UTILISATION OF PRE-SCHOOL CHILDREN'S HEALTH SERVICES IN IBARAPA DISTRICT: IMPLICATION FOR HEALTH EDUCATION

Abstract

Differential utilisation is a phenomenon common to most health delivery systems. This situation is aggravated when it involves one of the vulnerable groups in the community, who are too young to express their health needs. It is pertinent to re-examine the services presently being provided, to determine how far it is coping in meeting the needs of this section of the community. This study was designed to examine those factors that impede utilisation of pre-school children health services based on the theories and concepts in health education in the light of which education strategies would be put forward and recommendations towards their implementations made. 400 mothers who make use of the pre-school children health services in Igangan, (Ibarapa district) were interviewed, in the course of which information on their knowledge, beliefs and perceptions were gathered. 3 research tools- questionnaires, documentation, and observation were used. In administering the questionnaire, multistage and random sampling technique were employed and the sample units consisted of those mothers with a child under fiver years of age. Analysis of the data by means of chi-square and correlation coefficient revealed that the utilisation pattern is influenced by certain antecedents factors which using Green's model could be grouped into three. These are predisposing factors (persistence of beliefs, poor knowledge of disease conditions and perceptions of provided services); enabling factors (time spent at the clinic, lack of facilities for imunisation, probable inconvenience of present scheduled visits) and reinforcing factors (advice and cooperation received from the husband, family and health workers). The utilisation behaivour of mothers existed in two interrelated perspectives: (1)Immunological status in relation to clinic attendance; mothers who had immunized their children (48.8%) and those mothers with no child immunized (51.3%). (2.) Frequency of visits by mothers to clinics: mothers with clinic attendance for health supervision below 50% (48%) those with attendance between 50-74% (28.75%) and those with attendances above 74% (23.3%). The attendance rate is fairly high while a disparity occurs in acceptance of immunization which showed that fewer mothers than those attending clinic accept immunization. In the light of the findings, educational strategies which included, use of communication methods that would effectively influence mothers beliefs and knowledge, and community organisation designed to make use of available local resources in the improvement of accessibility of services were suggested. Other methods include staff training and programme development to improve the attractiveness of the available services.