Health Seeking Behaviour and Access to Health Care Facilities at the Primary level in Nigeria: our experience.

Context: Health care at the primary level is accepted as the model for delivering basic health care to low income populations especially in developing countries such as Nigeria. Despite all the efforts and strategiesadapted in Nigeria, there is still high level of morbidity and mortality from the diseases primary health care (PHC) is expected to control. The aim of this study was to determine the effect of limited knowledge and accessto primary health care services on the health-seeking behaviour of NigeriansMethods: We carried out a multistage cross-sectional study in 10 health centres in Nigeria using qualitative and quantitative research methods. A semi-structured questionnaire was administered to the health care providers and patients while an in-depth interview was also conducted amongst the community members where the health centers were situated.Results: Out of the 166 questionnaires distributed, 161 (97%) were returned anonymously while 32 interviews were conducted giving a total of 193 response rate. One hundred and eleven (57%) seek health care at the health centres, 121 (62.7%) patent medicine stores, 87 (45%) medicine vendors, 100 (51.8%) private clinics, 56 (29%) prayer houses, 118 (61.1%) traditional healers. The commonest reason (79.8%) for preferred choice of visit was accessibility to health care services.Conclusion: Limited access to health care services and poor service organization of the primary health care (PHC) in Nigeria have been identified as reasons for seeking health care in an unothordox method, which often expose individual to the lure of witch doctors who claim to have cure to almost all the diseases Therefore, the PHC service organizations in Nigeria should among other things provide access to health care services and also appreciate the need for health outreach programme and communication in rural areas.Keywords: Health care services, Accessibility, Health-seeking behavour, Nigeria