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Socioeconomic status and health shocks; analysis of coping strategies in rural households of Enugu State, Nigeria

Authors:
Yemi Adewoyin at University of Nigeria
Yemi Adewoyin
Chinasa Urama at University of Nigeria
Chinasa Urama
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Abstract

Background: Health burden in developing countries is worsened by the limited coverage of health insurance. This leaves out-of-pocket spending as the major means of healthcare financing in these countries. Rural households in Nigerian suffer constrained access to quality healthcare, do not benefit significantly from health insurance and constitute about two thirds of the country’s poor. This study investigates how these households cope with health shocks and the influence of their socioeconomic status on the coping strategies. Method: Using a representative sample of 600 households from the three senatorial zones of Enugu State, Nigeria, data for the study was collected via an interviewer-administered questionnaire. Frequency, cross-tabulation, chi square and multiple regression statistical techniques were employed for data analysis. Findings: About 53% of the respondents were male household heads while borrowing from friends (47.65%), sales of assets (43.85%), diversion of funds meant for other activities (2.00%) and cutting down on household expenditure (6.48%) were the main coping strategies. Education level of household head, occupation, and income were statistically found to influence the coping strategies (P < 0.005) and they jointly accounted for 26.5% (R2 = 0.265, P < 0.001) of the variations in coping strategies in the study area. Conclusion: Having a rural healthcare policy and mainstreaming the informal sector, where the bulk of the poor eke a living, into the national health insurance scheme will ameliorate health shocks among the rural poor. Keywords: Health Shocks, Coping Strategies, Socioeconomic Status, Rural Households, Healthcare Expenditure, Enugu State, Nigeria
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Chinasa E. Urama1, Yemi Adewoyin2, Ezebuilo R. Ukwueze1
& Jecinta C. Ene3
1Department of Economics, University of Nigeria, Nsukka, Nigeria
2Department of Geography, University of Nigeria, Nsukka, Nigeria
3Department of Social Work, University of Nigeria, Nsukka
Email: yemiadewoyin@yahoo.com
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... First is the perception of ante-natal and post-natal care services, delay in service delivery, fear of adverse health outcomes, cultural and religious assumptions [4,11]. Again, factors including inequality in the distribution of health facilities between urban and rural areas, dilapidating equipment, inadequate number/attitude of health personnel, increasing corruption levels in the health sector, diseases, infections and high levels of household out-of-pocket payment for health goods and services, have been found in studies [15,37]. Worrisome are concerns ranging from ignorance of women owing to their socio-demographic characteristics including age and educational status, occupation, influence of spouse decision; associated with low healthcare utilization and unhealthy living has been reported in the literature [14,15]. ...
... Consequently, rural women with lower income will not afford the service charged for screening and treatment of these preventable health issues. Evidence from arrays of literature corroborate with the foregoing result on the under-utilization of healthcare services owing to low income in Nigeria [28,35,37]. We then recommend healthcare policies implementation, equity in funding of the three categories of health sectors and exploration of health innovations. ...
BMC Public Health Optimizing the utilization of maternal and reproductive healthcare services among women in low-resourced Nigerian settings
Article
Full-text available
  • Oct 2023
  • BMC PUBLIC HEALTH
Introduction Quality care delivery is an essential lifesaving interventions for maternal healthcare and reduction in mortality from preventable reproductive conditions. In African countries like Nigeria, numerous perceptions and militating factors present unique challenges in optimizing the utilization of maternal and reproductive healthcare services. As women continuously evolve away from the utilization of healthcare services, achieving universal health coverage for all emerges as a matter of concern. Method A phenomenological and descriptive research design was used. The study participants comprised a total of 38 women selected from primary and tertiary healthcare institutions. They were purposively selected from four healthcare institutions in Nsukka, Enugu State, Nigeria. Result Findings revealed that most rural women at the prenatal stage, utilize maternal healthcare services, but at the postnatal stage, they reject reproductive healthcare services owing to certain perceptions. Concerns about sub-optimal utilization of maternal and reproductive healthcare services were found under enabling, predisposing and need factors. Evidence-based interventions included instituting health insurance policies, improving the healthcare sector, personnel, collaboration among stakeholders, and grass-roots community education. Participants showed little knowledge of social workers’ engagement in healthcare institutions. Conclusion Functional network of care between private and public healthcare system is the key to optimizing maternal and reproductive healthcare utilization. The study recommends stakeholder and community engagement in achieving functional networks of care, strengthening relational linkages between frontline health workers and equip rural women with better knowledge. All these are geared toward achieving optimal utilization of maternal and reproductive healthcare services among women in low-resourced Nigerian settings.
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