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A contextual exploration of healthcare service use in urban slums in Nigeria

Author

Listed:
  • Olufunke Fayehun
  • Motunrayo Ajisola
  • Olalekan Uthman
  • Oyinlola Oyebode
  • Abiola Oladejo
  • Eme Owoaje
  • Olalekan Taiwo
  • Oladoyin Odubanjo
  • Bronwyn Harris
  • Richard Lilford
  • Akinyinka Omigbodun
  • On behalf of the Improving Health in Slums Collaborative

Abstract

Introduction: Many urban residents in low- and middle-income countries live in unfavorable conditions with few healthcare facilities, calling to question the long-held view of urban advantage in health, healthcare access and utilization. We explore the patterns of healthcare utilization in these deprived neighborhoods by studying three such settlements in Nigeria. Methods: The study was conducted in three slums in Southwestern Nigeria, categorized as migrant, indigenous or cosmopolitan, based on their characteristics. Using observational data of those who needed healthcare and used in-patient or out-patient services in the 12 months preceding the survey, frequencies, percentages and odds-ratios were used to show the study participants’ environmental and population characteristics, relative to their patterns of healthcare use. Results: A total of 1,634 residents from the three slums participated, distributed as 763 (migrant), 459 (indigenous) and 412 (cosmopolitan). Residents from the migrant (OR = 0.70, 95%CI: 0.51 to 0.97) and indigenous (OR = 0.65, 95%CI: 0.45 to 0.93) slums were less likely to have used formal healthcare facilities than those from the cosmopolitan slum. Slum residents were more likely to use formal healthcare facilities for maternal and perinatal conditions, and generalized pains, than for communicable (OR = 0.50, 95%CI: 0.34 to 0.72) and non-communicable diseases (OR = 0.61, 95%CI: 0.41 to 0.91). The unemployed had higher odds (OR = 1.45, 95%CI: 1.08 to 1.93) of using formal healthcare facilities than those currently employed. Conclusion: The cosmopolitan slum, situated in a major financial center and national economic hub, had a higher proportion of formal healthcare facility usage than the migrant and indigenous slums where about half of families were classified as poor. The urban advantage premise and Anderson behavioral model remain a practical explanatory framework, although they may not explain healthcare use in all possible slum types in Africa. A context-within-context approach is important for addressing healthcare utilization challenges in slums in sub-Saharan Africa.

Suggested Citation

  • Olufunke Fayehun & Motunrayo Ajisola & Olalekan Uthman & Oyinlola Oyebode & Abiola Oladejo & Eme Owoaje & Olalekan Taiwo & Oladoyin Odubanjo & Bronwyn Harris & Richard Lilford & Akinyinka Omigbodun & , 2022. "A contextual exploration of healthcare service use in urban slums in Nigeria," PLOS ONE, Public Library of Science, vol. 17(2), pages 1-14, February.
    • Handle: RePEc:plo:pone00:0264725
    DOI: 10.1371/journal.pone.0264725
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    References listed on IDEAS

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    1. Mark Montgomery & Paul Hewett, 2005. "Urban poverty and health in developing countries: Household and neighborhood Effects," Demography, Springer;Population Association of America (PAA), vol. 42(3), pages 397-425, August.
    2. May Sudhinaraset & Matthew Ingram & Heather Kinlaw Lofthouse & Dominic Montagu, 2013. "What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-12, February.
    3. Günther Fink & Isabel Günther & Kenneth Hill, 2014. "Slum Residence and Child Health in Developing Countries," Demography, Springer;Population Association of America (PAA), vol. 51(4), pages 1175-1197, August.
    4. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    5. Philippe Bocquier & Nyovani Madise & Eliya Zulu, 2011. "Is There an Urban Advantage in Child Survival in Sub-Saharan Africa? Evidence From 18 Countries in the 1990s," Demography, Springer;Population Association of America (PAA), vol. 48(2), pages 531-558, May.
    6. Alayne M Adams & Rubana Islam & Sifat Shahana Yusuf & Anthony Panasci & Nancy Crowell, 2020. "Healthcare seeking for chronic illness among adult slum dwellers in Bangladesh: A descriptive cross-sectional study in two urban settings," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-18, June.
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