Perceptions and Barriers to Utilisation of Primary Health Care Services among 1,010 households in Health District IV, Lagos State.

Abstract

Background: Primary Health Care (PHC) forms the backbone of public health and is central to achieving universal health coverage in Nigeria. Yet, its utilisation remains inconsistent, even in urban settings. This study assessed household perceptions, barriers, and factors influencing PHC utilisation in Health District IV, Lagos State. Methodology: A community-based cross-sectional survey was conducted among 1,010 households in Health District IV of Lagos State, using a multistage sampling technique. Data was collected through a structured interviewer-administered questionnaire assessing socio-demographic characteristics, awareness and perceptions of PHC services, and PHC utilisation in the preceding year. Results: About half (51%) of the respondents utilized PHC services in the preceding year, predominantly for illness-related care rather than preventive services. The majority (85.9%) were aware of a PHC close to their residence, and 97.5% correctly identified its location. Concerning non-utilization of services, more than half (59.9%) of respondents reported they had not fallen ill. Other barriers included alternative health seeking behaviour (12.2%), long patient waiting time (9.4%), absence of medical doctors (8.2%), poor staff attitudes (7.3%). Health insurance coverage was low (20.7%), and half perceived costs as moderate. Conclusions: Despite high awareness, PHC utilisation remains moderate and predominantly curative. Strengthening service organisation, enhancing financial risk protection, and improving community engagement are essential to reposition PHCs to deliver comprehensive, people-centred care.