Project – Health Information-Seeking Behaviour and Utilisation of Primary Healthcare Services: A Study of Residents of Mushin Local Government Area, Lagos State

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Health is a fundamental component of human well-being and socioeconomic development. The ability of individuals and communities to obtain appropriate health information and make informed decisions about available healthcare services is essential to the prevention of disease, early diagnosis, effective treatment and improvement of quality of life. Health information enables individuals to understand symptoms, identify possible risks, adopt preventive practices, determine when professional care is necessary and make choices concerning where and when to seek treatment. Consequently, the manner in which individuals seek, evaluate and use health information can influence their health-seeking behaviour and, ultimately, their utilisation of available healthcare services.

Health information-seeking behaviour refers broadly to the activities through which individuals seek, obtain, evaluate and use information relating to health, illness, disease prevention, treatment and healthcare services. People may obtain health information from healthcare professionals, family members, friends, pharmacists, traditional healers, religious organisations, radio, television, newspapers, social media, websites and other digital platforms. The increasing availability of information and communication technologies has significantly expanded the range of sources through which people can obtain health information. However, the availability of information does not necessarily guarantee that individuals will obtain accurate, relevant or professionally validated information. The ability to identify trustworthy information has therefore become increasingly important.

Obaremi (2022) found that residents of rural communities in Ibadan obtained health information from a mixture of formal and informal sources, including radio, hospitals and health centres, doctors, health sensitisation programmes, family and other community sources. The study also identified financial, infrastructural, geographical and language-related barriers to accessing and using appropriate health information. This demonstrates that health information-seeking is influenced not only by the availability of information but also by the socioeconomic and environmental circumstances in which individuals live.

The growth of the Internet and social media has further transformed health information-seeking behaviour. Individuals can now search for information about symptoms, diseases, medications, nutrition, reproductive health and preventive practices without immediately consulting a healthcare professional. While this development can improve access to information, it also creates concerns regarding misinformation, self-diagnosis and the use of unreliable sources. Research involving Nigerians has shown that online health information is widely used and that users consider factors such as accessibility, source reputation, accuracy and verifiability when judging information credibility. Thus, contemporary health information-seeking behaviour involves both opportunities and challenges.

Health information-seeking behaviour is closely connected with health-seeking behaviour. Health-seeking behaviour refers to the actions individuals take when they perceive a health problem or need healthcare. Such actions may include self-medication, consultation with family or friends, visiting patent medicine vendors, consulting traditional or faith-based practitioners, attending private hospitals, visiting public health facilities or seeking specialised medical care. The decision regarding which source or facility to use may be influenced by perceived severity of illness, cost, distance, previous experience, availability of drugs and personnel, quality of services, waiting time, cultural beliefs and trust in healthcare providers.

Primary healthcare occupies a particularly important position in this process because it represents the level of the health system closest to individuals, families and communities. The World Health Organization (WHO) and UNICEF (2020) describe primary healthcare as a whole-of-society approach that combines integrated health services, multisectoral action and empowered individuals and communities. The approach emphasises promotive, preventive, curative, rehabilitative and palliative services across the life course. The WHO therefore considers primary care to be a foundation for universal health coverage because it provides first-contact access, continuity, coordination, comprehensiveness and people-centred care.

The importance of primary healthcare is particularly relevant in developing countries such as Nigeria, where health systems continue to face challenges involving accessibility, affordability, quality, human resources, essential medicines and health infrastructure. A well-functioning primary healthcare system can provide communities with early and relatively affordable access to health services while reducing unnecessary pressure on secondary and tertiary hospitals. The effectiveness of such a system, however, depends partly on whether community members are aware of available services, trust the facilities and actually utilise them.

Nigeria’s primary healthcare system has experienced several policy and institutional interventions aimed at strengthening healthcare delivery at the community level. Nevertheless, utilisation of primary healthcare services remains uneven. Nwokoro et al. (2022), in a cross-sectional study in Enugu State, found that only 46.2% of respondents reported using a primary healthcare facility the last time they were sick. Reasons for non-utilisation included perceived poor quality of services, unavailability of doctors, long waiting times and lack of drugs. The study further found that affordability, adequacy of healthcare staff, waiting time and satisfaction with previous services were associated with utilisation.

Similar concerns have been reported in other Nigerian settings. Muhammed et al. found that only 7.6% of households surveyed in Batsari Local Government Area utilised primary healthcare facilities, while a much larger proportion preferred patent medicine stores. Lack of essential drugs, cost of services and inadequate infrastructure were among the important barriers to PHC utilisation. Although Batsari differs substantially from an urban Lagos community, the findings demonstrate that proximity to healthcare facilities does not automatically translate into utilisation.

The relationship between information and healthcare utilisation is particularly important because knowledge can influence how individuals interpret symptoms and evaluate treatment options. A person who has adequate health information may be more likely to recognise danger signs, understand the importance of early treatment, appreciate preventive services and identify an appropriate healthcare facility. Conversely, inadequate or inaccurate information may contribute to delayed treatment, self-medication, reliance on unverified advice or inappropriate healthcare choices. Health information therefore has the potential to function as an important link between individuals and formal healthcare services.

The urban context presents additional complexities. Residents of large cities may have relatively greater physical access to health facilities, pharmacies, digital information and healthcare professionals than people in remote rural communities. However, urban residents may still face substantial barriers related to cost, overcrowding, waiting time, quality of care, employment demands, transportation, distrust and preference for alternative sources of care. The presence of multiple healthcare providers may also make healthcare decision-making more complex because residents must choose among public facilities, private hospitals, pharmacies, patent medicine vendors, traditional practitioners and other providers.

Lagos State provides an important setting for examining these issues because of its large and densely populated urban environment and the diversity of its population. Within Lagos, Mushin Local Government Area represents a particularly relevant setting for studying health information-seeking behaviour and PHC utilisation. An earlier study by Roberts, Balogun, Sekoni, Inem and Odukoya (2015) specifically investigated health-seeking preferences among residents of Mushin LGA. The study surveyed 400 households and found that residents’ preferences varied according to the nature and perceived severity of health conditions. For severe adult illnesses, for example, 48.1% preferred doctors in government facilities, while respondents also demonstrated preferences for private facilities and patent medicine vendors for other conditions. Educational level of household heads was significantly associated with preferences for certain maternal and child health services.

The findings of Roberts et al. (2015) are important because they demonstrate that residents of Mushin do not necessarily make healthcare choices solely on the basis of physical proximity. Their decisions may be influenced by the perceived seriousness of an illness, type of service required, provider characteristics and socioeconomic factors. The authors also noted the need for further investigation of household decision-making processes concerning healthcare provision. This provides a useful basis for investigating the broader relationship between information-seeking behaviour and utilisation of primary healthcare services among Mushin residents.

Mushin also has a history of research demonstrating the relevance of health knowledge and service utilisation. For instance, research conducted among young males in Mushin examined knowledge and utilisation of sexual and reproductive health services, showing the continuing importance of understanding how community members acquire health knowledge and translate that knowledge into healthcare practices. In addition, research on health insurance and health-service utilisation among Mushin residents has highlighted the importance of financial considerations in healthcare decisions. A household study involving 422 residents of Mushin examined perceptions of health insurance, patterns of health-service utilisation and methods of healthcare payment.

The contemporary relevance of this issue is reinforced by recent evidence from Lagos State. Oloniyi et al. (2026), in a community-based study involving 1,010 households in Lagos State Health District IV, found that approximately half of respondents had utilised PHC services in the preceding year. Although awareness of nearby PHC facilities was high, utilisation was predominantly curative rather than preventive. Reported barriers included alternative health-seeking behaviour, long waiting times, absence of doctors and poor staff attitudes, while health insurance coverage remained low. These findings suggest that awareness of the existence of healthcare facilities does not necessarily translate into regular or appropriate utilisation.

This distinction between awareness, information-seeking and actual utilisation is central to the present study. A resident may know that a primary healthcare centre exists but may not know the services it provides, its opening hours, cost structure, preventive programmes or referral arrangements. Similarly, an individual may actively seek health information but rely on informal or unreliable sources. It is therefore important to examine not merely whether residents seek health information, but also the sources they use, the frequency with which they seek such information, the factors influencing their choices and the extent to which the information obtained affects their decisions to utilise primary healthcare services.

The quality and credibility of health information are also important. Information obtained from trained healthcare professionals may differ substantially from information obtained through social media, friends, family members or commercial sources. In Nigeria, where digital platforms are increasingly accessible, individuals may encounter conflicting health messages. The challenge is therefore not simply information scarcity but also information quality, interpretation and trust. The ability of residents to distinguish between credible and unreliable health information may influence whether they seek appropriate professional care or delay care while pursuing alternative options.

Furthermore, socioeconomic status may influence both information-seeking and healthcare utilisation. Individuals with higher education may have greater ability to search for and evaluate health information, while individuals with limited education may depend more heavily on family members, community networks or informal providers. Income can also influence healthcare choices because consultation fees, medicines, transportation and diagnostic services may create financial barriers. Previous experiences with health facilities may similarly determine whether residents return to PHC centres or seek alternative providers.

The role of healthcare providers cannot be overlooked. Respectful communication, confidentiality, availability of medicines, waiting time, staff attitudes and perceived competence may influence whether people trust health facilities. When individuals have negative experiences, they may share these experiences with family members and community networks, potentially discouraging others from using the facility. Conversely, positive experiences may strengthen trust and encourage continued utilisation. Thus, healthcare utilisation should be understood as the outcome of an interaction between individual knowledge, social influences and characteristics of the healthcare system.

The WHO (2022) emphasises that primary healthcare should be people-centred and responsive to population needs, with monitoring systems capable of identifying gaps in service coverage and health outcomes. The emphasis on empowered people and communities also highlights the importance of ensuring that individuals possess adequate knowledge and participate actively in decisions concerning their health. Consequently, investigating health information-seeking behaviour at the community level can provide useful evidence for improving primary healthcare utilisation.

Against this background, the present study focuses on Health Information-Seeking Behaviour and Utilisation of Primary Healthcare Services among Residents of Mushin Local Government Area, Lagos State. The study seeks to examine the sources and patterns of health information-seeking among residents, identify the factors influencing their search for health information, assess their utilisation of primary healthcare services and determine whether health information-seeking behaviour is significantly related to PHC utilisation. The findings are expected to provide evidence that can assist healthcare managers, public health practitioners and policymakers in designing more effective health education, communication and community engagement strategies for Mushin and similar urban communities.

1.2 Statement of the Problem

Primary healthcare is intended to provide accessible, affordable and comprehensive health services to individuals and communities. Despite the importance of PHC to disease prevention, early treatment and universal health coverage, utilisation of primary healthcare services remains inadequate in many Nigerian communities. The problem is particularly important because underutilisation can result in delayed treatment, self-medication, inappropriate use of medicines, avoidable complications and unnecessary pressure on secondary and tertiary healthcare facilities.

One major concern is that the existence of health information does not necessarily mean that community residents possess adequate, accurate and actionable health knowledge. Individuals may receive information from healthcare workers, family members, friends, religious organisations, radio, television, social media, websites and medicine vendors. These sources may provide information of varying quality and reliability. The increasing availability of online information has made it easier for individuals to search for information independently, but it has also increased exposure to misinformation and unverified health claims. The challenge is therefore to understand how residents identify and use health information and whether their information-seeking behaviour encourages appropriate use of formal healthcare services.

A second problem is the possibility of a gap between knowledge and healthcare behaviour. Individuals may know about a health facility but still choose not to use it. Previous studies have demonstrated that awareness of PHC facilities can coexist with relatively moderate utilisation. Recent evidence from Lagos State, for example, found high awareness of nearby PHC facilities but only about half of surveyed households had utilised PHC services during the preceding year. This suggests that other factors, including perceived quality, cost, waiting time, staff attitudes, availability of doctors and alternative healthcare options, may intervene between knowledge and utilisation.

The problem is particularly relevant to Mushin LGA because previous research has demonstrated diverse healthcare preferences among its residents. Roberts et al. (2015) found that residents selected different healthcare providers depending on the type and severity of illness, with preferences extending across government facilities, private facilities and patent medicine vendors. This indicates that healthcare decision-making in Mushin is complex and cannot be explained simply by the availability of primary healthcare facilities.

Another concern is the role of socioeconomic factors. The cost of consultation, medicines, transportation and diagnostic procedures may discourage residents from utilising formal healthcare services. The problem may be more pronounced for low-income households, who may delay seeking care, purchase medicines directly from drug vendors or rely on informal advice. Although healthcare information can potentially encourage appropriate service use, the information may have little practical effect if residents cannot afford the recommended services.

Quality of care is also an important concern. Research in Nigeria has identified poor perceived service quality, lack of healthcare workers, long waiting times and unavailable medicines as important reasons for non-utilisation of PHC facilities. Similar barriers have been identified in Lagos State, including waiting time, absence of doctors and poor staff attitudes. If residents perceive primary healthcare facilities as inconvenient, poorly equipped or unresponsive, they may ignore health information encouraging PHC utilisation and choose alternative sources of care.

There is also insufficient community-level evidence specifically linking health information-seeking behaviour with general utilisation of primary healthcare services among residents of Mushin LGA. The existing Mushin study by Roberts et al. (2015) focused principally on healthcare provider preferences for maternal and child health and selected illnesses. Other studies in Mushin have examined specific issues such as health insurance, reproductive health and healthcare workers’ referral practices. However, there remains a need for a broader investigation of how residents obtain health information, which sources they trust, how they use the information obtained and whether such behaviour is associated with utilisation of PHC services.

The problem, therefore, is not merely the availability of primary healthcare services in Mushin but whether residents possess and use appropriate health information in ways that support timely and appropriate utilisation of those services. Understanding this relationship is important because health information can influence perceptions of illness, decisions about treatment, choice of provider and timing of care. Without adequate evidence concerning these processes, health education and community mobilisation programmes may fail to address the actual information needs and decision-making patterns of residents.

This study consequently seeks to investigate health information-seeking behaviour and utilisation of primary healthcare services among residents of Mushin Local Government Area, Lagos State. It will examine the major sources of health information, the frequency and nature of information-seeking, factors influencing health information-seeking, patterns of PHC utilisation, barriers to utilisation and the relationship between health information-seeking behaviour and utilisation of PHC services.

1.3 Purpose of the Study

The general purpose of this study is to examine the relationship between health information-seeking behaviour and utilisation of primary healthcare services among residents of Mushin Local Government Area, Lagos State.

The specific objectives are to:

1. examine the major sources of health information used by residents of Mushin Local Government Area;
2. determine the frequency and patterns of health information-seeking behaviour among residents of Mushin LGA;
3. identify the factors influencing health information-seeking behaviour among residents;
4. assess the level and patterns of utilisation of primary healthcare services among residents of Mushin LGA

1.4 Research Questions

The following research questions will guide the study:

1. What are the major sources of health information used by residents of Mushin Local Government Area?
2. How frequently do residents of Mushin LGA seek health information?
3. What factors influence health information-seeking behaviour among residents of Mushin LGA?
4. What is the level and pattern of utilisation of primary healthcare services among residents of Mushin LGA?

1.5 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀: There is no significant relationship between health information-seeking behaviour and utilisation of primary healthcare services among residents of Mushin Local Government Area, Lagos State.

1.6 Significance of the Study

The study will be significant to residents of Mushin Local Government Area because it may contribute to a better understanding of the importance of obtaining reliable health information and making appropriate use of primary healthcare services. By identifying common information sources and barriers to healthcare utilisation, the study may help promote informed health decisions within the community.

The study will also be useful to healthcare professionals working in primary healthcare facilities. The findings may enable healthcare workers to understand the information needs, preferences and perceptions of community residents. Such knowledge can assist them in improving patient education, communication, counselling and community outreach programmes.

Public health practitioners and health educators may also benefit from the study. Information obtained from the research may help in designing health communication programmes that use sources trusted and frequently accessed by residents. The findings may also assist in developing strategies for combating misinformation and encouraging early use of appropriate healthcare services.

The study will be relevant to Lagos State health authorities and local government health administrators. Evidence on the factors influencing PHC utilisation can contribute to better planning of health education, community mobilisation, service delivery and resource allocation. The study may also assist policymakers in identifying barriers such as cost, waiting time, staff attitudes and inadequate information.

Researchers and students in public health, nursing, health education, community medicine, information science and related disciplines may find the study useful as reference material. It will contribute to the literature on health information-seeking behaviour and healthcare utilisation in urban Nigerian communities.

Finally, the study will contribute to existing research on Mushin Local Government Area. Previous research has examined specific aspects of healthcare preferences and service utilisation in the area; this study broadens the focus by examining the relationship between health information-seeking and general primary healthcare utilisation.

1.7 Scope of the Study

The study is geographically limited to Mushin Local Government Area of Lagos State, Nigeria. The study will focus on adult residents of the Local Government Area and their health information-seeking behaviour and utilisation of primary healthcare services.

The study will specifically examine sources of health information, frequency of information-seeking, perceived credibility of information sources, factors influencing information-seeking, patterns of PHC utilisation and barriers to utilisation. Primary healthcare services considered in the study will include preventive, promotive, maternal and child health, immunisation, treatment of common illnesses, health education and other appropriate first-contact services.

The study will not focus primarily on tertiary healthcare services or specialised hospital treatment except where respondents’ choices of such services are relevant to understanding their preference for or non-utilisation of primary healthcare services.

1.8 Limitations of the Study

One limitation of the study may be the possibility of recall bias. Respondents may not accurately remember the sources of health information they have used or the frequency with which they have utilised healthcare services.

Another limitation may be the sensitivity of some health-related questions. Some respondents may be reluctant to provide complete information because of concerns about privacy, cultural beliefs or fear of judgement. The researcher will therefore assure participants of confidentiality and anonymity.

The study will also be limited by its geographical focus on Mushin LGA. Consequently, the findings may not be generalised automatically to all residents of Lagos State or Nigeria because other communities may have different socioeconomic, cultural and healthcare conditions.

Finally, because the study is expected to use a cross-sectional survey design, it will primarily establish associations between health information-seeking behaviour and PHC utilisation rather than prove cause-and-effect relationships.

1.9 Operational Definition of Terms

Health: A state of physical, mental and social well-being and not merely the absence of disease or infirmity.

Health Information: Knowledge or information concerning diseases, symptoms, prevention, treatment, healthy lifestyles, healthcare providers and available health services.

Health Information-Seeking Behaviour: The activities undertaken by individuals to identify, obtain, evaluate and use information relating to health, illness, disease prevention and healthcare services.

Health-Seeking Behaviour: The actions taken by individuals when they perceive a health problem or require healthcare, including seeking information, self-treatment, visiting health facilities or consulting formal and informal healthcare providers.

Primary Healthcare (PHC): Essential, accessible and people-centred healthcare services provided as the first level of contact between individuals, families and the health system, including promotive, preventive, curative, rehabilitative and palliative services.

Primary Healthcare Services: The health services provided at primary healthcare facilities, including health education, immunisation, maternal and child healthcare, treatment of common illnesses, disease prevention and other first-contact services.

Utilisation: The actual use of available healthcare services by individuals when they require or desire healthcare.

Healthcare Facility: An establishment where health services are provided by health professionals, including primary healthcare centres, clinics and hospitals.

Health Information Source: Any person, organisation, medium or platform from which an individual obtains health-related information, such as healthcare workers, family members, radio, television, newspapers, social media and the Internet.

Residents: Individuals who live within Mushin Local Government Area and constitute the population from which respondents for this study will be selected.

Mushin Local Government Area: A Local Government Area in Lagos State, Nigeria, which serves as the geographical setting of this study.

1.10 Organisation of the Study

The study will be organised into five chapters.

Chapter One presents the introduction, background of the study, statement of the problem, purpose of the study, research questions, research hypothesis, significance, scope, limitations and operational definitions.

Chapter Two will review relevant literature on health information-seeking behaviour, health-seeking behaviour, primary healthcare, healthcare utilisation and factors influencing healthcare decisions. It will also present the theoretical framework and review relevant empirical studies.

Chapter Three will describe the methodology of the study, including research design, study area, population of the study, sample size, sampling procedure, research instrument, validity, reliability, method of data collection and method of data analysis.

Chapter Four will present and analyse the data collected from respondents and interpret the findings according to the research questions and hypothesis.

Chapter Five will present the summary of findings, conclusion and recommendations and will identify areas for further research.

Project – Health Information-Seeking Behaviour and Utilisation of Primary Healthcare Services: A Study of Residents of Mushin Local Government Area, Lagos State