Barriers to Primary Healthcare Utilisation among Mothers of Children Under Five Years in Isiala Mbano Local Government Area, Imo State, Nigeria

Abstract

Primary healthcare (PHC) provides an important point of contact between communities and the formal health system, particularly for mothers and children under five years. However, utilisation may be constrained by provider-related, service-related, socioeconomic and sociocultural factors. This study examined perceived barriers to PHC utilisation among mothers of children under five years in Isiala Mbano Local Government Area (LGA), Imo State, Nigeria, with specific attention to health personnel attitudes and immunisation-related factors. A cross-sectional survey design was adopted. The study population comprised 9,713 mothers of children under five years, from whom 398 were selected using proportionate, cluster and simple random sampling techniques. Data were collected using researcher-developed Barriers to Primary Healthcare Utilisation Questionnaire (BPHUQ), which was subjected to expert validation and had a reported reliability coefficient of 0.76. Data were analysed using mean and standard deviation. Results revealed that health personnel attitudes recorded an aggregate mean of 2.31. Mothers reported unfavourable perceptions of empathy (M = 2.20), respect (M = 2.18), professionalism (M = 2.19) and care (M = 2.17), whereas effective communication was favourably rated (M = 2.79). For immunisation-related factors, fear of side effects was the only item above the criterion mean (M = 2.79). Poor knowledge of immunisation schedules (M = 2.17), accessibility (M = 2.18), cultural beliefs (M = 2.21) and religious beliefs (M = 2.22) were below the criterion mean. Unfavourable perceptions of health personnel, particularly regarding empathy, respect, professionalism and care, may represent important perceived barriers to PHC utilisation. Fear of immunisation side effects was also a notable concern. However, PHC authorities should strengthen continuing professional development on respectful, empathetic and client-centred care.