Attitude of Undergraduates Towards The Utilization of Existing Health Facilities of A Tertiary Institution In Benin, Edo State, Nigeria

Research article

Attitude of Undergraduates Towards The Utilization of Existing Health Facilities of A Tertiary Institution In Benin, Edo State, Nigeria

Corresponding authorDr. Florence O. Adeyemo, Ladoke Akintola University of Technology, Osogbo, Osun state, Nigeria, Tel: +2348055915239; Email: doctoradeyemo@yahoo.com
Abstract
Objective
This study assessed undergraduates’ attitude towards the utilisation of existing health facilities of a tertiary institution in Benin.
Methods
The study employed survey design. The target population was undergraduates and random sampling technique was employed to select 1,570 students from faculties of Engineering, Law, Arts and School of Basic Medical Sciences. Samples were proportional to the size of the students’ population in each faculty. Data was collected using a pre-tested, self-administered anonymous structured close-ended questionnaire. The questionnaire was prepared based on the available literature and the opinion generated from the undergraduates. 1,176 (75%) questionnaires were retrieved out of 1,570. Students who gave their consent to participate in the study received elaborate explanation on the purpose of the study. Data processing and analysis were done using Epi Info version 6.04 and SPSS 10.1 statistical programmes. Descriptive statistics used were frequencies and percentages while inferential statistical used multiple regressions and the independent t-test analysis at p ≤ 0.05 significant level.
Result: Showed that the undergraduates had a positive attitude towards the university health service. Furthermore, students’ discipline did not significantly influence utilization of health services. However, more females than male students utilize the services of the Health Service Department.
Conclusion: Male students under-utilise the health services which might be due to insensitivity and ignorance.

Keywords: Attitude; Utilization; Undergraduates; Health Services 

Introduction
An important determinant of students’ morbidity and mortality rate is the access to and use of quality healthcare services [1]. The provision of quality health care is an increasingly difficult task. Globally, universities do have health centres to provide quality and affordable health care to students of the institution [2]. Access to quality health services provided by the university management is crucial to having a reduced rate of students’ morbidity and mortality. Attitude towards utilization of  health services will be related to the availability of drugs, health care providers, equipment and accessibility. The World Health Assembly mandated sound health for all people in the year 2000 because it was necessary for socially productive life [3]. In low resource countries, the hospital bed-population and doctor-population ratio was about 0.4 and 0.2 per 1,000 population respectively, while the corresponding figures for the developed  ountries are 6 and 3 per thousand population. Health expenditure per capita ranges from a mere USD 26.8 in low income countries to USD 224 in middle income countries, USD 382 in upper middle income countries and USD 4,879 in high income countries [4]. Oyekale and Eluwa lamented the persistent low quality and inadequacy of health services in many public health facilities in Nigeria [3]. Studies have identified many reasons for the utilization of various health care facilities such as perceived health status or health related quality of life, socio-economic status, level of education, accessing general practitioners or specialists’ services [5].
Some students may find it difficult to access the health service facilities when sick because the university information system is inefficient, thus creating a negative attitude towards the utilization of this crucial service rendered by the university and seeking alternative source. Other factors that discourage students from accessing the university health care facility includes: cost of health services, distance of health facilities, waiting time and quality of care [6]. The strategic policy formation in all health care systems should be based on information  relating to health promoting, seeking and utilization behaviourwithin institutional structure such as family, community or the health care services [7]. The utilization of health services is a key factor in improving health outcomes. Data revealed that  the health care utilization rate in Kenya was approximately77% for those who were reported been sick, thus, a large  percentage (22.8) of the population does not seek care despitebeing ill [8]. Awoyemi et al. also opined that level of education, health seeking behaviour, expected competency of the provider, income of the individual, long distance and time spent as factors affecting the utilization of health facilities [9].
The University of Benin (UNIBEN) management tried to put in numerous efforts to establish a functioning healthcare system, but it seems that many students rely on self medication for healthcare needs. The level of awareness of individual students about all the facilities available in the health service department including availability of drugs and equipments, cost and attitude of the health workers will determine the utilization of UNIBEN health services.
This study aims to show the attitude of undergraduates towards utilization of the university health services. It will also contribute to the available literature on the utilization of health facilities by students.
Objectives
1. To assess undergraduates’ attitude towards existing health services in the health service department of a tertiary institution
in Benin.
2. To determine if area of discipline (faculty of study) will influence the utilization of health services of a tertiary institution in Benin.
3. To determine if gender of students will influence the utilization of health services of a tertiary institution in Benin.
Research Question
1. What is the attitude of undergraduates towards the existing facilities in the health service department?
Statement of Hypothesis
1. There is no significant relationship between the area of students’ discipline and the utilization of health services rendered in the health service department.
2. There is no significant difference between the gender of students and utilization of health services rendered in the health service department.
Methods
Design
The study employed Descriptive survey.
Study Area
This study was conducted at University of Benin, Benin City, Edo. UNIBEN was founded in 1970. It was formally called Institute of Management and Technology and was made a full-fledged university by National Universities Commission (NUC) in 1971, Christened UNIBEN in 1972 and became a Federal university in 1975.
Target Population
Undergraduates from various faculties.
Sampling Technique
Simple random sampling technique was used to select 4 faculties within the University. These Faculties include Engineering, Basic Medical Sciences, Pharmacy and Arts. 1,570 students were randomly selected, 271 data were missing and 123 could not be retrieved. On the whole, 1176 representative sample of students were randomly selected for the study. Samples were selected in proportion to the size of the student population in each faculty.
Instruments
Data was collected using a pre tested self-administered anonymous structured close-ended questionnaire. The questionnaire was prepared based on the available literature and the opinion generated by students during Focus Group Discussions conducted prior to the survey in one faculty that was not included in this study. The content of the questionnaire included: demographic profile, students attitude towards services, influence of discipline and influence of gender of students on the utilization of health services rendered in the health service department. Likert rating scale was used to measure attitude. It was conducted in May 2012.
Validity Test
The questionnaire was given to colleagues for review.
Reliability
Of the research instrument was done through test-retest method which gave 0.84 reliability co-efficient.
Procedure for Data Collection
The questionnaire was administered and data was collected from respondents within a period of two months.
Data Analysis
Data processing and analysis was done using Epi Info version 6.04 and SPSS 10.1 statistical programs. Frequencies and percentages of the variables of interest were done to determine the attitude of students towards the utilization of services rendered  in the health service department. Statistical significancewas considered at p value less than 0.05 using descriptive statistics, multiple regressions and the independent t-test analysis to test hypothesis.
Ethical Consideration
Students who gave their consent to participate in the study received elaborate explanation on the purpose of the study and the type of questions and how to answer by trained facilitators.
Results
Table 1 reveals the response pattern of students’ attitude towards health services utilization. The responses of respondents to each of the items formed the unit of analysis.
Calculation of the responses reveals that 48% of respondents strongly disagree to all the items used to assess respondent’s attitude towards the university health services. A breakdown of respondents responses to each item reveals that 846 (84.60%) disagreed to “I don’t go to the health centre because of the attitude of the health workers”; 887 (75.42%) disagreed to “I don’t go to health centre because l cannot afford the cost”; 995 (75.42%) “I make use of the health insurance scheme so I attend the health centre; 923 (78.48%) “I do not go to health centre because it is not convenient; 805 (68.45%) “I do not go to health centre because of the long waiting hours”; 1071 (91.07%) “do not go to health centre because the personnel are not expert”; 1039 (88.35%) “I do not go to health centre because of embarrassment”. From the response of respondents it can be deduced that students of University of Benin have a positive attitude toward the University Health Centre.
HO1
Does the area of students’ discipline significantly influence utilization of the University of Benin Health Centre? The independent variables in this analysis are the students’ area of discipline which is categorised into four: Engineering; Basic Medical Sciences; Pharmacy and Art while the dependent variable is utilization of University of Benin Health Centre. Multiple regression was used to test this hypothesis at p <.05. The result is presented in Table 2
Table 2 reveals the descriptive statistics and regression ANOVA of area of discipline of respondents and utilization of health services.
Result from the table indicates that, there is no significant difference in the mean values of respondents from the four disciplines.
The calculated F value of 1.75 is less than the critical f-ratio of 3.08 at p <.05, this implies that the null hypothesis which states that the area of students’ discipline does not significantly influence utilization of University of Benin health service is retained.
HO2
There was no significant differences between gender of students and utilization of Health Centre. The independent variable in this hypothesis is gender categorised as male and female while the dependent variable is utilization of health services, the independent t-test analysis was used to test this hypothesis at p <.05. The result is presented in Table 3.
*Significant at p <.05; df = 1174;
Result of table 3 reveals the mean, standard deviation and t-value of the respondents. The calculated t-value of 5.23 is greater than the critical t-value of 1.96 at p <.05 with df = 1174. This implies that the null hypothesis which states that, there is no significant difference between gender of students and utilization of health centre is rejected while the alternate is retained. The mean value of females (M = 30.12) is higher than the mean value of male (26.51), this means that though females are more represented in the sample than males, they patronize the university Health Centre than their male counterparts. Therefore the results show that, there are significant differences between gender of students and utilization of health centre.
Discussion
In this study we investigated the attitude of the undergraduates towards the use of existing health services of a tertiary institutions in Benin, Edo state of Nigeria. 1176 representative sample of students were randomly selected for the study from the faculties of Engineering, Basic medical sciences, Pharmacy and Arts.
This study showed that the undergraduates have a positive attitude towards the utilization of the University Health Centre with majority of them not been discouraged by the cost of health care, long waiting hours, attitude of the health workers and other factors. This is in line with the study of Pappa and Niakas [8]. One factor that may have contributed to the positive attitude of these undergraduates is implementation of National Insurance Health Scheme by the management of University of Benin. Daniel & Chunhuei observed that characteristics such as physician supply and availability of physicians in the community would be important contextual variables to be considered within the health services utilization [10]. This result is also contrary to the findings of Adeyemo et al. who observed that majority of the undergraduates in Ogbomoso preferred using Pharmacy store, Private health institutions and other alternative therapies with respect to their reproductive health problems [11].
The findings further revealed that the area of students’ discipline does not significantly influence utilization of the Health Centre in a tertiary institution in Benin. This is in line with the study of Pappa and Niakas that seem to suggest the existence of equity in the use of primary health care services in Athens area [5].
 Lastly, the result of the study showed that there are significant differences between gender of students and utilization of health services. This means that females patronize the Health  Centre more than their male counterparts. In order words females are more aware about their health. This study supports the findings of Shaikh and Hatcher in a reversed manner, stating that Women suffering from an illness report less frequently for health care as compared to men [7].
Conclusion
This study has demonstrated a positive attitude among undergraduates towards the utilisation of the existing health services of the University of Benin. Cost, attitude of health workers, long waiting hours and other factors does not discourage the students from seeking medical assistance in the clinic. Furthermore, it was found out that females are more health conscious in the institution and visit the health centres more often. The results have potential implications in health policy-making of the management and particularly emphasizing the proper education of the undergraduates about their health.

References

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