Abubakar Sadik Hassan

AN ASSESSMENT OF HEALTH SEEKING BEHAVIOR IN WUNTIN DADA BAUCHI
LOCAL GOVERNMENT AREA, BAUCHI STATE
BY
ABUBAKAR SADIK HASSAN
BASUG/UG/SMS/SOC/19/0746
A RESEARCH PROJECT SUBMITTED TO THE DEPARTMENT OF SOCIOLOGY IN
FULFILLMENT OF THE REQUIREMENT FOR THE AWARD OF BACHELOR OF
SCIENCE (B.Sc) DEGREE IN THE DEPARTMENT OF SOCIOLOGY FACULTY OF
SOCIAL SCIENCES, SA’ADU ZUNGUR UNIVERSITY, BAUCHI.
OCTOBER, 2024
i
DECLARATION
I Abubakar Sadik Hassan with Matric number BASUG/UG/SMS/SOC/19/0746 hereby,
declare that this research project titled “An Assessment of Health Seeking Behavior in Wuntin
Dada Bauchi Local Government Area, Bauchi State” it has not been presented or published
anywhere by any person, institutions or organization for any previous application for a degree or
any other qualifications. All sources of information have been duly acknowledged by means of
references.
Abubakar Sadik Hassan ……………………....………………….

Sign &Date
ii
CERTIFICATION
This project has been read and approved as meeting the requirement of the department of
Sociology, faculty of social sciences, Sa’adu Zungur University, Bauchi for the award of B.Sc in
Sociology by the undersigned personalities.
Mal. Sani Musa Tilde _____________________

Project Supervisor Sign & Date
Dr. Jibril Babayo Suleiman _____________________

Head of Department Sign & Date
______________________ _____________________
External Examiner Sign & Date
iii
DEDICATION
This research work is dedicated to Almighty Allah and to my parents as well as to my beloved
Malam Hassan Abdullahi and Malama Fatima Abubakar Sadik
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ACKNOWLEDGEMENT
All praise and thanks are indeed due to Almighty God the most merciful and compassionate
whose incredible benevolence and great guidance helped me to accomplish this project. To my
very supportive and committed supervisor Mal. Sani Musa Tilde I express my utmost gratitude
for his valuable suggestions, guidance, encouragement, thorough editing, intuitive comment, and
constructive criticism towards the success of this project. My appreciation also goes to all my
lecturers and staff of the department of Sociology, including; Mal. Laraban Abdul Gamawa,
Malama Amina Ahmad, Dr. Jibril Babayo Suleiman (HOD) Mr. Abarshi for their immense
contributions toward making this endeavor a reality. My profound gratitude also goes to my
beloved parents; Malam Hassan Abdullahi and Malama Fatima Abubakar Sadik for their
sacrificial and immeasurable efforts towards my success in life. Without your support and
prayers this achievement would have remain a dream. May the Almighty God continue to
shower his unlimited blessing upon you (Amen).
A big thank you goes to my, brothers and sisters; Ahmad Alamin Hassan, Zafira Muhammad
Bello, I thank you all for your support, love and care throughout my studies. May we be united to
keep the dreams of our parents alive till eternity (Amen).
This acknowledgement will stand incomplete without mentioning the efforts of my friends
Mustapha Suleiman, Rabiu Sirajo, Alamin Isah Nayaya and their likes. It is indeed a pride
having you as friends who impacted positively in pursuing my undergraduate studies. May
Almighty God grant you all the desires of your hearts.
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TABLE OF CONTENTS
COVER PAGE……………………………………………………………………………………i
TITLE PAGE…………………………………………………………………………………...…ii
DECLARATION.............................................................................................................................ii
CERTIFICATION..........................................................................................................................iii
DEDICATION................................................................................................................................iv
ACKNOWLEDGEMENT...............................................................................................................v
TABLE OF CONTENTS...............................................................................................................vi
ABSTRACT.................................................................................................................................viii
CHAPTER ONE: INTRODUCTION
1.1 Background to the Study........................................................................................................1
1.2 Statement of the Problem.......................................................................................................3
1.3 Research Question..................................................................................................................4
1.4 Objectives of the Study..........................................................................................................5
1.5 Significance of the study:.......................................................................................................5
1.6 Scope and Delimitations of the Study....................................................................................6
1.7 Operational Definition of Terms............................................................................................6
CHAPTER TWO: LITERATURE REVIEW AND THEORETICAL FRAMEWORK
2.0 Introduction............................................................................................................................8
2.1 Review...................................................................................................................................8
2.1.1 Socio-economic factors influencing Health Seeking Behavior..........................................8
2.1.2 Level of Availability of Primary Health Care Services Centers.......................................12
2.1.3 Level of utilization of Primary Health Care Service Centers...........................................18
2.2 Theoretical Framework........................................................................................................21
2.2.1 Three Phase Delay Model.................................................................................................21
2.2.2 Application of the theories................................................................................................25
CHAPTER THREE: METHODOLOGY
3.0 Introduction..........................................................................................................................27
3.1 Research Design...................................................................................................................27
3.2 Description of the Study Area..............................................................................................27
3.3 Population of the Study........................................................................................................29
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3.4 Sampling Size......................................................................................................................29
3.5 Sampling Techniques...........................................................................................................29
3.6 Method of Data Collection...................................................................................................30
3.7 Instruments for Data Collection...........................................................................................30
3.8. Method of Data Analysis....................................................................................................31
3.9 Ethical Considerations.........................................................................................................31
CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
4.1 Introduction..........................................................................................................................32
4.2 Data Presentation and Analysis............................................................................................32
4.3 Discussion of Findings.........................................................................................................45
CHAPTER FIVE: SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
5.0 Introduction..........................................................................................................................47
5.1 Summary of the Major Findings..........................................................................................47
5.2 Conclusion...........................................................................................................................48
5.3 Recommendations................................................................................................................49
5.4 Suggestion for Further Studies.............................................................................................50
REFERENCES...........................................................................................................................51
APPENDICES...............................................................................................................................54
APPENDIX I: INTRODUCTORY LETTER................................................................................54
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ABSTRACT
The study examined the Assessment of Health Seeking Behavior in Wuntin Dada Bauchi Local
Government Area, Bauchi State. Against the study between three objectives which are to
examine the socio-economic factors affecting the access and utilization of healthcare service in
Wuntin Dada Bauchi Local government Area of Bauchi state, to determine the level of
availability of primary health care services centers and to determine the level of utilization of
primary health care service centres. This study employed three delay models to predict and
understand the topic under study. The surveys research method was used for this study using
questionnaire with a sample size of one hundred and twenty six (126). The result found that there
are enough primary health care services, people don’t have to go long distance for primary
health care services, women access maternal health care services with ease, local and private
hospitals provide the required health care services and that each and every individual in Wuntin
Dada can afford Maternal health care services. The study concluded that the persistence of these
socio-economic barriers indicates a need for targeted interventions aimed at addressing the root
causes of inequities in healthcare access, thereby improving overall health outcomes for
vulnerable populations within the community. Based on the findings the study recommended that
government should implement comprehensive health promotion initiatives that incorporate
preventative health screenings aimed at young adults. These programs should focus on
encouraging proactive health management to prevent the early onset of diseases, fostering a
culture of regular health check-ups and early intervention.
KEYWORDS: Health, Health Seeking Behavior, Health Care, Access and Utilization.
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CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Globally, socio-economic status significantly impacts healthcare access. According to the World
Health Organization (WHO), approximately half the world's population lacks access to essential
health services (WHO, 2022). Economic inequality exacerbates this issue, with marginalized
communities facing barriers such as high costs, inadequate infrastructure, and limited healthcare
facilities (WHO, 2022).Moreover, the global trend of privatization in healthcare exacerbates
disparities. In many countries, the commodification of healthcare leads to a system where only
those with financial means can afford quality services, leaving behind those who cannot afford to
pay (Birch et al., 2020). This perpetuates a cycle of poverty and ill-health, further entrenching
socio-economic inequalities.
In Asia, economic growth has led to significant improvements in healthcare access in some
regions. Countries like Japan and South Korea boast robust healthcare systems with universal
coverage (Reddy et al., 2021). However, disparities persist, particularly in rural areas and among
migrant populations (Reddy et al., 2021). Socio-economic factors such as poverty, education
levels, and cultural beliefs shape healthcare-seeking behaviors, further widening the gap (Reddy
et al., 2021).In rural parts of Asia, healthcare infrastructure remains underdeveloped, with
limited access to hospitals, clinics, and trained medical professionals. This disparity is
exacerbated by factors such as geographical isolation, lack of transportation, and insufficient
government investment in rural healthcare (Kim et al., 2022). As a result, individuals from rural
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areas often face significant challenges in accessing even basic healthcare services, let alone
specialized treatments (Katung, 2021).
Africa faces formidable challenges in healthcare accessibility, exacerbated by socio-economic
factors. Despite progress in combating infectious diseases, the continent grapples with
inadequate infrastructure, healthcare workforce shortages, and limited financial resources
(Nabyonga-Orem et al., 2022). Socio-economic disparities, including poverty, gender inequality,
and political instability, hinder equitable access to healthcare services (Nabyonga-Orem et al.,
2022).Moreover, Africa's healthcare systems are burdened by the double-edged sword of
communicable and non-communicable diseases. While infectious diseases like malaria and
HIV/AIDS remain prevalent, the rise of non-communicable diseases such as diabetes and
cardiovascular disorders poses new challenges (Ataguba et al., 2020).
In Nigeria, socio-economic factors significantly influence healthcare accessibility. Despite being
Africa's largest economy, healthcare infrastructure remains underdeveloped, particularly in rural
areas (Oleribe et al., 2021). Poverty, unemployment, and corruption exacerbate these challenges,
leaving millions without adequate care (Oleribe et al., 2021). The funeral system mirrors these
disparities, with affluent families affording proper healthcare and funeral arrangements, while
the less privileged struggle to access basic services.Moreover, cultural beliefs and practices
impact healthcare-seeking behaviors in Nigeria. Traditional medicine is often favored over
modern healthcare due to its perceived accessibility, affordability, and alignment with cultural
norms (Akande et al., 2022). While traditional healers play a crucial role in many communities,
reliance on traditional medicine can delay or prevent individuals from seeking timely medical
care, particularly for serious health conditions.
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Bauchi State, including Wuntin DadaBauchi LGA, grapples with inadequate healthcare
infrastructure, exacerbated by socio-economic disparities. While urban areas like Wuntin Dada
boast relatively better healthcare facilities, rural communities face significant challenges
accessing essential services (Yakubu et al., 2021). Limited healthcare infrastructure in rural
areas, including Wuntin DadaBauchi LGA, contributes to disparities in access, with marginalized
populations bearing the brunt of these inadequacies (Yakubu et al., 2021).Moreover, socio-
economic factors such as poverty, unemployment, and education levels intersect to deepen
healthcare inequalities. Residents of Wuntin DadaBauchi LGA, particularly those from low-
income backgrounds, often face financial barriers to healthcare access (Sambo et al., 2022). High
out-of-pocket expenses for medical services deter individuals from seeking timely care, leading
to adverse health outcomes and perpetuating the cycle of poverty and ill-health.
1.2 Statement of the Problem
Articulating the challenges in securing healthcare for the entire population is complex, as
understanding health is a very broad and unique phenomenon. An individual’s health status does
not determine their future health status as various factors influence it as it is not merely about
pursuing a healthy lifestyle and accessing the necessary medical care. An analysis and
understanding of an individual’s sense of well-being is an intricate and complex study as health
status is merely a component of well-being. The World Health Organization (WHO) defines
health as a state of complete physical, mental, and social well-being and not merely the absence
of disease or infirmity (WHO, 2022). By using the WHO’s expanded and holistic approach to
health, it is clear that our health status is equally influenced by social factors as by physiological
factors. Similarly, understanding how an individual interacts with the health care system cannot
be understood in terms of their health status alone. A more holistic approach to understanding
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health care utilization would have to take full recognition of the medical need for health care, as
well as the social factors that influence health care utilization.
Moreover, cultural beliefs and practices also influence healthcare-seeking behaviors in Wuntin
DadaBauchi LGA. Traditional healing practices coexist with modern medicine, shaping
individuals' perceptions and choices regarding healthcare utilization (Dakok et al., 2020). While
traditional healers play a crucial role in local communities, reliance on traditional medicine can
sometimes delay or deter individuals from seeking appropriate medical care, particularly for
acute or chronic conditions (Dakok et al., 2020).Furthermore, cultural norms surrounding gender
roles and family dynamics impact healthcare access. In Wuntin DadaBauchi LGA, women and
children often face additional barriers to healthcare, stemming from traditional gender norms and
limited decision-making power within households (Sambo et al., 2022). Addressing these
cultural barriers requires culturally sensitive interventions that and requires indepth research into
these socio-economic factors affecting utilization and access to health care facilities. This is what
prompt this study to examine the socio-economic factors affecting accessibility of healthcare
services in Bauchi state, where Wuntin DadaBauchi LGA.
1.3 Research Question
The research questions are:
1. What are the socio-economic factors influencing health seeking behavior in Wuntin
Dada, Bauchi LGA
1. What is the level of availability of primary health care services centers?
2. What is the level of utilization of primary health care service centres?
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1.4 Objectives of the Study
The main aim of the study is to assess health seeking behavior of in wuntin Dada, Bauchi, LGA.
Thus, the specific objectives are:
2. To examine the socio-economic factors influencing health seeking behavior in Wuntin
Dada, Bauchi LGA
3. To determine the level of availability of primary health care services centers.
4. To determined the level of utilization of primary health care service centres.
1.5 Significance of the study:
This study has both theoretical and practical significance. It will add to the existing knowledge
and literature in the social sciences.
The study will be of great importance in creating awareness of the economic importance of
healthcare service to society and of the necessity of creating a healthy community. To this end,
this may stimulate the interest of the government in providing adequate services especially in
urban communities or modify and assist various groups and families to complement the efforts of
the government.
Finally, it will be of great benefit to other stakeholders in their quest for socioeconomic reform in
healthcare service. This study will be of great importance, as it will provide necessary
information on the socio-economic factors affecting accessibility of healthcare service in Bauchi
state. The study will also inform illiterate people and parents who are concerned about the socio-
economic factor and how to access healthcare service in their various communities. The study
will also be useful for research in socio-economic factors affecting the accessibility of Health
Care Services in Bauchi State.
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1.6 Scope and Delimitations of the Study
The study is limited to the evaluation of socio-economic factors affecting accessibility of
healthcare services in Bauchi state, where Wuntin DadaBauchi LGA was chosen as the case
study.
Moreover, the limitation of the study to Wuntin Dada Bauchi LGA is due to the following
reasons;
Time Frame: The time frame within which the study was meant to be concluded was not enough
to gather the necessary datum for the entire Bauchi state. Hence, the researcher limits the
research work to Wuntin Dada North.
Finance:Another limitation to the study is finance as the research don’t have enough income to
cover all the Bauchistate, hence the study is limited to Wuntin Dada North due to lack of finance.
1.7 Definition of Terms
Accessibility: According to Maxwell (2021), “The quality of being easily understood or
appreciated. Also, it is the quality of being easy to obtain or use.
Education: Education is the process of facilitating learning, or the acquisition of knowledge,
skills, values, morals, beliefs, habits, and personal development.
Factors: A factor is one of the things that affects an event, decision, or situation.
Healthcare Service: According to John (2022), “Health Care service means any service
provided by a health care professional, or by any individual working under the supervision of a
health care professional, that relates to the diagnosis, prevention, or treatment of any human
disease or impairment.
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Single Parenting: A single parent, sometimes called a solo-parent is a parent that is not living
with a spouse or partner, who has most of the day-to-day responsibilities in raising the child or
children (Dowd, 2022).
Socio-Economic: This is relating to, or involving a combination of social and economic factors
(Merriam, 2022). It is a branch of economics that looks at how economic activity influences
social behavior as well as how social trends and patterns influence society.
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CHAPTER TWO
LITERATURE REVIEW AND THEORETICAL FRAMEWORK
2.0 Introduction
This section of the study is divided into two parts. The first part focuses on the review of recent
and relevant literatures on; socio-economic factors affecting the access and utilization of
healthcare service, level of availability of primary health care services centers and the level of
utilization of primary health care service centres. These literatures will be reviewed based on the
contributions of scholars in this area. It concludes by stating the gap the study intends to fill. The
second parts discussed the theoretical framework upon which the study will based it course.
2.1 Review
2.1.1 Socio-economic factors influencing Health Seeking Behavior
Studies that have attempted to describe factors that significantly affect health-seeking behavior
during illness episodes can be broadly classified into two groups (Hausmann-Muela et al., 2020).
The first group comprises studies that emphasize the utilization of the formal system, or the
health care-seeking behavior of people. The studies that fall under this category involve the
development of models that describe the series of steps people take toward health care. These
models are sometimes referred to as 'pathway models' (Hausmann-Muela et al., 2020). While
there are several variations of these models, the Health Belief Model and Andersen's Health
Behavior Model are often used as a basis in discussions involving HSB (Aday & Andersen,
2021).
8
The second group comprises studies that emphasize the process of illness response, or health-
seeking behavior. These studies demonstrate that the decision to engage with a particular medical
channel is influenced by a variety of factors, such as socio-economic status, sex, age, social
status, the type of illness, access to services, and perceived quality of the service (MacKian,
2003; O'Donnell, 2007). The majority of the studies under this second category focus on specific
genres of determinants that lie between patients and services, such as geographical, social,
economic, cultural, and organizational factors (O'Donnell, 2007; Hausmann-Muela et al., 2003;
Ensor & Cooper, 2004). For example, access to health facilities, socio-economic status, and
perceived quality of service have been found to be significant influencers of health-seeking
decisions among different population segments (Ensor & Cooper, 2004; Gage & Guirlène
Calixte, 2006; Thiede, 2005).
Several studies were conducted on the factors affecting the utilization of health care services
both locally and internationally for instance; Chimela, Nkem, Nanaemeka and Abiodun (2022)
found in their study that average age was 45.44 years, with a majority being females. Most of
them were married, and households typically comprised 5.23 individuals. A large proportion of
respondents demonstrated good knowledge of primary health centers in their area, and a
significant number utilized these centers moderately. Analysis revealed a significant relationship
between respondents' socio-economic characteristics and their utilization of primary health care
services, as indicated by the computed F-ratio value exceeding the tabulated value at a
significance level of 1%. Consequently, the null hypothesis suggesting no significant relationship
was rejected.
A socio-economic gradient in health, whereby wealthier, more highly educated persons
experience better health than poorer, less educated persons, have been well reported across and
9
within many countries (Veugelers, 2020). A study done in Ebonyi and Enugu in 2020 showed
that as SES increases (from lower to upper social class), households used more of own money to
pay for health care. Also, as SES quartile decreased (from upper to lower social class), the
households sold their assets to pay for healthcare (Onwujekwe, et al., 2020). Another study later
done in Anambra state in 2013 revealed that as SES quintiles increases, there was an increase in
outpatient department expenditure in public hospitals suggesting an income effect since the
poorer quintiles were constrained by their budgetary limits to spend less on healthcare and also
possibly travel shorter distances or use less comfortable but cheaper means of transportation to
visit healthcare providers (Onwujekwe, Onoka & Uzochukwu, 2020).
Studies in Tajikistan showed that healthcare utilization differed across SES groups according to
ability to pay and showed that Out – of – pocket spending on healthcare (OOPS) prevented poor
people from seeking care and prevented those that did from receiving appropriate care (FMOH,
2022). Out-of-pocket spending (OOPS) on healthcare are formal charges levied or payments
made at the point of use for any aspect of healthcare services, and they may be charged as
consultation fees, fees for drugs and medical supplies or charges for any health service rendered,
such as outpatient or inpatient care (Hercot, 2020). Payment for healthcare services in the form
of out-of-pocket user charges, are likely to present a barrier to access and utilization of quality
healthcare services.
According to Buor (2020), using developing countries as a case study (Nigeria inclusive), the
low budgetary disbursement on health care services has negatively influenced the supply of
adequate and effective health facilities and services. Likewise, poor economic status makes
quality health care out of reach to a larger segment of the population which has influenced the
effective health care services usage among individuals in urban cities. In view of these, Buor
10
(2022) argues that, economic conditions that relate to the environment, as well as lifestyle and
access to health care services are seen as important factors affecting people in obtaining adequate
health care services utilization.
Studies that have attempted to describe factors that significantly affect health-seeking behavior
during illness episodes can be broadly classified into two groups (Andersen, 2021; Kroeger,
2020; Thaddeus & Maine, 2020). The first group consists of studies that emphasize the
utilization of the formal system, or the health care-seeking behavior of people. The studies that
fall under this category involve the development of models that describe the series of steps
people take towards health care. These models are sometimes referred to as ‘pathway models’
(Janz & Becker, 2021). While there are several variations of these models, the Health Belief
Model and Andersen’s Health Behavior Model are often used as a basis in discussions involving
health-seeking behavior (HSB) (Janz & Becker, 2022; Andersen, 2023).
The second group comprises those studies that emphasize the process of illness response, or
health-seeking behavior. These studies demonstrate that the decision to engage with a particular
medical channel is influenced by a variety of factors such as socioeconomic status, sex, age,
social status, type of illness, access to services, and perceived quality of the service (Aday &
Andersen, 2021; Mechanic, 2023). The majority of studies under this second category focus on
specific determinants, such as geographical, social, economic, cultural, and organizational
factors (Andersen, 2022; Thaddeus & Maine, 2020). For example, access to health facilities,
socioeconomic status, and perceived quality of service have been found to be significant
influencers of health-seeking decisions among different population segments (Kroeger, 2021;
Thaddeus & Maine, 2020).
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Socio-economic factors play a significant role in shaping health-seeking behavior, influencing
when, where, and how individuals seek medical attention. One of the most influential factors is
income level, which can either facilitate or hinder access to healthcare services. People with
higher incomes generally have more resources to access formal healthcare services, afford better
treatment, and even pursue preventive healthcare measures. Conversely, low-income individuals
often face financial barriers that prevent them from seeking timely care, exacerbating health
disparities. Research has shown that people from lower-income brackets may delay seeking care
or opt for informal treatment due to the cost of services, transportation, and medications (Dantas
et al., 2021; Ahmed et al., 2015).
Education also strongly influences health-seeking behavior by shaping people's understanding of
their health needs and the importance of formal healthcare services. Individuals with higher
levels of education tend to be more knowledgeable about symptoms, healthcare options, and the
long-term benefits of seeking professional help. This awareness often leads to earlier diagnosis
and treatment of diseases, improving health outcomes. On the other hand, those with lower
education levels may have limited awareness of healthcare systems and resources, leading to
delayed care or reliance on traditional or alternative medicine (Tey et al., 2014).
Another important socio-economic factor is employment status, particularly in relation to access
to health insurance. Those with formal employment often have access to employer-sponsored
health insurance, which facilitates access to a wider range of healthcare services. On the
contrary, individuals employed in informal sectors or those who are unemployed may lack health
insurance and therefore face significant barriers in accessing healthcare. As a result, people in
informal or low-paying jobs may rely on self-medication or underutilize health services (Ahmed
et al., 2015).
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Geographical access to healthcare facilities also affects health-seeking behavior, especially for
rural populations. People living in rural areas often face longer travel distances to healthcare
centers, inadequate health infrastructure, and fewer healthcare professionals. These barriers,
when combined with socio-economic challenges, significantly reduce healthcare utilization rates
in rural regions compared to urban areas. Research has shown that rural populations are more
likely to seek care from informal healthcare providers due to the lack of accessible formal
healthcare facilities (Ogunleye & Adeyemi, 2020).
Cultural beliefs and social roles also intersect with socio-economic factors to influence health-
seeking behavior. For example, gender norms in certain cultures may limit women's autonomy in
seeking healthcare, especially in lower-income settings. Women may prioritize the health of their
families over their own or may lack financial independence to afford healthcare services. Social
stigmas around certain illnesses, particularly mental health conditions, can further deter
individuals from seeking care (Kaggwa et al., 2021; Bhagat et al., 2019).
2.1.2 Level of Availability of Primary Health Care Services Centers
Agofure and Sarki (2021) who studied the utilization of Primary Health Care Services in Jaba
Local Government Area of Kaduna State Nigeria, and that of Taokik, Oluwatosin, Dipelu,
Oluwasanu, and Adeosu (2024) who studied utilization of primary health care facilities in Lagun
Community of Lagelu Local Government Area of Oyo State Nigeria, all implicated. lack of
drugs and basic laboratory services, and a regular absence of physician on site at the facility as
well as nonchalant attitudes of health care workers at the PHC facilities towards their clients of
care.
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Similarly, Anyebe, Ngaski, Murtala and Balarabe (2020) concluded in his study that PHC service
providers and users reported that PHC centers lacked any formal MHSs, and only a few personal
efforts by service providers were mentioned. The service users could not attest to even these
unofficial services. Primary MHSs remain conspicuously absent at community level in the study
areas. Both service providers and users attest to the near-complete scarcity despite their
willingness to provide and use the services, respectively, if and when formal arrangements can
be made.
Oluwadare, Adegbilero-Iwari, Fasoro and Faeji (2024) concluded that the proportion of those
who had ever utilized PHC services was 45.7%. Significant predictors of the utilization of PHC
centers include knowledge of the location of a PHC center, awareness that PHC centers operate
24 hours every day, and awareness that community members are part of the PHC staff.Non-
availability of medical personnel and ease of access to secondary and tertiary health institutions
are potential threats to the use of PHC facilities. Adejumo et al., (2024) Among the 305 health
facilities assessed, 96 (31.5%) were in urban, 94 (30.8%) in semiurban and 115 (37.7%) in rural
local government areas. Majority of the health facilities (43.0%) were manned by community
extension workers. Only 1.6% and 19.7% of the health facilities had physicians and pharmacy
technicians, respectively. About 22.3% of the providers had training in hypertension in the last 1
year. All the PHCs lacked adequate supply of essential antihypertensive medications. The
identified deficiencies were less common in the urban PHCs compared with others.
According to Abang et al. (2022) the above issues have led to the preference of indigenous
treatment and health care over modern medicine. Indigenous treatment and services charges are
very moderate and accessible, in some cases, the users of this traditional medicine have access to
credit facilities, which in modern medicine is not the case because charges are usually
14
standardized as given by the Council or government, which has over the years affected the
effective use of healthcare services from those found in low socio-economic groups (Mekonnen
and Mekonnen, 2022). Anderson (2020), emphasized the role of economic indices in the
utilization of health care services, and see family income as playing key role in the healthcare
services usage pattern of families. Agunwa et al, (2020) concluded that PHC services utilisation
was low. Improving utilisation would require addressing cost of health services, adequacy of
healthcare staff, patient waiting time and ensuring patient satisfaction with PHC services.
Health care services in Nigeria are provided by a multiplicity of health care providers in the
public and private sectors. As at December 2011, 34 173 health facilities from 36 states and the
Federal Capital Territory were listed in the National Health Facility Directory. Of this number,
30 098 (88%) are PHC facilities, 3992 (12%) are secondary-level facilities, while 83 (1%) are
tertiary-level facilities. More than 66% of the facilities are public (government) owned. There are
efforts to make the master facility list interoperable with the national District Health Information
System platform to strengthen routine health data analysis (NPHCDA, 2015). Most services
provided by private and public formal establishments are clinic based, with minimal outreach,
home and community-based services. Provision of community-based health services by CHEWs
is severely lacking, with very few or no CHEWs spending 80% of their time in the community,
mainly because of challenges with logistics. There is consequently weak community
participation and ownership (Uzochukwu &Ezenekwe, 2020).
Private providers include formal and informal forprofit or not-for-profit establishments such as
private hospitals, maternities, pharmacies, patent medicine vendors and traditional health care
providers. The private sector delivers health care to approximately 60% of the population and
serves as the first point of call for over 80% of people (Wang, 2022). However, the engagement
15
of the private sector through private– public partnership mechanisms is currently weak, as the
exact nature of the role that private sector actors might play is far from certain. Some see
working with the private sector as a pragmatic necessity in a government-dominated system,
others see the role for the private sector as focusing on service provision, while others see a
distinct role for private financing (Ogunbanjo, 2021).
Most primary health facilities across the country are poorly equipped, with only a quarter of
health facilities having more than 25% of the minimum equipment package. A large proportion
of these facilities are in deplorable condition, largely due to poor funding at the state and local
government levels. The functionality of PHC facilities varies with geographical location and
geopolitical zone. The proportion of PHC facilities providing immunization services ranges from
0.5% in the North East to 90% in the South West. The capacity to provide basic emergency
obstetric services remains very limited – only around 20% of PHC facilities have that capacity
(NPHCDA, 2015).
The availability of basic amenities to support an enabling working environment and quality
services (for example electricity or generator, emergency transportation system, and good
sanitary and waste management practices) is poor in many of the PHC facilities (Nwafor, 2020).
Data on the case management competency of health facility staff across a number of tracer
diseases, including malaria and other common conditions with a high burden, show that on
average only 37.4% of all cases considered were correctly diagnosed by all health workers
(Primary health care review, 2020).
Although primary health centres were established in both rural and urban areas in Nigeria with
the intention of equity and ease of access, the rural population is seriously underserved compared
16
to their urban counterparts (Abdulraheem, 2021). This inequity has been attributed to (a)
governmental factors, such as lack of political commitment, inadequate funding or
misappropriation of funds, weak intersectoral collaboration and intergovernmental struggles for
power and control; (b) people- or client-related factors, such as community perceptions of poor
quality and inadequacy of available services in the PHC centres, underutilization of PHC
services and low levels of community participation; and (c) other factors, such as lack of
motivation in the workplace (for example due to poor remuneration), unhealthy rivalry between
various categories of health workers, non-involvement of the private health sector in the planning
and implementation of PHC, poor management of information systems and heavy dependence on
initiatives funded by foreign donors (Abdulraheem, 2020).
The primary healthcare (PHC) system is the closest level of healthcare to individuals, the family,
and the community, as enshrined in the National Health Policy (Federal Ministry of Health,
2024; National Primary Health Care Development Agency, 2020). Effective delivery of
healthcare services requires the availability of adequate infrastructure, basic diagnostic medical
equipment, drugs, and well-trained medical personnel. Quality PHC initiatives have been
recognized as fundamental to improving health outcomes (World Health Organization, 2008;
Global Health Workforce Alliance, 2023). Strengthening PHC is the most inclusive, effective,
and efficient approach to enhance people’s health and well-being. PHC is the cornerstone of a
sustainable health system for universal health coverage and health-related Sustainable
Development Goals (SDGs), especially SDG 3, which aims to ensure healthy lives and promote
well-being for all at all ages. There is a need for equity and efficiency in healthcare service
delivery through the provision of technical and financial support to healthcare facilities at all
levels of administering services (Global Health Workforce Alliance, 2023; World Health
17
Organization, 2021). To effectively manage health services and achieve good quality of care,
standards have to be put in place (National Primary Health Care Development Agency, 2020;
World Health Organization, 2021).
The Ward Health System (WHS), which is the strategic thrust for the delivery of PHC services in
Nigeria, was introduced by the National Primary Health Care Development Agency (NPHCDA)
in 2020 to improve health and sustain effective and efficient PHC service delivery at the
electoral ward level. In addition, to ensure effective delivery of PHC services, the Ward
Minimum Health Care Package (WMHCP) was developed to provide the wards with a minimum
set of health services needed to meet the basic health requirements of households towards
achieving the global target of “Health for All” at a low cost (Federal Ministry of Health, 2004;
National Primary Health Care Development Agency, 2020). To facilitate this, effective
integration of all PHC services under one authority is needed to reduce fragmentation in the
delivery of PHC services, thus bringing Primary Health Care Under One Roof (PHCUOR)
(World Health Organization, 2022; National Primary Health Care Development Agency, 2020).
2.1.3 Level of utilization of Primary Health Care Service Centers
According to Anderson (2022), the choice of utilizing health services involves ability to perceive
and recognize symptoms, the degree to which the side effects are seen as hazardous, the measure
of resilience for the manifestations, and essential needs that lead to rejection of health services
utilization. Several factors such as cultural, social, gender, economic and geographic variables
predispose people to poor utilization of health services. The dimensions normally connected with
socioeconomic status differentials are occupational status, educational accomplishment, income,
poverty and wealth (Krieger et al., 2020).
18
In numerous societies, there are individuals and groups placed in prominent economic status
having better privileges and opportunities to enjoy better health care services than their low
income counterparts. Abodurin (2020), added that the decision to utilize a particular health care
facility is to a great extent controlled by the satisfaction derived from services and the apparent
nature of care provided. This decision is sometimes restricted by variables for example,
affordability, accessibility, availability of services of the health care outlets; customs and beliefs,
critical nature of care required including the confidence in the efficacy of service provided to
address of the need of the user (Abdulraheem& Amodu, 2022). The choice is also impacted by
the client's comprehension of the capacity of the various degrees of function of the different
levels of health facilities. In Nigeria, health care structure is a framework consisting of both
public and private health services. In the public segment, services include: Primary Health Care
(PHC), Secondary and Tertiary health care which correspond to the different levels of
administration. More so, in the private sector, the health care service utilization is capital
intensive and health care service utilization is highly tied to monetary terms, and services are
only rendered to those who patronize them (Omonona, 2022).
According to the World Health Organization (2021), the life expectancy rate of Ghanaians is
62.5 years. However, Ghana is riddled with non-communicable diseases such as hypertension,
diabetes and stroke which reduces the quality of life for the aged. About 422 million people in
the world are living with diabetes, and a majority of this population are found in low and middle-
income countries including people in the sub-Saharan Africa. Every year, diabetes accounts for
over 1.6 million deaths in the world. Currently 19 million adults are living with diabetes in
Africa. This is projected to increase to 47 million in the next 20 years due to Impaired Glucose
Tolerance which increases the risk of developing type 2 diabetes (IDF,2020). Unfortunately, the
19
incidence and prevalence of diabetes continue to rise (WHO,2020). There has been a significant
increase in the burden of diabetes in Africa from 6.2% to 13.9% (Boaheng,2020). The prevalence
of diabetes in Ghana is consistent with that of countries in the sub-Saharan Africa.
Diabetes requires accurate diagnosis in order to design appropriate treatment and intervention.
Any hindrance in finding and receiving appropriate medical care early for an array of health
conditions may lead to development of complications that may lead to disabilities and death or
increased cost of care due to the progression of the disease (Nuhu, 2021). Early detection of
diabetes is vital in order to prevent Diabetes related health complications such as cardiovascular
problems encapsulate ischemic heart disease, myocardial infarctions, high blood pressure and
stroke. Sociodemographic characteristics, belief systems and practices, level of education and
political systems have been noted to play a huge role in the health seeking behavior of
individuals. Research indicates that Inappropriate Health Seeking Behavior can be connected to
worse health outcomes, increased morbidity and mortality rates and poorer health statistics of a
country (Atuyambe, 2020).The utilization of Primary Health Care (PHC) service centers remains
a critical focus in improving healthcare delivery worldwide. Several factors affect the level of
utilization, especially in low- and middle-income countries. According to recent studies, key
determinants include geographical accessibility, socio-economic status, perceived quality of care,
availability of healthcare professionals, and community engagement.
For example, access to PHC services is generally higher in urban areas where infrastructure is
better established, compared to rural regions where healthcare facilities are often sparse. In rural
areas, the introduction of mobile clinics and community-based health programs has been shown
to improve PHC utilization by overcoming geographical barriers. However, factors such as
socio-economic disparities, social isolation, and cultural beliefs also play significant roles in
20
determining whether individuals seek healthcare at PHC centers (JAMA Network, 2020). Social
isolation, especially among older adults, significantly reduces healthcare utilization, highlighting
the need for stronger community-based interventions (Frontiers, 2023).
In some settings, employer-sponsored primary care models have proven effective in increasing
the use of PHC services by offering convenient, subsidized access to healthcare. These models,
however, tend to show higher utilization among specific segments of the population, such as
older or higher-income employees, indicating the need for tailored approaches to ensure equity in
healthcare access (Basu et al., 2020).Improving utilization also requires strengthening healthcare
systems through better training of healthcare workers, increasing public awareness of the
available services, and ensuring a reliable supply of essential medicines and equipment.
2.2 Theoretical Framework
Theories are formulated to explain, predict, and understand phenomena and, in many cases, to
challenge and extend existing knowledge within the limits of critical bounding assumptions. The
theoretical framework is the structure that can hold or support a theory of a research study. The
theoretical framework introduces and describes the theory that explains why the research
problem under study exists. This study will employed three delay model to predict and
understand the topic under study.
2.2.1 Three Phase Delay Model
Thaddeus and Maine (1994) proposed the three phase delay model. In delay one,deciding to seek
care. They discuss health seeking behaviour as being influenced by the “characteristics of the
illness as perceived by individuals”. “pregnancy and childbirth are commonly considered natural,
normal work for women…just as pregnancy is considered a normal event, death during labour
21
and delivery may sometimes be considered ‘normal’ or inevitable” (2020:2022). A decision to
seek care, whether self-care, traditional, modern or a combination of them, depends on the cause
to which an illness, in this case, prolonged labour, is attributed. Traditional remedies may be
tried first because that is what is available and accessible.
Delay two: Delay in reaching a health facility. “The accessibility of services plays a dual role in
the health-care-seeking process. On the one hand, it influences people’s decision making but on
the other hand, it determines the time spent in reaching a facility after the decision to seek care
has been made” (Thaddeus & Maine, 1994:1156). In rural areas delays due to distance and the
unavailability of transportation are common. People may have to travel long distances over
difficult terrain to reach the few medical facilities that exist. Secondly, the scarcity of
transportation means that rural people often have to walk or improvise transportation to reach a
medical facility.
Delay Three: Delay in receiving adequate/appropriate care in a facility. Delays in this phase are
an indication of inadequate care that results from shortages of staff, essential equipment,
supplies, drugs and blood as well as inadequate management. Late or wrong diagnosis and
incorrect action by the staff are other factors that contribute to delays in timely provision of
needed care (Thaddeus and Maine, 1994).
The Three Phase Delay Model, often applied in health-seeking behavior research, was developed
to explore and explain the reasons for delays in receiving adequate medical treatment. The model
is divided into three distinct phases: the delay in deciding to seek care, the delay in reaching a
healthcare facility, and the delay in receiving adequate treatment at the healthcare facility. Each
phase of delay represents different obstacles and challenges that individuals may face, which can
22
have significant consequences on health outcomes. This model provides a useful framework for
understanding why people may delay seeking care, particularly in low-resource settings, where
access to healthcare is often limited (Thaddeus & Maine, 1994).
The first phase, delay in deciding to seek care, involves factors that prevent individuals from
recognizing the need for medical attention and making the decision to seek care. This phase is
influenced by socio-economic factors, cultural beliefs, and knowledge about health conditions.
For instance, in many societies, cultural norms or gender roles may prevent women from seeking
medical care without the permission of male family members (Foster & McBeth, 2020). In
addition, individuals may delay seeking care due to a lack of understanding of the seriousness of
their condition, fear of stigma, or reliance on traditional healing practices. Understanding this
first phase is crucial because it highlights the role of health education and awareness in
improving timely access to healthcare.
The second phase, delay in reaching a healthcare facility, refers to the physical and logistical
barriers that prevent individuals from accessing medical services. These barriers often include
geographical distance, lack of transportation, poor road infrastructure, and high travel costs. This
phase is particularly relevant in rural areas, where healthcare facilities may be few and far
between. Studies have shown that longer travel times are associated with increased mortality
rates, especially in cases of emergencies like obstetric complications (Gizaw et al., 2020). The
availability of ambulances, improved roads, and community-based health initiatives have been
identified as important strategies to reduce delays in this phase.
The third phase, delay in receiving adequate care, takes place at the healthcare facility and
encompasses the time from arriving at the facility to receiving the necessary treatment. This
23
phase is often influenced by healthcare system factors, such as overcrowding, understaffing, lack
of medical supplies, or insufficient training of healthcare providers. Delays in this phase can also
occur due to misdiagnosis or administrative inefficiencies, which prolong the time patients spend
waiting for care (Mujinja et al., 2020). Strengthening the capacity of healthcare facilities,
improving the efficiency of hospital workflows, and ensuring the availability of essential medical
supplies can help address this delay.
In the context of maternal health, the Three Phase Delay Model has been extensively used to
explain why women in low- and middle-income countries often experience delays in accessing
emergency obstetric care, which contributes to high maternal mortality rates. Research has
shown that delays in recognizing the severity of complications, coupled with limited
transportation options and poorly equipped healthcare facilities, often result in preventable
maternal deaths (Souza et al., 2021). Interventions that target all three phases of delay, such as
improving maternal health education, expanding rural healthcare infrastructure, and enhancing
the training of healthcare providers, have been proposed to reduce these delays.
Moreover, the Three Phase Delay Model is not limited to maternal health; it can be applied to a
variety of healthcare contexts. For example, in cancer treatment, delays in diagnosis and
treatment are common, particularly in low-resource settings. Patients may delay seeking care due
to a lack of awareness about cancer symptoms, and even when they do seek care, they may face
challenges in accessing specialized treatment due to the high cost and scarcity of oncology
services. The delay in receiving appropriate treatment at healthcare facilities due to long waiting
lists or the absence of necessary medical equipment further exacerbates these delays (McKenzie
et al., 2020).
24
Addressing the three phases of delay requires a comprehensive approach that considers the
complex interplay of individual, community, and healthcare system factors. Efforts to reduce
delays in deciding to seek care must focus on improving health literacy, addressing cultural
barriers, and encouraging early health-seeking behavior through community outreach programs.
Reducing delays in reaching healthcare facilities requires investments in infrastructure,
transportation, and the decentralization of healthcare services to bring care closer to communities
(Waiswa et al., 2020). Finally, improving the quality and timeliness of care at healthcare
facilities requires adequate staffing, better resource management, and continuous professional
training of healthcare providers.
The model also emphasizes the importance of health system strengthening to ensure timely and
quality care. Systemic weaknesses, such as poor facility management and inadequate resources,
often contribute to delays in receiving care once a patient has arrived at a health center. Health
system reforms that focus on resource allocation, staff training, and patient flow management
can reduce the time between arrival and treatment, ultimately improving health outcomes (Van
den Broek & Ntonya, 2020).
2.2.2 Application of the theories
The Three Phases of Delay is a model designed to explain causes of maternal mortality.
Thaddeus and Maine view delay as having three phases. Delay may occur in the decision to seek
care. They call this phase I delay. Once the decision to seek care has been made, and even when
it is a timely decision, delay may occur on the way to the care facility. This is phase II delay.
Finally, once a pregnant woman has reached a medical facility, she may be delayed in receiving
needed care. This is phase III delay. In other words, the patient's decision to seek care, the
availability of transportation, the condition of the roads, and the facility's capabilities to deal
25
promptly with complications can cause delay in seeking care. Thus, delay is a concept that unites
a number of seemingly disparate factors such as distance, patient's status, distribution of facilities
and shortage of hospital supplies.
26
CHAPTER THREE
METHODOLOGY
3.0 Introduction
This chapter presented the methodology to be use in conducting this research work. And the
chapter is organized on the following headings: description of the study area, research design,
population of the study, sample size and sampling procedure, method of data collection,
instrument of data collection and method of data analysis.
3.1 Research Design
A research design is a procedural plan that is adopted by the researcher to answer questions
validly, objectively, accurately and economically. A research design therefore answers questions
that was determined the path you are proposing to take for your research journey. Through a
research design you decide for yourself and communicate to others your decisions regarding
what study design you propose to use, how you are going to collect information from your
respondents, how you are going to select your respondents, how the information you are going to
collect is to be analyzed and how you are going to communicate your findings (Sajid, 2022).The
surveys research method was used for this study. This will be considered because survey design
generally can be used to effectively investigate problems in realistic settings.
3.2 Description of the Study Area
Wuntin Dada is a notable historical and cultural site in Bauchi Local Government Area (LGA) of
Bauchi State, Nigeria. Its history is deeply intertwined with the rich heritage of Bauchi,
particularly in its role in the early settlement patterns, political developments, and the socio-
27
cultural life of the region.The name "Wuntin Dada" refers to the Wunti Dada rock formation,
which is a natural feature that overlooks Bauchi town. The area surrounding Wuntin Dada was
originally a small settlement founded by early inhabitants who sought the natural protection
offered by the hills and rocks. The location was strategically advantageous, serving as a refuge
during times of conflict and invasions. The area’s history dates back to pre-colonial times when
communities relied heavily on natural formations like Wuntin Dada for security .
Wuntin Dada has gained historical prominence due to its association with traditional rulers and
the historical significance of Bauchi itself. Bauchi State, established in 1976, has its capital in
Bauchi town, which has long been a hub for trade and governance in northern Nigeria . The
Wuntin Dada area is often associated with the indigenous people of Bauchi, who were part of the
larger Habe or Hausa community before the Fulani Jihad of the early 19th century .The rock
formation at Wuntin Dada is regarded as a cultural landmark, and its surrounding area has
become a part of local legends and folklore. Oral history suggests that Wuntin Dada served as a
meeting point for the people and played a role in local governance, especially during the reign of
traditional rulers in the early history of Bauchi.
During the British colonial period, Bauchi, including Wuntin Dada, underwent significant
changes. Bauchi emerged as an important administrative center, and the colonial government
recognized the area’s strategic importance. Wuntin Dada’s proximity to the heart of Bauchi town
made it a point of interest for both colonial authorities and the local elite . The surrounding areas
witnessed the development of infrastructure, including roads and government buildings, linking
Bauchi to other parts of northern Nigeria.
28
In the post-colonial era, Wuntin Dada has remained a significant landmark within Bauchi LGA.
The area has gradually urbanized, though efforts to preserve its historical and natural features
have been made. The rock formations at Wuntin Dada are now considered important for both
tourism and local history, attracting visitors interested in the cultural heritage of Bauchi .Wuntin
Dada has also contributed to the local economy through tourism. The scenic view provided by
the rock formations has made it a minor tourist attraction within Bauchi State. Additionally,
Wuntin Dada continues to serve as a residential and commercial area, supporting the local
population in Bauchi LGA .
3.3 Population of the Study
The population will be drawn from the entire population of Wuntin Dada North. Wuntin Dada
Bauchi LGA has a total population 45,000 as at 2022 (Macrotrend, 2022). Also, the population
of the study comprised of both Male Female within the age of 18 and above.
3.4 Sampling Size
To determine the sample size to beusein selecting the sample for the population, the Krecie and
Morgan 1970 tablewas adopted.Adopting from the table a total of one hundred and twenty (120)
will be use as a result distributed to the general population of Wuntin Dada.
3.5 Sampling Techniques
Several sampling techniques are in disposal of a researcher. Meanwhile, in the course of the
research, the multi stage cluster sampling technique will be adopted. This method of sampling
will be adopted because it was difficult to compile an exhaustive list of the total population. The
multi stage cluster sampling technique together with simple random sampling was used for the
selection of respondents.
29
3.6 Method of Data Collection
In carrying out this research, the research instrument for collecting information consists of
questionnaire. The questionnaire will be developed from the statement of the problems, research
questions and literature review. They will also be designed around the objectives of the study
bearing in mind the desire to systematically obtain from the respondents the most reliable
information to achieve maximum effect. The research question will be based on, (Agree,
Disagree and Undecided) etc in order to comprehensively tabulate the responses of the
respondents.
3.7 Instruments for Data Collection
This study will utilize the questionnaire to solicit responses from the research sample elements
on the topic under study. The questionnaire will be preceded by an introductory letter explaining
the purpose of the questionnaire and assuring the respondents that their responses is kept
confidential,anonymous and used strictly for academic purposes. The questionnaire will be
divided into two sections.
Section A contained questions concerning the demographics of the respondents. Section B
contained questions which were related to the research objectives. The questions will be set in
simple conversational language that is easy to understand.
The copies of the questionnaire will be administered directly and collected back after completion
by the respondents on the spot.
30
3.8. Method of Data Analysis
Ali (2006) describes statistics as "the appropriate treatment or analysis of quantitative measures
or values obtained from observing or testing a sample." For the purpose of this study, descriptive
statistics like percentages, tables, frequencies and charts will be used to analyse and present the
findings. The simple percentage will be considered appropriate for the researcher, as it will
enable him plot each item against it responses.
3.9 Ethical Considerations
Ethical considerations entails doing a task in accordance with principles of conduct that are
considered correct, especially those of a given profession or group. For this reason, a letter of
introduction will be produced by the Head of Sociology Department, Faculty of Social Sciences,
Saadu Zungur University, Bauchi, requesting permission and assistance from potential
respondents and key Informants to enable the successful completion of the research field work.
Their voluntary consent was sought, to give detail information on the phenomena under
study;research participants were guaranteed their confidentiality. All the questions asked was
relevant to the research as no issue was raised that could cause any excessive emotional outburst
from the participants. Money or any incentive will not be given to any of the participants for
information. In the course of the research, no participant was harmed in any form and the choice
of time and location was left at the discretion of the participants.
31
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
4.1 Introduction
This chapter deals with the presentation and analysis of data collection from the completed and
returned questionnaires administered during survey. To facilitate the analysis, tabular format
have been used in which response are summarized and displayed.
4.2 Data Presentation and Analysis
One hundred and twenty six (126) questionnaires were distributed to respondents which the
researcher successfully retrieved one hundred and twenty (120), hence all the analysis is based
on the one hundred and twenty questionnaires retrieved.
Table 1: Gender of the Respondents
Items Frequency Percentage
Male 80 66.7%
Female 40 33.3%
Total 120 100%
Source: Field Work, 2024.
Table 1 above showed that 80 representing 66.7% of the respondents are male while 40
accounting for 33.3% of the respondents are female. This result indicated that majority of the
respondents are male.
Table 2: Age category of the Respondents
32
Age category Frequency Percentage
15 – 24 30 25%
25 – 34 60 50%
35 – 44 20 16.7%
45 and above 10 8.3%
Total 120 100%

The table 2 above shows that 30 representing 25% of the respondents are within 15 – 24 years,
60 representing 50% of the respondents are within 25 – 34 years, 20 accounting for 16.7% of the
respondents are within 35 – 44 years while only 10 accounting for 8.3% of the respondents are
within 45 and above. This shows that majority of the respondents are aged between 25 – 34
years.
Table 3: Occupation of the Respondents
Occupation Frequency Percentage
Business 50 41.7%
Civil servant 20 16.7%
Farmer 10 8.3%
Students 35 29.2%
Unemployed 5 4.2%
Total 120 100%

Table 3 above shows that 50 accounting for 41.7% of the respondents are Business men/women,
20 accounting for 16.7% of the respondents are civil servant, 10 representing 8.2% of the
respondents are farmers, 35 accounting for 29.2% of the respondents are Students while only 5
33
representing 4.2% of the respondents are unemployed. This result shows that the occupation with
the highest frequency/percentage is business men/women.
Table 5: Marital Status of the Respondents
Marital status Frequency Percentage
Single 45 37.5%
Married 70 58.3%
Divorced 5 4.2%
Total 120 100%
Source: Field Work, 2024
Table 5 above on the marital status of the respondents shows that 45 accounting for 37.5% of the
respondents are single, 70 accounting for 58.3% of the respondents are married while 5
representing 4.2% are divorced. This shows that majority of the respondents are married.
WHAT ARE THE SOCIO-ECONOMIC FACTORS INFLUENCING HEALTH
SEEKING BEHAVIOR
Table 6: Finance is one of the factor that affect the access and utlizaton of health care
services in Wuntin Dada
Strongly Agreed 41 34.2%
Agreed 37 30.8%
Undecided 27 22.5%
Strongly Disagreed 8 6.7%
Disagreed 7 5.8%
Total 120 100
Table 11 above shows that 41 (34.2%) of the respondents strongly agreed that finance is one of
the factor that affect the access and utlizaton of health care services in Wuntin Dada, 37 (30.8%)
34
of the respondents agreed, 27 (22.5%) of the respondents are undecided, 8 (6.7%) of the
respondents strongly disagreed while 7 (5.8%) of the respondents disagreed. This result shows
that finance is one of the factor that affect the access and utlizaton of health care services in
Wuntin Dada.
Table 7: Education affect the access and utilization of healthcare services in Nigeria
Agreed 30 25%
Undecided 21 17.5%
Strongly Disagreed 18 15%
Disagreed 11 9.2%
Total 120 100
The table 12 above shows that 40 (33.3%) of the respondents strongly agreed that education
affect the access and utilization of healthcare services in Nigeria, 30 (25%) of the respondents
agreed, 21 (17.5%) of the respondents are undecided, 18 (15%) of the respondents strongly
disagreed while 11 (9.2%) of the respondents disagreed. This result shows that education affects
the access and utilization of healthcare services in Nigeria.
Table 8:Family background hinder the access and utilization of health care services
35
Agreed 37 30.8%
Undecided 22 18.3%
Disagreed 6 5%
Total 120 100
The table 13 above shows that 38 (31.7%) of the respondent strongly agreed that family
background hinder the access and utilization of health care services, 37 (30.8%) of the
respondents agreed 22 (18.3%) of the respondents are undecided, 17 (14.2%) of the respondents
strongly disagreed while 6 (5%) of the respondents disagreed. This result showed that family
background hinder the access and utilization of health care services.
Table 9: Culture and religious belief affect the access and utilization of healthcare services
in Wuntin Dada

Agreed 27 22.5%
Undecided 25 20.8%
Disagreed 6 5%
Total 120 100
The table 14 shows that 53 (44.2%) of the respondents strongly agreed that culture and religious
belief affect the access and utilization of healthcare services in Wuntin Dada, 27 (22.5%) of the
respondents agreed, 25 (20.8%) of the respondents are undecided, 9 (7.5%) of the respondents
36
strongly disagreed while 6 (5%) of the respondents disagreed. This result showed that culture
and religious belief affect the access and utilization of healthcare services in Wuntin Dada.
Table 10: Poverty affect the usage and utilization of health care services in Nigeria
Agreed 29 24.2%
Undecided 20 16.7%
Disagreed 9 7.5%
Total 120 100
The table 15 above shows that 50 (41.7%) of the respondents strongly agreed that poverty affect
the usage and utilization of health care services in Nigeria, 29 (24.2%) of the respondents agreed,
20 (16.7%) of the respondents are undecided, 12 (10%) of the respondents strongly disagreed
while 9 (7.5%) of the respondents disagreed. This result indicated that poverty affect the usage
and utilization of health care services in Nigeria.
LEVEL OF UTILIZATION OF PRIMARY HEALTH CARE SERVICE CENTRES

Table 11: I regularly visit the primary health care service center for check-ups and medical
advice.
37
Agreed 38 31.7%
Undecided 21 17.5%
Disagreed 10 8.3%
Total 120 100
Table 16 above indicated that 39 (32.5%) of the respondents strongly agreed that they regularly
visit the primary health care service center for check-ups and medical advice, 38 (31.7%) of the
strongly disagreed while 10 (8.3%) of the respondents disagreed. This result showed that the
respondents regularly visit the primary health care service center for check-ups and medical
advice.
Table 12: The primary health care service center is easily accessible from my location

38
Agreed 32 26.7%
Undecided 19 15.8%
Disagreed 10 8.3%
Total 120 100
The table 17 above shows that 44 (36.7%) of the respondents strongly agreed that the primary
health care service center is easily accessible from my location, 32 (26.7%) of the respondents
agreed, 19 (15.8%) of the respondents are undecided, 15 (12.5%) of the respondents strongly
disagreed while 10 (8.3%) of the respondents disagreed. This result indicated that the primary
health care service center is easily accessible from my location.
Table 13: The services provided by the primary health care center meet my health needs
Agreed 26 21.7%
Undecided 25 20.8%
Disagreed 6 5%
Total 120 100
The table 18 above shows that 53 (44.2%) of the respondents strongly agreed that the services
provided by the primary health care center meet my health needs, 26 (21.7%) of the respondents
agreed, 25 (20.8%) of the respondents are undecided, 10 (8.3%) of the respondents strongly
disagreed while 6 (5%) of the respondents disagreed. This result indicated that the services
provided by the primary health care center meet my health needs.
39
Table 14: I am satisfied with the quality of care received at the primary health care service
center.
Agreed 29 24.2%
Undecided 16 13.3%
Disagreed 11 9.2%
Total 120 100
The table 19 above shows that 51 (42.5%) of the respondents strongly agreed that theyare
satisfied with the quality of care received at the primary health care service center , 29 (24.2%) of
the respondent agreed, 16 (13.3%) of the respondents are undecided, 13 (10.8%) of the
respondents strongly disagreed while 11 (9.2%) of the respondents disagreed. This result showed
that the respondents are satisfied with the quality of care received at the primary health care
service center.
Table 15: I rely on the primary health care service center for most of my health care needs
Agreed 37 30.8%
40
Undecided 18 15%
Disagreed 10 8.3%
Total 120 100

The table 20 above shows that 43 (35.8%) of the respondents strongly agreed that they rely on
the primary health care service center for most of my health care needs, 37 (30.8%) of the
respondents agreed, 18 (15%) of the respondents are undecided, 12 (10%) of the respondents
strongly disagreed while 10 (8.3%) of the respondents disagreed. This result indicated that the
respondents rely on the primary health care service center for most of my health care needs.
LEVEL OF AVAILABILITY OF PRIMARY HEALTH CARE SERVICES CENTERS
Table 16: There are enough primary health care services in Wuntin Dada North
Agreed 31 25.8%
Undecided 19 15.8%
Disagreed 10 8.3%
Total 120 100
Table 6 above shows that 45 (37.5%) of the respondents strongly agreed that there are enough
primary health care services in Wuntin Dada North, 31 (25.8%) of the respondents agreed, 19
(15.8%) of the respondents are undecided, 15 (12.5%) of the respondents strongly disagreed
41
while 10 (8.3%) of the respondents disagreed. This result indicated thatthere are enough primary
health care services in Wuntin Dada North.
Table 17: People don’t have to go long distance for primary health care services in Wuntin
Dada North
Agreed 38 31.7%
Undecided 20 16.7%
Disagreed 9 7.5%
Total 120 100
The 7 table above shows that 39 (32.5%) of the respondents strongly agreed that people don’t
have to go long distance for primary health care services in Wuntin Dada North, 38 (31.7%) of
the respondents agreed, 20 (16.7%) of the respondents are undecided, 14 (11.7%) of the
respondents strongly disagreed while 9 (7.5%) of the respondents disagreed. This result indicated
that people don’t have to go long distance for primary health care services in Wuntin Dada
North.
Table 18: Women access maternal health care services with ease in Wuntin Dada
Agreed 37 30.8%
42
Undecided 18 15%
Disagreed 10 8.3%
Total 120 100
The table 8 shows that 43 (35.8%) of the respondents strongly agreed that women access
maternal health care services with ease in Wuntin Dada, 37 (30.8%) of the respondents agreed,
18 (15%) of the respondents are undecided, 12 (10%) of the respondents strongly disagreed
while 10 (8.3%) of the respondents disagreed. This result indicated thatwomen access maternal
health care services with ease in Wuntin Dada.
Table 19: Local and private hospitals provide the required health care services in Wuntin
Dada North

Agreed 29 24.2%
Undecided 16 13.3%
Disagreed 11 10.8%
Total 120 100
The table 9 shows that 51 (42.5%) of the respondents strongly agreed that local and private
hospitals provide the required health care services in Wuntin Dada North, 29 (24.2%) of the
43
strongly disagreed while 11 (9.2%) of the respondents are undecided. This result showed that
local and private hospitals provide the required health care services in Wuntin Dada North.
Table 20: Each and every individual in Wuntin Dada North can afford Maternal health
care services
Agreed 33 27.5%
Undecided 15 12.5%
Disagreed 11 9.2%
Total 120 100
Table 10 above shows that 50 (41.7%) of the respondents strongly agreed that each and every
individual in Wuntin Dada North can afford Maternal health care services, 33 (27.5%) of the
strongly disagreed while 11 (9.2%) of the respondents disagreed. This result indicated that each
and every individual in Wuntin Dada North can afford Maternal health care services
4.3 Discussion of Findings
The study is on assessed health seeking behavior of in wuntin Dada, Bauchi, LGA. Based on the
developed research questions and objectives the study was able to found that: finance, education,
family background, culture and religious belief as well as poverty are the major socio-economic
factors affecting the access and utilization of health care services in Wuntin Dada, Bauchi of
Bauchi state. Supporting these findings are the study of Chimela, Nkem, Nanaemeka and
44
Abiodun (2019) revealed a significant relationship between respondents' socio-economic
characteristics and their utilization of primary health care services, as indicated by the computed
F-ratio value exceeding the tabulated value at a significance level of 1%.
Consequently, the null hypothesis suggesting no significant relationship was rejected.A socio-
economic gradient in health, whereby wealthier, more highly educated persons experience better
health than poorer, less educated persons, have been well reported across and within many
countries (Veugelers, 2020). A study done in Ebonyi and Enugu in 2020 showed that as SES
increases (from lower to upper social class), households used more of own money to pay for
health care. Also, as SES quartile decreased (from upper to lower social class), the households
sold their assets to pay for healthcare (Onwujekwe, et al., 2020). Another study later done in
Anambra state in 2013 revealed that as SES quintiles increases, there was an increase in
outpatient department expenditure in public hospitals suggesting an income effect since the
poorer quintiles were constrained by their budgetary limits to spend less on healthcare and also
possibly travel shorter distances or use less comfortable but cheaper means of transportation to
visit healthcare providers (Onwujekwe, Onoka & Uzochukwu, 2020).
Moreover, the study found that there are enough primary health care services, people don’t have
to go long distance for primary health care services, women access maternal health care services
with ease, local and private hospitals provide the required health care services and that each and
every individual in Wuntin Dada North can afford Maternal health care services. These findings
are in line with the study of Agofure and Sarki (2017) who studied the utilization of Primary
Health Care Services in Jaba Local Government Area of Kaduna State Nigeria, and that of
Taokik, Oluwatosin, Dipelu, Oluwasanu, and Adeosu (2024) who studied utilization of primary
health care facilities in Lagun Community of Lagelu Local Government Area of Oyo State
45
Nigeria, all implicated. lack of drugs and basic laboratory services, and a regular absence of
physician on site at the facility as well as nonchalant attitudes of health care workers at the PHC
facilities towards their clients of care.
Similarly, Anyebe, Ngaski, Murtala and Balarabe (2020) concluded in his study that PHC service
providers and users reported that PHC centers lacked any formal MHSs, and only a few personal
efforts by service providers were mentioned. The service users could not attest to even these
unofficial services. Primary MHSs remain conspicuously absent at community level in the study
areas. Both service providers and users attest to the near-complete scarcity despite their
willingness to provide and use the services, respectively, if and when formal arrangements can
be made.
Moreover, supporting the study findings Oluwadare, Adegbilero-Iwari, Fasoro and Faeji (2024)
concluded that the proportion of those who had ever utilized PHC services was 45.7%.
Significant predictors of the utilization of PHC centers include knowledge of the location of a
PHC center, awareness that PHC centers operate 24 hours every day, and awareness that
community members are part of the PHC staff.Non-availability of medical personnel and ease of
access to secondary and tertiary health institutions are potential threats to the use of PHC
facilities.
46
CHAPTER FIVE
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
5.0 Introduction
This chapter outlines the summary of the study. The chapter also presents the conclusions of the
study based on the findings and recommendations.
5.1 Summary of the Major Findings
The study examined the assessed health seeking behavior of in wuntin Dada, Bauchi, LGA. The
major findings of this study are summarized below in line with the objectives of the
study.Finance, education, family background, culture and religious belief as well as poverty are
the major socio-economic factors affecting the access and utilization of health care services in
Wuntin Dada, Bauchi of Bauchi stateMoreover, the study found that there are enough primary
health care services, people don’t have to go long distance for primary health care services,
women access maternal health care services with ease, local and private hospitals provide the
required health care services and that each and every individual in Wuntin Dada North can
afford Maternal health care services.
The study also found that women regularly visit the primary health care service center for check-
ups and medical advice, the primary health care service center is easily accessible from my
location, the services provided by the primary health care center meet my health needs, women
are satisfied with the quality of care received at the primary health care service center and that
women rely on the primary health care service center for most of my health care needs.
47
5.2 Conclusion
The study's findings underscore the significant role that socio-economic determinants such as
financial constraints, educational attainment, family background, cultural norms, religious
beliefs, and poverty play in influencing healthcare accessibility and utilization in Wuntin Dada,
Bauchi, Bauchi State. These factors are critical in shaping individuals' healthcare-seeking
behaviors, potentially leading to disparities in access to and utilization of healthcare services.
The persistence of these socio-economic barriers indicates a need for targeted interventions
aimed at addressing the root causes of inequities in healthcare access, thereby improving overall
health outcomes for vulnerable populations within the community.
However, the study also reveals a positive dimension to healthcare accessibility in the region.
Despite the socio-economic challenges, the availability and distribution of primary healthcare
services in Wuntin Dada, Bauchi appear to be adequate, particularly in terms of maternal
healthcare. The proximity of healthcare facilities, the affordability of services, and the
satisfaction expressed by women regarding the quality of care suggest that the healthcare
infrastructure is relatively well-developed and capable of meeting the needs of the local
population. These findings highlight the importance of maintaining and further enhancing the
existing healthcare services while simultaneously addressing the socio-economic disparities that
continue to affect healthcare access.
48
5.3 Recommendations
Based on the findings the researcher recommends that;
Here are the improved recommendations:
1. Government should implement comprehensive health promotion initiatives that
incorporate preventative health screenings aimed at young adults. These programs should
focus on encouraging proactive health management to prevent the early onset of diseases,
fostering a culture of regular health check-ups and early intervention.
2. These programs should aim to dispel negative perceptions and misconceptions about the
quality of treatment and services provided, thereby increasing trust and utilization of
public healthcare resources.
3. There is need to establish male-friendly healthcare initiatives that create a welcoming and
comfortable environment for men. These programs should address the unique health
needs of men, reduce barriers to healthcare access, and promote regular engagement with
healthcare services.
4. Encourage private healthcare providers to adopt inclusive policies that cater to diverse
populations, particularly those with low income or low educational levels. This could
include offering services and information in African languages, increasing the presence
of African specialists and physicians, and creating a more culturally sensitive healthcare
environment that does not alienate users.
5. Promote the utilization of healthcare facilities among vulnerable groups such as the
uneducated or semi-literate, the unemployed, and those living in rented homes. Specific
outreach and support programs should be designed to overcome the barriers these groups
face in accessing healthcare services.
49
5.4 Suggestion for Further Studies
Based on the findings of the study the following were suggested for further studies:
1. Since education was found to be one of the major factor affecting access and utilization
of health care, study should be conducted on the influence of education on accessibility
and utilization of health care services in Wuntin Dada North
2. Other studies should be conducted in other local governments of the state so as to
compare the findings with the present study.
3. Conduct additional studies to explore the influence of other socio-economic factors on
healthcare utilization. This research should aim to identify and address the broader range
of barriers that may impact access to healthcare, leading to more comprehensive
strategies for improving health equity.
50
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53
APPENDICES
APPENDIX I: INTRODUCTORY LETTER
Department of Sociology,
Faculty of Social Sciences,
Sa’adu Zungur University
Bauchi Campus,
September, 2024
Dear Respondents,
I’m Abubakar Sadik Hassan with matriculation Number BASUG/UG/SMS/SOC/19/0746 the
student of the above mentioned institution carrying out a research on the topic; “Assessment
health seeking behavior of in wuntin Dada, Bauchi, LGA”. Please read carefully and tick ()
the appropriate column for each statement as promptly as possible. All information gathered
shall be used purely for research purpose and shall be treated with confidentiality.
Yours Faithfully
ABUBAKAR SADIK HASSAN

BASUG/UG/SMS/SOC/19/0746
54
SECTION A:SOCIO-DEMOGRAPHIC CHARACTERISTICS OF THE RESPONDENTS
1. Marital Status a) Married [ ] b) Single [ ] c) Divorced [ ]d) Widowed [ ]
2. Age: a) 18 -25 [ ] b) 26-30 [ ] c) 31-36[ ] d) 37 & above [ ]
3. Education: a) Primary [ ] b) Secondary [ ]c) NCE/OND [ ] (d) B.sc
(e) Others Specify…………
4. Religion: a) Islam [ ] b) Christianity [ ] c) Traditional [ ]
e) Others Specify…………
5. Tribe: a) Hausa [ ] b) Fulani[ ] c) Birom [ ] d) Jarawa [ ]
e) Ngas [ ] f) Miyango [ ] g) Other Specify. . . . . . . . . . . .
SECTION B: QUESTIONNAIRE ITEMS

RESEARCH QUESTION 1: WHAT ARE THE SOCIO-ECONOMIC FACTORS
INFLUENCING HEALTH SEEKING BEHAVIOR
S/N Items SA A N D SD
1. Finance is one of the factor that
influence health seeking behavior
2. Education influence health seeking
behavior
3. Family background influence health
seeking behavior
4. Culture and religious belief that
influence health seeking behavior
5. Poverty affect influence health seeking
behavior
55
RESEARCH QUESTION 2: WHAT IS THE LEVEL OF AVAILABILITY OF PRIMARY
HEALTH CARE SERVICES CENTERS?
1. There are enough primary health care
services in Wuntin Dada.
2. People don’t have to go long distance for
primary health care services in Wuntin
Dada
3. Women access maternal health care
services with ease in Wuntin Dada
4. Local and private hospitals provide the
required health care services in Wuntin
Dada
5. Each and every individual in Wuntin
Dada can afford Maternal health care
services
RESEARCH QUESTION 3: WHAT IS THE LEVEL OF UTILIZATION OF PRIMARY

HEALTH CARE SERVICE CENTRES?
1. I regularly visit the primary health care
service center for check-ups and medical
advice.
2. The primary health care service center is
easily accessible from my location.
3. The services provided by the primary
health care center meet my health needs.
4. I am satisfied with the quality of care
received at the primary health care
service center.
5. I rely on the primary health care service
center for most of my health care needs.
56

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AN ASSESSMENT OF HEALTH SEEKING BEHAVIOR IN WUNTIN DADA BAUCHI

LOCAL GOVERNMENT AREA, BAUCHI STATE

ABUBAKAR SADIK HASSAN

A RESEARCH PROJECT SUBMITTED TO THE DEPARTMENT OF SOCIOLOGY IN

FULFILLMENT OF THE REQUIREMENT FOR THE AWARD OF BACHELOR OF

SCIENCE (B.Sc) DEGREE IN THE DEPARTMENT OF SOCIOLOGY FACULTY OF

SOCIAL SCIENCES, SA’ADU ZUNGUR UNIVERSITY, BAUCHI.

I Abubakar Sadik Hassan with Matric number BASUG/UG/SMS/SOC/19/0746 hereby,

Abubakar Sadik Hassan ……………………....………………….

Sociology by the undersigned personalities.

Mal. Sani Musa Tilde _____________________

Dr. Jibril Babayo Suleiman _____________________

Malam Hassan Abdullahi and Malama Fatima Abubakar Sadik

shower his unlimited blessing upon you (Amen).

keep the dreams of our parents alive till eternity (Amen).

Almighty God grant you all the desires of your hearts.

1.1 Background to the Study

facilities (WHO, 2022).Moreover, the global trend of privatization in healthcare exacerbates

exacerbated by factors such as geographical isolation, lack of transportation, and insufficient

specialized treatments (Katung, 2021).

Africa faces formidable challenges in healthcare accessibility, exacerbated by socio-economic

inadequate infrastructure, healthcare workforce shortages, and limited financial resources

(Nabyonga-Orem et al., 2022). Socio-economic disparities, including poverty, gender inequality,

2022).Moreover, Africa's healthcare systems are burdened by the double-edged sword of

cardiovascular disorders poses new challenges (Ataguba et al., 2020).

In Nigeria, socio-economic factors significantly influence healthcare accessibility. Despite being

Africa's largest economy, healthcare infrastructure remains underdeveloped, particularly in rural

impact healthcare-seeking behaviors in Nigeria. Traditional medicine is often favored over

care, particularly for serious health conditions.

1.2 Statement of the Problem

understanding of an individual’s sense of well-being is an intricate and complex study as health

well as the social factors that influence health care utilization.

services in Bauchi state, where Wuntin DadaBauchi LGA.

1.3 Research Question

The research questions are:

Dada, Bauchi LGA

1. What is the level of availability of primary health care services centers?

2. What is the level of utilization of primary health care service centres?

Thus, the specific objectives are:

2. To examine the socio-economic factors influencing health seeking behavior in Wuntin

Dada, Bauchi LGA

3. To determine the level of availability of primary health care services centers.

4. To determined the level of utilization of primary health care service centres.

1.5 Significance of the study:

and literature in the social sciences.

information on the socio-economic factors affecting accessibility of healthcare service in Bauchi

Care Services in Bauchi State.

The study is limited to the evaluation of socio-economic factors affecting accessibility of

research work to Wuntin Dada North.

1.7 Definition of Terms

Accessibility: According to Maxwell (2021), “The quality of being easily understood or

appreciated. Also, it is the quality of being easy to obtain or use.

Education: Education is the process of facilitating learning, or the acquisition of knowledge,

skills, values, morals, beliefs, habits, and personal development.

children (Dowd, 2022).

LITERATURE REVIEW AND THEORETICAL FRAMEWORK

2.1.1 Socio-economic factors influencing Health Seeking Behavior