Health seeking behaviour among married women in northern Nigeria : a framework to promote autonomy

Abstract

Introduction and background Morbidity and mortality rates (MMR) continue to be a major health care problem in developing countries such as Botswana, Cameroon, Chad, Congo, Guyana, Lesotho, Namibia, Somalia, Swaziland, Zimbabwe, Nigeria, South Africa and many others. The majority of deaths are often as a result of disparities that prevail in health care delivery, especially in rural areas such as inaccessibility, unavailability of health care facilities, inadequate material, lack of human resources, poor road infrastructure to facilitate the utilisation of ante natal care, and difficult access to health care providers by pregnant women. The cultural and social beliefs of the community cannot be overlooked due to their influence on the decision to utilise health care services. Autonomy to seek healthcare among married women (MW) is a major challenge in most developing countries, including Nigeria. Autonomy is the ability to make your own decisions without being controlled by anyone else, or the right of an organisation, country or region to be independent and govern itself. Cultural and religious beliefs affect the MW from Nigeria, many of whom face the possibility of dying due to the lack of autonomy to seek healthcare early. Globally, men often control decisions about the health of their wives and children, including the family’s use of healthcare services. Aim of the study: The study aimed to develop a framework to promote healthcare decisionmaking autonomy amongst MW in northern Nigeria. Objectives of the study: The objectives of the study were to explore the process of healthcare decision-making and autonomy practices among married men (MM) and women in northern Nigeria, then develop a framework to facilitate healthcare decision-making and autonomy practices among MW in that region. Method: A qualitative descriptive research design was employed whereby data were gathered from both the MM and MW from the Lemu community in Gbako Local Government Area of Niger State Nigeria through semi-structured interviews and focus group discussions. Findings: The current study was guided by Andersen’s Health Belief Model and findings from the study confirmed poor health seeking behaviours due to lack of autonomy for health seeking decisions for MW from the Lemu rural community in northen Nigeria. Recomendations from the study focused mainly on strategies to ensure awareness of MM and other community members regarding the importance of autonomy for MWs to be able to make decisions to visit healthcare centres. This study also found that strengthening collaboration and partnerships between healthcare workers and the community was a means to create a platform where critical information regarding healthcare related issues could be discussed. A tailored practice framework to facilitate healthcare decision-making and autonomy practices among MW in northern Nigeria was developed. Conclusion: The findings from the study confirm that although autonomy for MW for making health-seeking decisions is one of the critical factors that influence health seeking behaviour, several socio-demographic and socio-economic factors are also responsible for health-seeking behaviour.