Barriers to use of primary health care in a low-income setting in Nigeria: a cross-sectional descriptive study

Abstract Background Primary health care aims to provide essential health services and commodities to individuals and communities using available, acceptable, and sustainable resources. However, the demand for and use of primary care has fallen despite government investment. We sought to identify the main barriers affecting use of primary health-care services in Batsari (Katsina, Nigeria). Methods We did a cross-sectional descriptive study. The study population consisted of heads of households within the catchment area of the 21 primary health centres in Batsari. A sample size of 630 was drawn using cluster and random sampling techniques (using a random number table for all houses clustered within 30 min walking distance from primary health centre). We asked participants about predominant health problems and major determinants of access and use of primary health-care services. We analysed the results with SPSS (version 17.0). Findings 337 of 630 participants (53%) preferred to seek care from local pharmacies run by community health workers or artisans compared with only 49 (8%) who used primary health-care services. The most common reasons for not using these services were a lack of essential drugs (n=276; 44%), high cost of services (n=149; 24%), and inadequate infrastructure in primary health-care facilities (n=42; 7%). Interpretation Our findings show the underutilisation of primary health-care services, and so will guide policy makers in improving health-care delivery, especially where the need is greatest—at the level of local governance —in line with the national health policy and national health strategic development plan of Nigeria. Funding None.