Introduction
Materials and methods
Study design and setting
Sample size and Study population
Sampling
Data collection
Study instrument
Data management and variables
Statistical analyses
Score computation
Data analysis
Ethical considerations
Results
Characteristics | N | (%) |
---|---|---|
Age group (years)
| ||
18–24 | 110 | (15.3) |
25–39 | 342 | (47.7) |
40–59 | 196 | (27.3 |
≥ 60 | 69 | (9.6) |
Mean Age
|
\(36.9\pm 13.7\)
| |
Gender
| ||
Male | 205 | (28.6) |
Female | 512 | (71.4) |
Marital status
| ||
Single | 120 | (16.8) |
Cohabiting/Married | 561 | (78.2) |
Formerly married | 36 | (5.0) |
Highest level of education
| ||
No-formal | 46 | (6.4) |
Primary | 92 | (12.8) |
Secondary | 370 | (51.6) |
Tertiary | 209 | (29.1) |
Place of residence
| ||
Urban | 360 | (50.3) |
Rural | 357 | (49.7) |
Religion
†
| ||
Christianity | 462 | (64.4) |
Islam | 252 | (35.2) |
Traditional/Others | 3 | (0.4) |
Ethnicity
| ||
Yoruba | 676 | (94.3) |
Others (Igbo, Hausa,.) | 41 | (5.7) |
Wealth Index
| ||
Poor | 208 | (29.0) |
Middle | 271 | (37.8) |
Rich | 238 | (33.2) |
Occupation
| ||
Professional/Managerial | 78 | (10.9) |
Skilled & Partially skilled | 226 | (31.5) |
Unskilled | 341 | (47.6) |
Unemployed | 72 | (10.0) |
Health status
| ||
Poor | 50 | (7.0) |
Good | 667 | (93.0) |
Disability status
| ||
Yes | 38 | (5.3) |
No | 679 | (94.7) |
Chronic illness
| ||
Yes | 41 | (5.7) |
No | 676 | (94.3) |
Last visit to health facility
| ||
Last 30 days | 215 | (30.0) |
Last 3 months | 235 | (32.8) |
Last 6 months | 116 | (16.2) |
6–12 months | 151 | (21.0) |
Person in need of healthcare
| ||
Respondent | 521 | (72.6) |
Respondents’ child | 196 | (27.4) |
Type of facility visited
| ||
Government hospital | 476 | (66.4) |
Private hospital/NGO | 241 | (33.6) |
Reason for last visit
| ||
Communicable disease | 438 | (61.0) |
Non-communicable disease | 93 | (13.0) |
Preventive services | 126 | (17.6) |
Others | 60 | (8.4) |
Level of facility visited
| ||
Primary | 327 | (45.6) |
Secondary | 349 | (48.7) |
Tertiary | 41 | (5.7) |
Facility visited was a usual place
| ||
Yes | 577 | (80.5) |
No | 140 | (19.5) |
Expenses at Last Visit to Health Facility (₦)
| (n = 650) | (n = 650) |
Below 1,000 | 139 | (21.4) |
1,000–4,999 | 311 | (47.8) |
5,000–9,999 | 107 | (16.5) |
10,000 or more | 93 | (14.3) |
Average expenses (₦) Mean ± SD | 6997.5 ± 720.7 | 6997.5 ± 720.7 |
Covered by Health Insurance
| ||
Yes | 56 | (7.8) |
No | 661 | (92.2) |
Domains of HSR | N | (%) | |||
---|---|---|---|---|---|
Autonomy
| |||||
Poor | 326 | (45.5) | |||
Good | 391 | (54.5) | |||
Choice
| |||||
Poor | 289 | (40.3) | |||
Good | 428 | (59.7) | |||
Communication
| |||||
Poor | 342 | (47.7) | |||
Good | 375 | (52.3) | |||
Confidentiality of Information
| |||||
Poor | 201 | (28.0) | |||
Good | 516 | (72.0) | |||
Dignity
| |||||
Poor | 261 | (36.4) | |||
Good | 456 | (63.6) | |||
Prompt Attention
| |||||
Poor | 409 | (57.0) | |||
Good | 308 | (43.0) | |||
Quality of Environment
| |||||
Poor | 304 | (42.4) | |||
Good | 413 | (57.6) | |||
Overall Responsiveness
| |||||
Poor | 379 | (52.9) | |||
Good | 338 | (47.1) |
Reasons for discrimination | N | (%) |
---|---|---|
Treated worse for any reason (
N
= 717)
| ||
Yes
| 21 | 3.1 |
No
| 695 | 96.9 |
Treated worse due to Lack of Money (
n
= 21)
| ||
Yes
| 11 | 52.4 |
No
| 10 | 47.6 |
Treated worse due to Social Class (
n
= 21)
| ||
Yes
| 7 | 33.3 |
No
| 14 | 66.7 |
Treated worse due to Type of Illness (
n
= 21)
| ||
Yes
| 6 | 28.6 |
No
| 15 | 71.4 |
Domains of HSR | HSR inequality index |
---|---|
Autonomy
| 0.483 |
Choice
| 0.506 |
Communication
| 0.497 |
Confidentiality of Information
| 0.409 |
Dignity
| 0.452 |
Prompt Attention
| 0.595 |
Quality of Environment
| 0.453 |
Overall Responsiveness
| 0.228 |
Domain | Total |
---|---|
Mean and SD
| |
Autonomy
|
\(5.6\pm 3.2\)
|
Confidentiality
|
\(5.5\pm 2.9\)
|
Choice
|
\(4.4\pm 3.1\)
|
Communication
|
\(8.1\pm 2.0\)
|
Dignity
|
\(6.9\pm 2.8\)
|
Prompt Attention
|
\(7.9\pm 2.2\)
|
Quality of Amenities
|
\(6.1\pm 2.6\)
|
Variable
|
Autonomy
|
Communication
|
Confidentiality
|
Choice
|
OR (95%CI)
|
OR (95%CI)
|
OR (95%CI)
|
OR (95%CI)
| |
Age
| ||||
\(\ge 60\) years | Ref | Ref | Ref | Ref |
40–59 years | 1.11 (0.63–1.95) | 0.60 (0.32–1.04) | 1.03 (0.54–1.97) | 0.76 (0.42–1.36) |
25–39 years | 1.10 (0.64–1.88) | 0.92 (0.53–1.58) | 1.09 (0.59–2.00) | 0.87 (0.50–1.51) |
18–24 years | 0.99 (0.53–1.87) | 1.02 (0.54–1.94) | 1.52 (0.76–3.07) | 1.30 (0.68–2.48) |
Gender
| ||||
Female | Ref | Ref | Ref | Ref |
Male | 0.89 (0.63–1.25) | 0.95 (0.68–1.34) | 1.17 (0.80–1.70) | 1.13 (0.80–1.61) |
Marital status
| ||||
Married/cohabiting | NA | Ref | Ref | NA |
Single/Formally married | 1.17 (0.79–1.75) | 1.40 (092–2.12) | ||
Education
| ||||
Tertiary | Ref | Ref | Ref | Ref |
Secondary | 0.96 (0.69–1.37) | 1.04 (0.73–1.50) | 1.36 (0.90– 2.04) | 0.89 (0.61–1.29) |
Primary | 1.51 (0.90–2.50) | 1.98 (1.18– 3.33)* | 1.18 (0.66–2.11) | 1.39 (0.83– 2.34) |
Non-formal | 1.65 (0.84–3.22) | 3.62 (1.73–7.57)* | 0.93 (0.43–2.01) | 1.46 (0.74–2.87) |
Wealth Index
| ||||
Rich | Ref | Ref | Ref | Ref |
Middle | 1.32 (0.91–1.92) | 1.11 (0.77–1.61) | 1.21 (0.80– 1.84) | 1.61 (1.09–2.37)* |
Poor | 1.78 (1.20–2.66)* | 1.37 (0.92–2.05) | 1.29 (0.83–2.00) | 1.93 (1.28–2.92)* |
Ownership of Facility
| ||||
Private | Ref | Ref | Ref | Ref |
Government | 1.31 (0.95–1.81) | 1.15 (0.83–1.60) | 1.08 (0.75–1.56) | 1.44 (1.02–2.02)* |
Place of residence
| ||||
Urban | Ref | Ref | Ref | Ref |
Rural | 0.95 (0.67–1.24) | 1.09 (0.79–1.51) | 0.80 (0.56–1.13) | 1.45 (1.04 − 2.01)* |
Self-rated health status
| ||||
Good health | NA | NA | NA | NA |
Poor health | ||||
Level of health facility
| ||||
Tertiary facility | NA | Ref | Ref | Ref |
Secondary facility | 1.34 (0.67–2.72) | 0.90(0.43–1.88) | 1.35 (0.66–2.74) | |
Primary facility | 1.04 (0.52–2.09) | 0.92 (0.44–1.93) | 0.99 (0.48–2.02) | |
Usual place of care
| ||||
Yes | NA | NA | NA | NA |
No | ||||
Variable
|
Dignity
|
Prompt Attention
|
Quality of amenities
|
Overall responsiveness
|
OR (95%CI)
|
OR (95%CI)
|
OR (95%CI)
|
OR (95%CI)
| |
Age
| ||||
\(\ge 60\)years | Ref | Ref | Ref | Ref |
40–59 years | 1.13 (0.62–2.05) | 0.91 (0.52–1.60) | 1.45 (0.80–2.65) | 0.69 (0.38–1.25) |
25–39 years | 1.03 (0.59–1.82) | 1.20 (0.70–2.06) | 1.47 (0.80–2.60) | 1.03 (0.59–1.80) |
18–24 years | 1.90 (0.99–3.66) | 1.42 (0.75–2.69) | 1.25 (0.63–2.40) | 1.43 (0.73–2.80) |
Gender
| ||||
Female | Ref | Ref | Ref | Ref |
Male | 0.87 (0.61–1.25) | 1.03 (0.73–1.44) | 1.04 (0.74–1.48) | 0.87 (0.61–1.23) |
Marital status
| ||||
Married/cohabiting | NA | NA | NA | Ref |
Single/formerly married | 1.16 (0.77–1.75) | |||
Education
| ||||
Tertiary | Ref | Ref | Ref | Ref |
Secondary | 1.14 (0.77–1.68) | 1.02 (0.71–1.46) | 0.59 (0.29– 1.20) | 1.22 (0.84–1.75) |
Primary | 1.41 (0.83– 2.41) | 1.22 (0.73–2.05) | 0.97 (0.57–1.64) | 2.19 (1.28–3.75) * |
Non-formal | 2.13 (1.08–4.21)* | 1.23 (0.62–2.42) | 1.02 (0.71– 1.49) | 2.81 (1.35–5.86) * |
Wealth Index
| ||||
Rich | Ref | Ref | Ref | Ref |
Middle | 1.47 (0.98–2.18) | 0.97 (0.67–1.41) | 1.51 (1.03–2.23)* | 1.36 (0.94–1.99) |
Poor | 1.67 (1.10–2.54)* | 1.51 (1.01–2.25)* | 1.53 (1.02– 2.31)* | 1.86 (1.23–2.80)* |
Ownership of Facility
| ||||
Private | Ref | Ref | Ref | Ref |
Government | 1.75 (1.23–2.49)* | 1.46 (1.06–2.02)* | 2.16 (1.54–3.04)* | 1.56 (1.11–2.19)* |
Place of residence
| ||||
Urban | Ref | Ref | Ref | Ref |
Rural | 0.76 (0.55–1.04) | 0.76 (0.56–1.03) | 1.84 (1.35–2.52)* | 1.15 (0.83–1.59) |
Self-rated health status
| ||||
Good health | NA | NA | NA | Ref |
Poor health | 1.03 (0.56–1.91) | |||
Level of health facility
| ||||
Tertiary facility | NA | NA | NA | Ref |
Secondary facility | 1.14 (0.56–2.31) | |||
Primary facility | 1.26 (0.62–2.55) | |||
Usual place of care
| ||||
Yes | Ref | Ref | NA | Ref |
No | 1.60 (1.08–2.37)* | 1.62 (1.09–2.40)* | 1.69 (1.13–2.53)* |