CHALLENGES AND OPPORTUNITIES TO ACCESS HEALTH CARE IN URBAN SLUMS OF LAGOS-STATE IN NIGERIA

Abstract

Background: Access to healthcare is a major public health challenge, especially in developing countries. Many Nigerians cannot avail the healthcare services they need with those in the urban slums being the worst hit. The aim of the study is to determine the issues regarding accessibility of healthcare services in three urban slums of Lagos State in Nigeria. All the aspects of accessibility including the geographical, financial and socio-cultural factors affecting the healthcare access were assessed. Methods: A descriptive cross-sectional study was conducted among slum dwellers of three urban slums in Lagos-State. A sample size of 427 individuals was used. The subjects were recruited using multi-stage sampling technique. Data was collected using a structured self-administered and close-ended questionnaire that was adapted from World Health Organization. Variables on geographical accessibility, financial accessibility and social-cultural factors affecting accessibility were analysed. Data analysis was performed using SPSS version 15 software. Results: A total of 80.3% of the respondents had an estimated travel distance ranging from 6 to 10 km to reach a healthcare facility. About 10-20% of the monthly household income was spent on healthcare by 46.8% of respondents. A total of 97.9% of respondents had no health insurance coverage. Self-medication was reported by 77.8% of the respondents who were unable to pay for healthcare services. Only 43.1% of respondents utilized government hospitals as the first point of contact. Conclusion: Our study concludes that there is limited geographical and financial access to healthcare services for slum dwellers in Lagos-State especially due to their financial constraints that affect their accessibility to healthcare services. Access to healthcare services still remains a major issue in slums of Nigeria. Increasing the coverage of the National Health Insurance Scheme and strengthening the primary healthcare infrastructure would help in addressing the issues of accessibility to healthcare in urban slums.