ABSTRACT

This study explored the influence of culture on the effective utilization of health care services by adult males and females of Esan West Local GovernmentEkpoma, Edo State.The objectives of the study were to determine the knowledge of health care services, cultural practices and beliefs of the people on health care services, to determine the cultural practices that could affect the effective utilization of health care services by the people, and to determine if cultural practices are the major reason for ineffective utilization of health care services by the people. The researcher used a descriptive non experimental study design in carrying out this research.The researcher used multistage random sampling technique to divide the Ekpoma community into ten wards. The simple random technique was then used to select three wards out of the ten that make up the Ekpoma community.A sample size of 400 people were surveyed, 192 gave their consent and a total of 100 questionnaires were retrieved. The instrument used for data collection included a self-structured questionnaire. Inferential statistics of chi square was used to test the hypothesis data which was analyzed and presented in tables and charts.Results obtained show that Majority of the respondents’ cultural beliefs on the causes of illness are natural causes (micro-organisms) as reported by 95% respondents, while 5% of the respondents’ cultural beliefs on the causes of illness are pre-natural causes (witchcraft). 86% of the respondents have hospital as their first choice of treatment when ill, 4% of the respondents patronized traditional healers when ill, while 10% of the respondents go to the chemist/pharmacies when ill.Findings shows that 60% of the respondents strongly disagreed, 20% disagreed, 12% agreed, while 8% strongly agreed that native medicine is more effective than orthodox medicine. The resultsshow thatculture has less effect on the utilization of health care services as a result of exposure to knowledge and the need for effective health care services irrespective of cultural differences.

TABLE OF CONTENTS

COVER PAGE. i

TITLE PAGE.. ii

CERTIFICATION.. iii

ABSTRACT.. iv

DEDICATION.. v

ACKNOWLEDGEMENT.. vi

LIST OF TABLES. viii

LIST OF FIGURES. ix

CHAPTER ONE: 1

Background of the Study. 1

Statement of Problem.. 3

Objective of Study. 4

Significance of Study. 4

Research Questions. 5

Research Hypothesis. 5

Scope of Study. 5

Limitation of the study. 5

Operational Definition of Terms. 6

CHAPTER TWO: 7

Literature Review …………………………..…………………………………………….………7

Introduction. 7

Components of Health Care Services. 8

The Influence Of Culture On The Utilzation Of Health Care Services  11

Conceptual Framework. 14

CHAPTER THREE: 16

Research Methodology. 16

Research Design. 16

Research Setting. 16

Target Population. 18

Sampling Techniques And Sample Size. 18

Instrument For Data Collection. 19

Validity of Instrument 19

Reliabilty of Instrument 19

Method of Data Collections. 20

Method of Data Analysis. 20

Ethical Consideration. 20

CHAPTER FOUR: 21

Presentation And Analysis Of Data. 21

Test of Hypothesis. 27

Conclusion. 29

CHAPTER FIVE: 30

Discussion Of Findings. 30

Nursing Implication. 32

Summary And Conclusion. 32

Recommendation. 33

REFERENCES. 35

QUESTIONNAIRE.. 37

LIST OF TABLES

LIST OF FIGURES

CHAPTER ONE

INTRODUCTION

BACKGROUND OF THE STUDY

The world health education (WHO) considered the institution of health care services as the vehicle that will convey the declaration of health for all by the year 2000 and beyond to all nations (Olu et al., 2007).

Since then, Nigerian Government has been spending huge sums of money to ensure that health services reach every individual in any part of the country at an affordable cost (Olu et al., 2007).

The services received or given focused more on preventive, promotive and curative measures. In spite of those efforts, communities in the rural areas do not make proper use of health care services provided through the health institution/hospital due to some impeding factors such as culture, poverty, insufficient health institutions and professionals to deliver these health care services and to name a few (MacLachlan, 2006).

Culture is one of the crucial factors that contribute to the development and delivery of quality care to all. The health of the people, their behavior, their customs, their habits, and the way they live are so closely linked that they can be said to be tied together (MacLachlan, 2006).

Communities have culture that gives guidelines to their way of life in a particular area. For instance, cultural beliefs with regards to dressing, eating, morals etc. he stated that there are some harmful cultural habits detrimental to health that needs to be discouraged while there are some good ones which should be promoted and encouraged. In cultural relatedness, we must not unquestionably accept every cultural variation. We should make an unbiased effort to evaluate norms, values, and customs in light of the distinctive culture (MacLachlan, 2006).

However, culture plays a role in the health care utilization pattern among Africans. It is to this effect that stated that in traditional African society, culture determines who to contact for the treatment of disease and illness. He made instances using mental illness. An average Nigerian believes that natural healers and prophets are more effective in the treatment of psychiatric problems which they mostly attributed to result from punishments by a deity or a spiritual attack from an enemy. These believes are closely related to the belief in the supernatural power of one’s ancestors who are regarded as part of the household and said to be able to guide the affairs of family members (Lasebikan, 2016)

The above expressions articulate that culture to some extent influences certain facets of the utilization and delivery of health to a given group of people.

This therefore, prompted the researcher to look into the influence of culture on the effective utilization of health care services by inhabitants of Esan West Local Government, Ekpoma, Edo Sate.

STATEMENT OF PROBLEM

Culture, which is the way of life of a people, is thought to have an influence on how individuals perceive health care (Black et al., 2005).

Different culture in diverse regions, play either positive or negative roles in influencing the attitude of individuals towards utilizing health care services. In some African regions, individuals especially the elderly tend to submit to old fashioned ways of attaining health for themselves through the use of roots and herbs and hence are usually persuaded by their young children who are more contemporary and conversant with new modern day trends of health care delivery, to the surrounding hospitals and health centers so as to get access to well refined health services (Black et al., 2005).

It is to this recognition, that the researcher considered it expedient to determine the influence of culture on the effective utilization of health services, by inhabitants of Esan West local government,Ekpoma, Edo State.

OBJECTIVE OF STUDY

The objectives of this study are;

1. To determine the knowledge of health care services, cultural practices and beliefs of the people on health care services.
2. To determine the cultural practices that could affect the effective utilization of health care services by the people.
3. To determine if cultural practices are the major reason for ineffective utilization of health care service by the people.

SIGNIFICANCE OF STUDY

It is expected that the findings of this study will:

1. Reveal the extent of utilization of health care services by inhabitants of Esan West local Government, Ekpoma.
2. Provide the researcher knowledge on the influence of culture on health care services.
3. Serve as basis for recommending ways for promoting the utilization of health care services.
4. Planning strategies for effective utilization of health care services.
5. Add to the body of already existing knowledge.

RESEARCH QUESTIONS

The study seeks to provide awareness to the following questions.

1. What is the level of awareness on health care services by the people of Esan West local Government, Ekpoma, Edo state?
2. What are the cultural practices influencing the utilization of health care services?
3. Are health care services effectively utilized?

RESEARCH HYPOTHESIS

1. There is no relationship between cultural practices and beliefs and the utilization of health care services in Esan West Local Government Ekpoma Edo State.
2. There is a relationship between cultural practices and beliefs and the utilization of health care services in Esan West Local Government Ekpoma Edo State.

SCOPE OF STUDY

The study was carried out in Ekpoma, Esan West Local government Edo State.

LIMITATION OF THE STUDY

In undertaking the research, the researcher was constrained by time factor as the time to undertake the study was limited and financial constraint for effective mobility. A total of 192 respondents were surveyed across the selected wards in Esan West LGA. However, 100 respondents gave their consent to fill the questionnaire, which were retrieved for analysis.

OPERATIONAL DEFINITION OF TERMS

1. Influence: The effect that something has on the way a person thinks.
2. Culture: This refers to the way of life which isunique to a particular group of people in a community.It includes their mode of dressing, eating, housing, marriage and belief.
3. Health Care Services: These are health related services that are rendered to people at different hospitals and health centers by qualified personnel such as nurses, doctor, pharmacists, radiologists etc. These services may include drug administration, infant deliveries, health education, counseling, therapeutic services. e.t.c.
4. Utilization: This is defined as making use of health care services rendered at health/hospital by the people in the locality
5. Effective: This means producing the result that is wanted or intended.

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