Healthcare decision-making in an African metropolis: Analysing determinants of health-seeking behaviour among Lagos residents

Abstract

Introduction: Health-seeking behaviour includes the actions taken by individuals upon perceiving illness or health concerns, impacted by demographic, socio-economic, cultural, religious, and organisational factors. This study assessed the health-seeking behaviours of Lagos State residents and identified the determinants influencing these behaviours. Method: A descriptive cross-sectional survey was conducted with 2,492 respondents from four Local Government Areas in Lagos, Nigeria, using a multistage sampling technique between January and April 2023. Data were collected using pre-tested semi-structured questionnaires, and statistical analysis was performed in Stata 15.0. Significance was established at p<0.05, with adjusted odds ratios (aOR) and 95% confidence intervals calculated. Results: The study found that purchasing drugs from chemists (43.4%) was the most common health-seeking action, while only 33.7% sought hospital care when symptoms worsened. At multivariable analysis, females (aOR= 1.29; 95%CI: 1.28–3.73; p= 0.014) had higher odds of appropriate health-seeking behaviour compared to males. Higher income was also positively associated with appropriate health-seeking behaviour, with respondents earning ₦50,000–₦100,000 (aOR = 2.50; 95%CI:1.77-3.53, p < 0.001) and >₦100,000 (aOR = 4.00; 95%CI: 2.71-5.92, p < 0.001) more likely to exhibit appropriate behaviour compared to those earning <₦30,000. In contrast, occupation was associated with lower odds of appropriate health-seeking behaviour (aOR = 0.64; 95% CI: 0.58–0.71; p < 0.001). Similarly, better perceived health status was associated with reduced odds of appropriate health-seeking behaviour (aOR = 0.85; 95%CI: 0.51–0.85; p = 0.011). Conversely, the presence of morbidity significantly increased the likelihood of appropriate health-seeking behaviour (aOR = 1.64; 95%CI: 3.23–18.24; p < 0.001). Conclusion: The study concluded that socio-economic/demographic characteristics, such as gender, income, occupation, and morbidity status, among others, significantly predict health-seeking behaviour; hence, targeted interventions are crucial to enhance healthcare utilisation in Lagos.