PERCEPTION AND UTILISATION OF FREE HEALTH SERVICES BY NURSING MOTHERS IN IGBO-ORA, OYO STATE

Abstract

A policy of free health services at Primary Health Care was introduced in Oyo Slate in 1999. The policy covers the following services: Antenatal Care (ANC), normal delivery, immunization, essential drugs, some curative services (minor trauma, malaria, acute infections, and diarrhea), consultation, admission (excluding feeding) and treatment of disease in children. Laboratory and X-ray services are subsidized. This study assessed the experiences of nursing mothers on this set of free and subsided services in Igbo-Ora, Oyo State, Nigeria. The study was descriptive and cross-sectional in design. The target population consisted of women who had delivered babies in years 2000 and 2001, after the introduction of free Health Care Policy, A list of family compounds in Igbo-Ora was compiled. Each family compound was visited to identify all women who had delivered babies in the years 2000 and 2001. The women with the most recent delivery were then selected to arrive at a sample of 351 women. Perceptions and experiences of factors that influence utilization of health facility such as cost, quality of services at health facility were obtained through four focus group discussions, and these were used to develop a semi structured questionnaire. The instrument was pretested and administered by trained interviewers. A total of 351 questionnaires were administered by 5 Research Assistants. The ages of 351 respondents ranged from 18 -50 years with a mean of 27.4 (SD ± 6.38), A majority 241.,(68.7%), were Muslims and 75 (21.4%) had no formal education. Two hundred and sixty-one (74.4%) had heard about free health services either on radio, television, churches, mosques or from health workers. Two hundred and .sixty-six (75.8%) had used local or state government facility, 66(18.8) used private clinics and 12(3.4%) had used other services including Traditional Birth Attendants. Two hundred and forty-five (69.8%) women with primary or no formal education had used government facility as compared with 106(30.2%) women with secondary or higher education (P =0.02). This shows that utilization of government facility was positively associated with lower education levels. Among the 266 who had used government facility, 251 (94.4%) paid money for free health services, the amount paid ranged from N5 to N700, with a mean of N242. On a 5-point rating scale on the quality oF free health care, those who attended public health facilities had a mean score of 3.8. A good proportion of women that utilized government facility. 115 (43.2%). identified problems associated with the free health services scheme to include inadequate drug supply and frequent absence from duty by the health workers. In conclusion, the study shows that government services are utilized mostly by low income earners who still pay for services that are supposed to be free most especially drugs. There is therefore a gap between government policy of free health services and its implementation. This point to the need for the government to properly monitor the implementation of the free health policy in Ibarapa Central LGA.