A Comparative Study of Predictors of Health Service Utilization among Rural and Urban Areas in Ilorin East Local Government Area of Kwara State

Abstract

Objective: Health facilities utilization among Nigerians is affected by access to hospitals and, availability of personnel. This study compared the predictors of health service utilization in rural and urban areas of Ilorin East Local Government Area of Kwara State.
Method: A cross-sectional study, involving 250 rural and 250 urban respondents selected through multi-stage sampling techniques. Quantitative data were collected using an interviewer-administered questionnaire. Qualitative data collection was done with an FGD guide. Data were analyzed using SPSS version 16. Chi-square, t-test, and z-test were used to test for significance. The level of significance was set at p < 0.05.
Results: The mean age of urban respondents was 37.1±7.9 years and 42.6 ±13.7 years for rural. Utilization among the urban respondents were 71.2%, and 89.2% among rural (z-score = 27.93; p-value = 0.01). Health services factors such as waiting time (Adjusted OR=1.012; p-value=0.989) were found to be a strong predictor of utilization among urban respondents compared with the availability of drugs (Adjusted OR= 1.696; p-value=0.407) and availability of drugs (Adjusted OR= 1.696; p-value=0.407) which were the strongest predictor among rural respondents, though they were all not statistically significant. Other factors identified were lack of staff 46.5% among rural and lack of drug 26.1% among urban communities respectively.
Conclusion: The study demonstrated higher utilization among the rural community. Knowledge of available health services was important for utilization; waiting time, and availability of drugs were major predictors of health service utilization among urban and rural communities respectively.