Abstract
This study addresses the quest for rural-based health care services among women in urban Nigeria relying on a large qualitative database obtained from 63 Igbo women living in Aba, Nigeria. Results indicate that urban Igbo women of different socioeconomic and demographic characteristics utilize the services of different rural-based health care providers—indigenous healers, traditional birth attendants (TBAs), faith/spiritual, western-trained doctors and nurses as well as chemist shopkeepers—for conditions ranging from infertility, through child birthing and abortions, to swollen body, epilepsy, bone setting, and stubborn skin diseases. Major attractions to rural-based therapists were the failure of urban-based health services to provide cure, perceived mystical nature of conditions, need to conceal information on therapeutic progress and/or the nature of specific disease conditions, belief in rural-based therapists’ ability to cure condition, and affordability of the services of rural-based health care providers. Findings underscore the critical implications of service characteristics, cultural beliefs, and the symbolic content of place(s) for care seekers’ patterns of resort. We suggest that need exists for policies and programs aimed at making health care services in urban Nigeria more responsive to care seekers’ socioeconomic and cultural sensitivities, integrating informal health care providers into Nigeria’s health care system, and strengthening public health education in Nigeria.
KeyWords: Igbo, Nigeria, Rural-based health care services, Urban women
Full Text
The Full Text of this article is available as a PDF (96.8 KB).
References
- 1.Igun UA. Stages of health-seeking behaviour: a descriptive model. Soc Sci Med. 1979;39:797–806. doi: 10.1016/0277-9536(94)90041-8. [DOI] [PubMed] [Google Scholar]
- 2.Ityavyar D. Health services inequalities in Nigeria. Soc Sci Med. 1988;27:1223–1235. doi: 10.1016/0277-9536(88)90352-8. [DOI] [PubMed] [Google Scholar]
- 3.Erinosho OA. Health Care and Health Care Services in Nigeria. Report on Research for African Development Foundation. Washington, DC: African Development Foundation; 1989. [Google Scholar]
- 4.Ogunbekun I, Ogunbekun A, Oraton N. Private health care in Nigeria: walking a tight rope. Health Policy Plan. 1999;14:174–181. doi: 10.1093/heapol/14.2.174. [DOI] [PubMed] [Google Scholar]
- 5.Izugbara CO. Women’s understanding of factors affecting their reproductive health. Afr J Reprod Health. 2000;4:62–68. [Google Scholar]
- 6.Murphy M, Baba T. Rural dwellers and healthcare in rural Nigeria. Soc Sci Med. 1981;15A:265–271. doi: 10.1016/0271-7123(81)90010-9. [DOI] [PubMed] [Google Scholar]
- 7.Annual Statistics. Lagos, Nigeria: Government Printer; 2003. [Google Scholar]
- 8.Ubani S. Life and Times in Aba; 1900–2000. Owerri, Nigeria: Ahiajoku Press; 2003. [Google Scholar]
- 9.Ndukwe P. Dirty Aba City. Weekly Voice. November 10,2002:17.
- 10.Uka CM. Cost of health services soars in Aba town. Champion. May 7, 2002:12.
- 11.Izugbara CO, Etukudoh IW, Brown AS. Transethnic itineraries for ethnomedical therapies: Igbo women seeking Ibibio cures. Health Place. 2005;11:1–14. doi: 10.1016/j.healthplace.2003.12.001. [DOI] [PubMed] [Google Scholar]
- 12.Ibanga UA. Introduction to Social Science Statistics. Jos, Nigeria: Jos University Press; 1996. [Google Scholar]
- 13.Nwaghaghi FN. A Religious Profile of the Ngwa of Southeastern Nigeria. Onitsha, Nigeria: Afa publishers; 1990. [Google Scholar]
- 14.Robey B, Ross J, Bhushan I. Meeting unmet needs: new strategies. Popul Rep J. 1996;43:1–43. [PubMed] [Google Scholar]
- 15.Westoff C, Bankole A. Unmet Need: 1990–1994, DHS Comparative Study No. 16. Calverton, MD: Macro International; 1995. [Google Scholar]
- 16.Izugbara CO, Ukwayi JK. An intercept of study persons attending traditional birth homes in rural southeastern Nigeria. Cult Health Sex. 2004;6:101–114. doi: 10.1080/136910501198851. [DOI] [Google Scholar]
- 17.Izugbara CO, Ukwayi JK. An intercept of study persons attending traditional birth homes in rural southeastern Nigeria. Health Women Int. 2003;24:177–192. doi: 10.1080/07399330304003. [DOI] [PubMed] [Google Scholar]
- 18.Alubo SO. Medical Professionalism and State Power in Nigeria. Jos, Nigeria: Centre for Development Studies, University of Jos; 1994. [Google Scholar]
- 19.Outwater A, Nkya L, Lyamuya E, et al. Health care seeking behaviours for sexually transmitted diseases among commerical sex workers in Morogoro, Tanzania. Cult Health Sex. 2001;3:1–18. doi: 10.1080/136910501750035644. [DOI] [Google Scholar]
- 20.Enwereji E. Views on tuberculosis among the Igbo of Nigeria. Indigenous Knowledge and Development Monitor. 1997;2:4–7. [Google Scholar]
- 21.Lambo TA. Traditional African culture and western medicine: A critical review. In: Foynter FML, editor. Medicine and Culture. London: Wellcome Institute of History of Medicine; 1968. pp. 89–101. [Google Scholar]
- 22.Jegede AS. African Culture and Health. Lagos, Nigeria: Stirling Holden Publishers; 1998. [Google Scholar]
- 23.Kuti O. Speech at the Opening Conference on Problems of Rural Dwellers in Nigeria. Kuru, Nigeria: National Institute of Policy and Strategic Studies; 1998. [Google Scholar]
- 24.Alubo SO. Drugging the people: pills, profits, and underdevelopment in Nigeria. Stud Third World Soc. 1985;24:89–113. [Google Scholar]
- 25.Alubo SO. Debt crisis, health and health services in Africa. Soc Sci Med. 1990;31:639–648. doi: 10.1016/0277-9536(90)90245-N. [DOI] [PubMed] [Google Scholar]
- 26.Harrison K. Macroeconomics and the African mother. J R Soc Med. 1995;89:361–362. [PMC free article] [PubMed] [Google Scholar]
- 27.Harrison K. Maternal morbidity and social conditions with particular reference to illiteracy and poverty. Sex Health Matters. 2001;2:50–54. [Google Scholar]
- 28.Asuquo EE, Etuk SJ, Duke F. Staff attitude as barrier to the utilization of University of Calabar Teaching Hospital for obstetric care. Afr J Reprod Health. 2000;4:69–73. [Google Scholar]
- 29.Eyles J. Senses of Place. Warrington, UK: Silver Book Press; 1983. [Google Scholar]