BARRIERS TO ACCESSING HEALTH CARE SERVICES AND COPING STRATEGIES AMONG PEOPLE WITH HEARING IMPAIRMENTS IN IBADAN METROPOLIS, OYO STATE

Abstract

People with hearing impairments experience various forms of barriers when accessing healthcare services. This is due to their inability to communicate with healthcare providers, poor health knowledge, low socioeconomic status among others. Because of the difficulties experienced while accessing quality healthcare services, this has resulted in their avoidance of health systems, misdiagnosis, frustrations and lack of confidence in the health system. Previous studies focused on communication barriers only. Hence, this study was, therefore, designed to explore the barriers to accessing healthcare services and coping strategies among people with hearing impairments in Ibadan Metropolis, Oyo State, Nigeria. A descriptive cross-sectional survey design was adopted for this study. A purposive sampling technique and snowball approach was employed to select 80 respondents who are residents within Ibadan Metropolis. A validated interviewer-administered structured questionnaire was used to obtain information on socio-demographic characteristics, health-seeking behaviour, individual/demand-side barriers, institutional/supply-side barriers, and the strategies employed in coping with these barriers. The data collected were analysed using descriptive statistics and inferential statistics such as fishers exact test with the level of significance set at p=0.05 Respondents’ age was 26.6±7.3. Majority (63.8%) of the respondents fall within 18-25 years age range and the major method of communication for people with hearing impairments is through the use of sign language (92.5%). Majority (66.3%) had secondary school education while few (18.8%) had tertiary education. Only 13.8% of the respondents were employed and 10.0% were self-employed. Majority (63.8%) of the respondents, do not have any source of monthly income and 1.3% earn about 40,000 and above monthly. Most (66.3%) of the respondents had been ill in the last twelve months and about 49% visited hospitals. The most common individual /demand side barriers were lack of finance (65.0%) followed by inability to communicate with physician (62.5%). Fear of misdiagnosis was also a barrier for 55.0% of the respondents while the most prevalent institutional/supply-side barrier was high financial cost (75.0%) followed by delay before seeing a doctor (68.8%). The absence of professional sign language interpreters in most health facilities is a major barrier for most (66.3%) of the respondents. Most (73.8%) respondents reported they seek help from other sources sometimes, while 67.5 % indicated that they were always accompanied by family members and friends who serve as interpreters in health care settings (67.5%). Less than half, (45.0%) of respondents indicated that the health facilities they visited provide sign language interpreters while 22.5% reported they do not visit hospitals or health facilities due to these barriers. No significant association was found between socio-demographic characteristics and health-seeking behaviour, barriers and health-seeking behaviour, and socio-demographic characteristics and coping strategies. Barriers to accessing health care services exist both at demand-side/individual and supply side/institutional level among people with hearing impairments in Ibadan Metropolis. The use of mass media in health education, advocacy and training of health professionals in sign language is very important in improving access to health care services among these population, so that health equity and equality can be achieved.