Abstract

  The COVID-19 virus is rapidly crossing borders and spreading across countries and the globe, with 212 countries currently affected as of May 2020, 6 months since reports of the first case in November 2019 in Wuhan, China. Global efforts to lessen the impact of COVID-19 pandemic span across surveillance, preparedness, response, prevention, testing, contact tracing, and treatment. Co-creation Hub (CcHUB) in collaboration with the Nigerian Institute of Medical Research (NIMR) and LifeBank developed a digital system to support the process of free testing of suspected COVID-19 cases to respond to the pandemic in Nigeria and deployed it in Lagos. An average of 25% of suspected cases presented for testing after scheduling appointments, meaning only a fourth of the high-risk cases as defined by the system were tested, revealing a drop-out rate of 74%. Preliminary analysis seeking to check which factors are associated with patients who presented themselves for testing yielded no significant factors, forming the rationale for our study. The study was a cross sectional study, seeking to 1) Understand determinants of healthcare seeking behaviors and healthcare utilization during a pandemic, 2) Provide information and guide health planners, administrators and policy makers on factors that enhance effective utilization of structures and platforms for service delivery. The variables collected were: demography and socioeconomic status, health status, satisfaction with healthcare system, satisfaction with NIMR service, mode of transport used/to be used and general feedback. Data collection was done using a close-ended survey and social media analysis - analysing twitter sentiments around COVID-19 testing in Nigeria. 300 study participants from a target population of 566 were selected using a simple random sampling for a finite population. Descriptive statistics and analysis looking for association (odds ratios (OR) with 95% confidence interval (CI), including bivariate and multivariate unconditional logistic regression) were conducted using STATA 16. Our results show that distance to facility, preexisting health conditions, knowledge of COVID-19 symptoms, previous healthcare experience, type of and frequency of communication influence healthcare seeking behavior of Nigerians, specifically during COVID-19. We recommend that the strategic placement of testing centers and increasing knowledge of disease could enhance service utilization.

Keywords: COVID-19; Degree of Freedom; World Health Organization (WHO)

References

1. World Health Organization. Situation Report 118 (2020).
2. National Academies of Sciences, Engineering, and Medicine. “Health-Care Utilization as a Proxy in Disability Determination”. Washington, DC: The National Academies Press (2018).
3. Fein R. “On Achieving Access and Equity in Health Care”. Milbank Quarterly4 (2005): 157-190.
4. Geense WW., et al. “Barriers, facilitators and attitudes influencing health promotion activities in general practice: an explorative pilot study”. BMC Family Practice20 (2013).
5. Panda B and Thakur HP. “Decentralization and health system performance - a focused review of dimensions, difficulties, and derivatives in India”. BMC Health Service Research 16 (2016): 1-14.
6. Setia MS. “Methodology Series Module 3: Cross-sectional Studies”. Indian Journal of Dermatology3 (2016): 261-264.
7. Centre for Disease Control and Prevention (CDC). Symptoms of Coronavirus (2020).
8. WHO (World Health Organization). Health impact assessment (HIA), determinants of health. Geneva, Switzerland: WHO (2017).
9. Healthy People 2020 topics and objectives: Disability and health. Washington, DC: US Department of Health and Human Services (2017b).
10. Thomas-Henkel C and M Schulman. “Screening for social determinants of health in populations with complex needs: Implementation considerations”. Washington, DC: Center for Health Care Strategies, Inc (2017).
11. Salganicoff A., et al. “Women and health care in the early years of the Affordable Care Act: Key findings from the 2013 Kaiser women’s health survey”. Menlo Park, CA: Kaiser Family Foundation (2014).
12. Chan C., et al. “Factors affecting uptake of cervical and breast cancer screening among perimenopausal women in Hong Kong”. Hong Kong Medical Journal 8 (2002): 334-341.
13. Pronyk PM., et al. “Assessing health seeking behaviour among tuberculosis patients in rural South Africa”. The International Journal of Tuberculosis and Lung Disease7 (2001): 619-627.
14. Health, United States. In Health, United States, 2016: With chartbook on long-term trends in health. Hyattsville (MD): National Center for Health Statistics (US) (2017b).
15. Pignatelli S., et al. “Factors predicting uptake of voluntary counselling and testing in a real‐life setting in a mother‐and‐child center in Ouagadougou, Burkina Faso”. Tropical Medicine and International Health 11 (2006): 350-357.
16. Ukwaja KN., et al. “Healthcare-seeking behavior, treatment delays and its determinants among pulmonary tuberculosis patients in rural Nigeria: a cross-sectional study”. BMC Health Services Research25 (2013).
17. Borges ALV., et al. “Women’s reproductive health knowledge, attitudes and practices in relation to the Zika virus outbreak in northeast Brazil”. PLoS ONE1 (2013): e0190024.
18. O'Sullivan T and Bourgoin M. “Vulnerability in an Influenza Pandemic: Looking Beyond Medical Risk”. Funded by the Public Health Agency of Canada (2010).
19. McKee-Ryan FM., et al. “Psychological and physical well-being during unemployment: A meta-analytic study”. Journal of Applied Psychology 1 (2005): 53-76.
20. Thomas KC and Ellis AR. “Patterns of healthcare use and employment among people with disabilities”. Disability and Health Journal 2 (2013): 133-140.
21. Li B., et al. “Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China”. Clinical Research in Cardiology 5 (2020): 531-538.
22. Yang J., et al. “Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis”. International Journal of Infectious Diseases 94 (2020): 91-95.
23. Onder,G., et al. “Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy”. JAMA18 (2020): 1775-1776.
24. Latunji OO and Akinyemi OO. “Factors influencing Health-Seeking Behaviour among Civil Servants in Ibadan, Nigeria”. Annals of Ibadan Postgraduate Medicine1 (2018): 52-60.
25. Centre for Disease Control (CDC). Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12-March 16, 2020. Morbidity Mortality Weekly Report (2020): 69.
26. Assessing competence in communication and interpersonal skills: the Kalamazoo II report (2020).
27. Bientzle M., et al. “The impact of physicians’ communication styles on evaluation of physicians and information processing: A randomized study with simulated video consultations on contraception with an intrauterine device”. Health Expectations5 (2017): 845-851.
28. Osamor P and Grady C. “Factors associated with women’s health care decision-making autonomy: empirical evidence from Nigeria”. Journal of Biosocial Science 50 (2018): 70-85.
29. Senarath U and Gunawardena NS. “Women’s autonomy in Decision Making for Health Care in South Asia”. Asia Pacific Journal of Public Health 21 (2009): 137-143.

Citation

Citation: O S Amoo., et al. “Care Seeking Behavior of Citizens During Pandemics: A Case Study of COVID-19 in Nigeria". Acta Scientific Microbiology 3.9 (2020): 137-152.

Copyright

Copyright: © 2020 O S Amoo., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.