Chapter one

1.0       introduction

1.1       Background to the study

According to Agyare, Mensah, & Osei-Asante (2021) The health care system is made up of numerous sections that together reflect the entire system in addition to the health structure. The family structure, social support networks, political institutions, environmental factors, cultural forces, and economic conditions all have an impact on how often people especially pregnant women seek medical attention. Nearly every developing nation has a health care system, with the public and private sectors interacting and influencing one another (Fournier, 2020).

In Africa, the amount that households pay out-of-pocket for healthcare can account for up to 80% of the annual total expenditures on medical treatment. The financial ability to access healthcare services hasn't changed all that much in Nigeria either  (Shaikbh and Hatcher 2022). In Nigeria, 76% of medical expenses are paid for out of pocket. This same element also determines how well a person or family can meet their overall health care needs. In Nigeria, the expense has undoubtedly been a significant deterrent to receiving quality medical care. The pursuit of health is akin to this intricacy, encompassing the utilisation of home remedies and self-medication with pharmaceuticals borrowed from a nearby pharmacy (Shaikbh and Hatcher 2022) . There is not much of a variation in the use of health services by economic class according to the National Health Survey. The disparity in the patterns of health service utilisation between the rural and urban populations is not indicative of equal health status among the two population segments. Despite having greater needs, rural impoverished pregnant women lack access to high-quality services and need-based treatments. Patients' distance from the closest medical facility has been noted as a significant deterrent to use, especially in rural areas..

According to Jegede & Odumosu (2022) The results of the national health survey show that at least 5%  of pregnant women see religion healers, homoeopaths,  pastors, alfas. Due to the conventional beliefs' tendency to relate the sickness itself with a number of indirect, social, and economic variables, this picture appears quite little. A non-formal doctor would be the closest and most accessible health professional in some  areas, and they would be referred mostly due to their low cost. Certainly, household finances restrict the options and chances for those seeking health care (Babar, 2020).

Furthermore, a healthy population is essential to any country's ability to meet its developmental objectives. The entire integrated development of the social, economic, political, and educational elements that affect people's lives and livelihoods determines their state of health (Sekhar, 2021). In order to maintain good health and enhance the health and quality of life of individuals and households, preventive, curative, and other healthcare services are offered. Indeed, a country's sustainable development and economic progress are intimately related to its state of health. Additional evidence has shown that health care spending has a significant positive economic impact. When everything else is equal, a 10% rise in life expectancy at birth (LEB) is associated with a 0.3 to 0.4 percentage point annual improvement in economic growth, according to the growth rates of a sample of developing countries from 1965 to 2022 (Jegede & Odumosu 2022). Thus, between a typical high income country and a typical least-developed country, the difference in yearly growth explained by life expectancy at birth is approximately 1.6 percentage points annually (Jegede & Odumosu 2022). Governments around the world have an obligation to protect citizens' health, particularly impoverished households and expectant mothers, who are typically not financially shielded, especially from high medical expenses (Olasehinde & Olaniyan, 2017). These expenses comprise both direct costs, like out-of-pocket payments (OOP), which are the costs that beneficiaries bear while using a certain healthcare service. For medical care as well as incidental expenses like missed wages due to illness or inability to go to a medical facility. These costs frequently take up a sizable portion of a household's disposable income and push many people farther into poverty (Leive & Xu, 2022).

Health costs, particularly for expectant mothers, can be disastrous. This occurs when a household's health costs surpass 40% of the money left over after meeting their basic necessities (Kouyaté & Flessa, 2021). Nigeria currently has the National Health Insurance Scheme (NHIS), a social health insurance program that is sponsored by the federal government. However, households account for more than 60% of all healthcare spending (Onwujekwe et al., 2019). Due to unequal income distribution and a high prevalence of poverty among women, the majority of impoverished households including expectant mothers , regrettably, have deteriorated health and cannot meet up with ante natal checkups  furthermore When people are sick, they frequently turn only to prayer, take medications by themselves, or see inexperienced medical professionals. All personal healthcare services, including as disease prevention, diagnosis, treatment, and rehabilitation for people with physical and mental disabilities, are included in the healthcare system. Holistic health restoration is the aim. Along with individuals, the government, business organizations, and other entities that finance various services, it also includes the institutions and labour force that supply these services. In summary, a healthcare system consists of all the sources from which a person obtains medical care and from which they are often compensated (Olasehinde & Olaniyan, 2017). As is evident in many developing nations, patterns of health seeking behavior—which is defined as a collection of behaviours and attitudes displayed by individuals and their social circle in response to physical cues interpreted as symptoms—also influence the amount of money spent on healthcare (Jegede & Odumosu, 2022).

The choice of whether and where to consult begins long before a patient enters a medical facility, and with so many conflicting and potentially confusing sources, a decision must be made quickly. Making ensuring that those in need of healthcare services can get them is a major problem still facing many developing countries today, given the lack of suitable healthcare facilities and the declining number and calibre of healthcare experts. Nonetheless, attempts to get through this obstacle have made it possible for the traditional and orthodox sources—the two main providers of healthcare services to coexist (Agyare, Mensah & Osei-Asante, 2021; Bello, 2021; Dalal, 2021). Nonetheless, a number of writers concurred that conventional medicine did not originate until much later than traditional medicine. Healthcare professionals (HCPs) in Nigeria are individuals who have had official training to provide orthodox healthcare services. Alternatively, informal medication salespeople, also referred to as patent medicine vendors (PMVs), may provide these services. They vary from chemists in that they usually manage over-the-counter (OTC) drug stores. Put differently, they sell drugs to customers directly without a prescription from a medical provider, whereas chemists manage retail locations for all medications (prescription and over-the-counter). Since neither formal pharmacy training nor any degree of education are necessary, their understanding of and stocking of suggested therapies for ailments is inadequate (Treleaven, Liu, Prach & Isiguzo, 2022). Conversely, providers of conventional medical care encompass herbalists, soothsayers, divine healers, midwives, spiritualists, bone setters, mental health therapists, and conventional surgeons (Malu, 2019). Certain Christians and Muslims hold the belief that healing happens in a supernatural way through prayer or divine intervention, instead of through medical intervention or the use of medication. As a result of this, some churches and mosques operate faith-based homes or centers where individuals of various racial and religious backgrounds congregate in times of illness or injury (Oosthuizen, 2023). The healing offered in these centers are purely prayer and faith. Regrettably, while this route was initially promised to be a free alternative to orthodox healthcare, it is at present being paid for (Owoeye, 2019). Above clearly shows few socio economic factors that influence Health Seeking Behavior Of Women in Nigeria. Therefore the study centers on Exploring the Influence Of Socio-economic Factors On Health Seeking Behavior Of Pregnant Women in Akungba.

1.2 statement of Problem

The health-seeking behavior of pregnant women is crucial for maintaining the wellbeing of both the mother and the foetus, but it is heavily influenced by a number of socioeconomic factors. Comprehending these factors is crucial in formulating efficacious public health tactics and measures. Numerous socioeconomic factors, including education, work position, income level, and access to healthcare services, has a significant impact on how pregnant women seek and use healthcare. For instance, while higher education levels may raise awareness and encourage the use of health services, lower economic levels may restrict access to high-quality prenatal care. Social variables including cultural values and social support networks can also have an effect on health-seeking behaviours. Even though the significance of these factors is acknowledged, a thorough understanding of how various socio-economic factors combine to influence pregnant women's health-seeking behaviour is frequently lacking. This information gap may lead to health policies and initiatives that are insufficient or improperly focused, failing to adequately address the needs of all demographic segments.. It is to this the study centres on Exploring The Influence Of Socio-Economic  Factors On Health Seeking Behaviour Of Pregnant Women  In Akungba

1.3 objectives of the study

The major purpose of this study is to examine exploring the Influence of Socio-Economic Factors on Health Seeking Behavior of Pregnant Women in Akungba. Other general objectives of the study are:

1) To examine the Influence educational Background on Health Seeking Behavior of Pregnant Women in Akungba

2) To examine the Influence of Age on Health Seeking Behavior of Pregnant Women in Akungba

3) To examine the Influence of Religion on Health Seeking Behavior of Pregnant Women in Akungba

4) To examine the influence of Culture on Health Seeking Behavior of Pregnant Women in Akungba

1.4 RESEARCH QUESTIONS

The following research questions shall guide this study and in the course of this research, we shall attempt to find answers to the following questions:

1) What is the Influence of educational Background on Health Seeking Behavior of Pregnant Women in Akungba?

2)  What is the Influence of Age on Health Seeking Behavior of Pregnant Women in Akungba?

3) What is the Influence of Religion on Health Seeking Behavior of Pregnant Women in Akungba?

4) What is  the influence of Culture on Health Seeking Behavior of Pregnant Women in Akungba?

1.5HYPOTHESIS OF THE STUDY

HO1: there is no Influence of educational Background on Health Seeking Behavior of Pregnant Women in Akungba

1.6 SIGNIFICANCE OF THE STUDY

The findings from the study could be used in providing structured modules that will be used in various hospitals for improving awareness on health seeking behavior among pregnant women. The availability of the project will make health seeking behavior information easier. The literate women can read and acquire the information on their own while the illiterate ones can be assisted by their husbands or children in acquiring the information. Also written information can reach more people. The study could enable the health workers to give appropriate information to the women who come to receive care from them. The findings from the study could create awareness to women about the need to seek treatment early enough

 1.7 SCOPE OF THE STUDY 

The study would cover exploring The Influence of Socio-Economic Factors on Health Seeking Behavior of Pregnant Women in Akungba. Akungba is a state in southwestern Nigeria. It was created on 3 February 1976 from the former Western State. Ondo borders Ekiti State to the north, Kogi State to the northeast for 45 km, Edo State to the east, Delta State to the southeast for 36 km, Ogun State to the southwest for 179 km, Osun State to the northwest for 77 km, and the Atlantic Ocean to the south.The state's capital is Akure, the former capital of the ancient Akure Kingdom. The State includes mangrove-swamp forest near the Bights of Benin

1.8 LIMITATIONS OF THE STUDY

The Researcher is likely to encounter certain problems in the course of conducting the research work, some of which may be

Financial Constraint:  A good and successful research project will involve various activities and processes, it will require sufficient finances. However, due to the researcher's limited financial means, this research project may run into financial difficulties.

Time Constraint: The institution has set a time restriction for the research work; nevertheless, this time limit may not be sufficient for the research job to be completed, limiting the breadth of the research.

1.9 DEFINITION OF TERMS

Socio Economic : Socioeconomic status is an economic and sociological combined total measure of a person's work experience and of an individual's or family's access to economic resources and social position in relation to others

Health seeking behavior: Health information-seeking behaviour, also known as health information seeking, health seeking behaviour or health information behaviour, refers to how people look for information about health and illness. HISB is a key strategy for many people to understand their health problems and to cope with illness.

Pregnant woman : having a child or other offspring developing in the body; with child or young, as a woman or female mammal.