beyond to all nations (Olu et al., 2007). Since then, Nigerian Government has been spending huge sums of money to ensure that health services reach every individual in any part of the country at an affordable cost (Olu et al., 2007).
The services received or given focused more on preventive, promotive and curative measures. In spite of those efforts, communities in the rural areas do not make proper use of health care services provided through the health institution/hospital due to some impeding factors such as culture, poverty, insufficient health institutions and professionals to deliver these health care services and to name a few (MacLachlan, 2006).
Culture is one of the crucial factors that contribute to the development and delivery of quality care to all. The health of the people, their behavior, their customs, their habits, and the way they live are so closely linked that they can be said to be tied together (MacLachlan, 2006). Communities have culture that gives guidelines to their way of life in a particular area. For instance, cultural beliefs with regards to dressing, eating, morals etc. he stated that there are some harmful cultural habits detrimental to health that needs to be discouraged while there are some good ones which should be promoted and encouraged. In cultural relatedness, we must not unquestionably accept every cultural variation. We should make an unbiased effort to evaluate norms, values, and customs in light of the distinctive culture (MacLachlan, 2006).
However, culture plays a role in the health care utilization pattern among Africans. It is to this effect that stated that in traditional African society, culture determines who to contact for the treatment of disease and illness. He made instances using mental illness. An average Nigerian believes that natural healers and prophets are more effective in the treatment of psychiatric problems which they mostly attributed to result from punishments by a deity or a spiritual attack from an enemy. These believes are closely related to the belief in the supernatural power of one’s ancestors who are regarded as part of the household and said to be able to guide the affairs of family members (Lasebikan, 2016)
Therefore, in Edo State where the research was carried out, the activities that was conducted is to know the Influence of Culture on the Effective Utilization of Health Care Services by Adult Males and Females.
1.3 Statement of Problems
Investigation revealed that the utilization of service is the actual coverage and it is categorized into ambulatory medical care services; inpatient services; and preventive services. To achieve optimal levels of utilization, all the three categories must enlist the cooperation and initiative of the population as well as those of the health service providers. Hitherto, the assumption has been that the Health Ministry and other providers of health services knew the demand on their resources, upon which planning was based, by the number of people that demand services.
There is at present increasing evidence, especially in the developing world, that many more who attempt to obtain such services are not getting them for a number of reasons. In Nigeria, the discrepancy between what the levels of health care utilization are and what they ought to be is easily discernible. This underlines current efforts in relating utilization to resources as well as to past and present planning efforts. It has been said that there is need to review planning efforts and their appropriateness, especially when viewed from the context of utilization of health care services.
1.4 Aim and Objectives of Study
The aim of the study is to investigate the Influence of Culture on the Effective Utilization of Health Care Services by Adult Males and Females in Edo State. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the knowledge of health care services, cultural practices and beliefs of the people on health care services;
- To assess the influence of religion of health care facilities utilization among community residents in Edo State;
- To examine the cultural practices that could affect the effective utilization of health care services by the people; and
- To find out whether cultural practices are the major reason for ineffective utilization of health care service by the people of Edo State.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Are people aware about the cultural practices and beliefs of receiving health care services in Edo State?
- Does people’s culture influence health care facilities utilization among community residents in Edo State?
- Does cultural practice affect the effective utilization of health care services by the people?
- Is cultural practice the major reason for ineffective utilization of health care service by the people of Edo State?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no relationship between cultural practices and beliefs and the utilization of health care services in the area under study.
- H1: There is a relationship between cultural practices and beliefs and the utilization of health care services in the area under study.
Hypothesis Two
- H0: Socio-economic factors do not have significant influence on the utilization of health care services by rural dwellers of Edo State
- H1: Socio-economic factors have significant influence on the utilization of health care services by rural dwellers of Edo State
1.7 Significance of Study
The findings of this study will enhance the knowledge of the society in general and the medical practitioners in understanding how culture is felt, lived, and experienced by the people. This would help professionals release the old stereotypes and prejudices that they have about certain cultural beliefs and practices. The religious freedom of the patients would not be infringed upon before, during and after treatment. The outcome of this study will also significant to community residents in Edo State and Nigeria in general in the following ways:
- The findings of this study would provide information on the adequacy or otherwise of health services provided to community residents in Edo State with a view to improving the services.
- The findings of this study would help policy makers to understand problems militating against effective utilization of health services among community residents in Edo State and the way forward.
- It would provide a basis for further research to other interested researchers.
- The findings of this study would contribute to existing knowledge on the provision and utilization of health care services.
1.8 Scope of Study
The scope of this research is focused on the Influence of Culture on the Effective Utilization of Health Care Services by Adult Males and Females in Etsako Central Local Government Area (LGA), Edo State.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Health: Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.
Status: Status is a state, condition, or situation.
Influence: The effect that something has on the way a person thinks.
Health Care Services: These are health related services that are rendered to people at different hospitals and health centers by qualified personnel such as nurses, doctor, pharmacists, radiologists etc. These services may include drug administration, infant deliveries, health education, counseling, therapeutic services. e.t.c.
Utilization: This is defined as making use of health care services rendered at health/hospital by the people in the locality
Effective: This means producing the result that is wanted or intended.
Culture: This refers to the way of life which is unique to a particular group of people in a community. It includes their mode of dressing, eating, housing, marriage and belief.
