Background
Methods
Study area
Study sites
Nigerian health care system and financing
Data collection
Data analysis
Results
Socio-demographic characteristics
Variables | A1 (Rural) N = 501 | A2 (Peri-urban) N = 500 | A3 (Urban) N = 500 | E1 (Rural) N = 500 | E2 (Peri-urban) N = 555 | E3 (Urban) N = 515 |
---|---|---|---|---|---|---|
Status in household
| ||||||
Female household head (%)
| 155(31) | 137(27) | 112(22) | 88(18) | 64(12) | 56(11) |
Male household head (%)
| 313(63) | 263(53) | 334(67) | 401(80) | 404(73) | 180(35) |
Respondent-Main income earner (%)
| 462(92) | 386(77) | 460(92) | 480(96) | 526(95) | 233(45) |
Sex (Male) (%)
| 309(62) | 270(54) | 352(71) | 397(81) | 403(73) | 183(36) |
Ever attended school (%)
| 329(66) | 434(87) | 420(85) | 389(82) | 509(92) | 500(97) |
Mean no of household residents (S.D)
| 5(3) | 5(5) | 5(5) | 5(2) | 6(4) | 6(3) |
Mean age in years of respondent (S.D)
| 44(11) | 47(15) | 45(15) | 49(12) | 42(12) | 42(13) |
Mean no of years spent in school (S.D)
| 9(3) | 11(4) | 10(4) | 9(4) | 11(4) | 13(5) |
Household asset ownership (%)
| ||||||
Radio (%)
| 491(98) | 490(98) | 471(96) | 474(95) | 548(99) | 497(97) |
Television (%)
| 405(81) | 474(95) | 454(91) | 351(71) | 529(96) | 490(95) |
Air-conditioner (%)
| 5(1) | 20(4) | 54(11) | 7(1) | 38(7) | 56(11) |
Bicycle (%)
| 141(28) | 21(4) | 43(9) | 146(29) | 10(2) | 51(10) |
Motorcycle (%)
| 131(26) | 44(9) | 69(14) | 141(28) | 49(9) | 53(10) |
Car (%)
| 42(8) | 126(25) | 145(29) | 45(9) | 108(20) | 211(41) |
Fridge (%)
| 212(42) | 349(70) | 337(68) | 188(38) | 386(70) | 459(89) |
Generator (%)
| 128(26) | 146(29) | 191(38) | 121(24) | 174(32) | 157(31) |
Electric fan (%)
| 476(95) | 480(96) | 473(95) | 365(73) | 542(98) | 506(98) |
Per capita weekly food expenditure in Naira (S.D) US$1 = N150
| 399(265) | 552(309) | 612(986) | 376(205) | 395(248) | 571(259) |
Illness patterns
Variables | A1 N = 191 | A2 N = 213 | A3 N = 162 | E1 N = 214 | E2 N = 203 | E3 N = 159 |
---|---|---|---|---|---|---|
Illness patterns
| ||||||
Had Malaria
| 97(51) | 106(50) | 97(60) | 125(58) | 131(65) | 101(64) |
Had Typhoid
| 40(21) | 25(12) | 30(19) | 30(14) | 12(6) | 18(11) |
Had Diarrhoea
| 4(2) | 3(1) | 7(4) | 4(2) | 0 | 1(1) |
Other
| 50(26) | 79(37) | 42(26) | 55(26) | 64(32) | 38(24) |
Where respondents first sought treatment (%)
| ||||||
Traditional Healer
/
Herbalist
| 15(8) | 10(5) | 4(3) | 12(6) | 9(4) | 2(1) |
Patent Medicine Dealer/Chemist
| 120(63) | 88(41) | 82(51) | 116(54) | 57(28) | 81(51) |
Home Treatment
| 3(2) | 4(2) | 14(9) | 9(4) | 3(2) | 5(3) |
Community Health Worker
| 1(1) | 2(1) | 0 | 2(1) | 0 | 0 |
Health Centre
| 1(1) | 5(3) | 0 | 4(2) | 1(1) | 0 |
Public/General Hospital
| 24(13) | 38(18) | 36(22) | 29(14) | 29(14) | 30(19) |
Private Hospital
| 26(14) | 58(27) | 24(15) | 52(24) | 47(23) | 37(23) |
Others
| 1(1) | 8(4) | 3(2) | 2(1) | 57(28) | 3(2) |
Travel And Treatment Cost (SD)
| ||||||
Mean no of minutes to treatment
| 25(40) | 27(33) | 27(22) | 39(34) | 21(24) | 27(27) |
Mean cost of Transport to treatment
| 63(271) | 100(295) | 107(375) | 127(125) | 44(101) | 82(185) |
Mean drug expenditure
| 936(1526) | 2840(4935) | 2377(10124) | 1466(1946) | 3237(19451) | 2260(4956) |
Mean total Treatment expenditure
| 1140(1896) | 3527(7711) | 2642(10239) | 2069(4922) | 3758(19600) | 3847(9869) |
Travel and treatment cost
Payment and payment coping mechanisms used to pay for health services by socio-economic status
Variables | Q1 N(%) | Q2 N(%) | Q3 N(%) | Q4 N(%) | Q5 N(%) | p-value | Q1:Q5 ratio |
---|---|---|---|---|---|---|---|
Out-of-Pocket but reimbursed
| 4(31) | 3(22) | 1(8) | 4(31) | 1(8) | 0.58 | 4 |
Out-of-Pocket without reimbursement
| 236(23) | 195(19) | 202(20) | 200(20) | 186(18) | 0.50 | 1.27 |
Health Insurance
| 1(25) | 1(25) | 0 | 0 | 2(50) | 0.41 | 0.5 |
Instalment
| 28(28) | 17(16) | 19(18) | 24(23) | 16(15) | 0.69 | 1.75 |
In-kind
| 2(33) | 1(17) | 1(17) | 2(33) | 0 | 0.75 | 0 |
Others
| 10(31) | 9(29) | 7(22) | 3(9) | 3(9) | 0.25 | 3.33 |
Payment coping mechanisms by SES (%)
| |||||||
Own money
| 245(23) | 202(19) | 207(20) | 206(20) | 190(18) | 0.70 | 1.29 |
Borrowed money
| 14(46) | 5(17) | 5(17) | 5(17) | 1(3) | 0.03 | 14 |
Sold moveable assets
| 0 | 0 | 0 | 1(100) | 0 | 0.40 | 0 |
Sold family land
| 0 | 0 | 0 | 0 | 0 | N/A | 0 |
Payment subsidized
| 12(43) | 6(21) | 3(11) | 2(7) | 5(18) | 0.09 | 2.4 |
Payment deferred
| 3(33) | 0 | 0 | 3(33) | 3(33) | 0.20 | 1 |
Community solidarity/someone else paid
| 4(21) | 4(21) | 4(21) | 7(37) | 0 | 0.17 | 0 |
Exempted
| 3(36) | 13) | 1(13) | 1(13) | 2(25) | 0.83 | 1.5 |
Others
| 1(7) | 4(29) | 3(21) | 1(7) | 5(36) | 0.20 | 0.2 |
Payment and payment coping mechanisms used to pay for health services by geographic location
Variables | Rural | Peri-urban | Urban | p-value | R:U ratio |
---|---|---|---|---|---|
Out-of-Pocket but reimbursed
| 6(43) | 1(7) | 7(50) | 0.051 | 0.86 |
Out-of-Pocket without reimbursement
| 369(36) | 382(37) | 284(27) | 0.24 | 1.3 |
Health Insurance
| 2(50) | 1(25) | 1(25) | 0.82 | 2 |
Instalment
| 36(34) | 45(43) | 24(23) | 0.28 | 1.5 |
In-kind
| 1(17) | 1(17) | 4(66) | 0.11 | 0.25 |
Others
| 8(24) | 7(21) | 18(55) | 0.003 | 0.44 |
Payment coping mechanisms by geographic location (%)
| |||||
Own money
| 385(36) | 395(37) | 286(27) | 0.004 | 1.35 |
Borrowed money
| 8(26) | 7(23) | 16(51) | 0.01 | 0.5 |
Sold moveable assets
| 0 | 0 | 1(100) | 0.28 | 0 |
Sold family land
| 0 | 0 | 0 | N/A | 0 |
Payment subsidised
| 13(46) | 1(4) | 14(50) | 0.001 | 0.93 |
Payment deferred
| 7(78) | 1(11) | 1(11) | 0.03 | 7 |
Community solidarity/someone else paid
| 2(11) | 12(63) | 5(26) | 0.03 | 0.4 |
Exempted
| 3(37) | 1(13) | 4(50) | 0.26 | 0.75 |
Others
| 3(21) | 3(21) | 8(58) | 0.03 | 0.38 |
Regression analysis
Odds ratio | Confidence interval | p-value | ||
---|---|---|---|---|
Quintile 1 (base)
| 1.00 | |||
Quintile 2
| 0.90 | 0.46, 1.80 | 0.778 | |
Quintile 3
| 1.28 | 0.59, 2.79 | 0.533 | |
Quintile 4
| 1.36 | 0.62, 2.99 | 0.438 | |
Quintile 5
| 1.54 | 0.67, 3.56 | 0.314 | |
Site group 1 (Rural)
| 1.00 | |||
Site group 2 (Peri-urban)
| 0.89 | 0.49, 1.63 | 0.703 | |
Site group 3 (Urban)
| 0.53 | 0.29, 0.99 | 0.048 | |
Age group 1 (<35)
| 1.00 | |||
Age group 2 (35–44)
| 0.60 | 0.25, 1.42 | 0.246 | |
Age group 3 (45–54)
| 1.02 | 0.41, 2.49 | 0.973 | |
Age group 4 (> = 55)
| 0.59 | 0.25, 1.37 | 0.218 | |
Total number of household residents
| 1.61 | 1.00, 2.61 | 0.051 | |
Sex
| 0.74 | 0.17, 3.22 | 0.684 | |
Main income earner
| 1.70 | 0.69, 4.17 | 0.248 | |
Ever attended school
| 1.16 | 0.61, 2.17 | 0.654 | |
Had malaria
| 1.71 | 1.05, 2.76 | 0.030 | |
Use of Patent Medicine Dealer
| 0.21 | 0.02, 2.06 | 0.181 | |
Status of household head (Male/Female)
| 1.41 | 0.32, 6.19 | 0.651 | |
LR Chi-square
| 24.97 | |||
Probability > Chi-square
| 0.0704 | |||
Pseudo R^2
| 0.0456 |
Odds ratio | Confidence interval | p-value | ||
---|---|---|---|---|
Quintile 1 (base)
| 1.00 | |||
Quintile 2
| 0.82 | 0.37, 1.82 | 0.623 | |
Quintile 3
| 1.40 | 0.55, 3.54 | 0.488 | |
Quintile 4
| 1.11 | 0.45, 2.74 | 0.825 | |
Quintile 5
| 1.57 | 0.57, 4.32 | 0.385 | |
Site group 1 (Rural)
| 1.00 | |||
Site group 2 (Peri-urban)
| 0.75 | 0.36, 1.57 | 0.444 | |
Site group 3 (Urban)
| 0.33 | 0.16, 0.69 | 0.003 | |
Age group 1 (<35)
| 1.00 | |||
Age group 2 (35–44)
| 0.51 | 0.16, 1.63 | 0.253 | |
Age group 3 (45–54)
| 0.68 | 0.21, 2.23 | 0.528 | |
Age group 4 (> = 55)
| 0.35 | 0.12, 1.09 | 0.071 | |
Total number of household residents
| 1.74 | 0.98, 3.08 | 0.058 | |
Sex
| 1.91 | 0.36, 10.05 | 0.447 | |
Main income earner
| 1.06 | 0.34, 3.25 | 0.925 | |
Ever attended school
| 1.87 | 0.93, 3.76 | 0.081 | |
Had malaria
| 1.08 | 0.61, 1.91 | 0.782 | |
Use of Patent Medicine Dealer
| 0.10 | 0.01, 1.02 | 0.052 | |
Status of household head (Male/Female)
| 0.83 | 0.15, 4.46 | 0.828 | |
LR Chi-square
| 33.79 | |||
Probability > Chi-square
| 0.0058 | |||
Pseudo R^2
| 0.0792 |