Use, Characteristics and Influence of Lay Consultation Networks on Treatment-seeking Decisions in Slums of Nigeria: a Cross-sectional Survey

Overview

Journal BMJ Open

Specialty General Medicine

Date 2023 May 16

PMID 37192804

Authors

Chinwe Onuegbu

Jenny Harlock

Frances Griffiths

Affiliations

Soon will be listed here.

Abstract

Objectives: To describe the use, characteristics and influence of lay consultants on treatment-seeking decisions of adults in slums of Nigeria.

Design: Cross-sectional survey using a pre-piloted questionnaire.

Settings: Two slum communities in Ibadan city, Nigeria.

Participants: 480 adults within the working age group (18-64).

Results: Most respondents (400/480, 83.7%) spoke to at least one lay consultant during their last illness/health concern. In total, 683 lay consultants were contacted; all from personal networks such as family and friends. No respondent listed online network members or platforms. About nine in 10 persons spoke to a lay consultant about an illness/health concern without intending to seek any particular support. However, almost all (680/683, 97%) lay consultants who were contacted provided some form of support. Marital status (OR=1.92, 95% CI: 1.10 to 3.33) and perceiving that an illness or health concern had some effects on their daily activities (OR=3.25, 95% CI: 1.94 to 5.46) had a significant independent association with speaking to at least one lay consultant. Age had a significant independent association with having lay consultation networks comprising non-family members only (OR=0.95, 95% CI: 0.92 to 0.99) or mixed networks (family and non-family members) (OR=0.97, 95% CI: 0.95 to 0.99), rather than family-only networks. Network characteristics influenced individual treatment decisions as participants who contacted networks comprising non-family members only (OR=0.23, 95% CI: 0.08 to 0.67) and dispersed networks (combination of household, neighbourhood and distant network members) (OR=2.04, 95% CI: 1.02 to 4.09) were significantly more likely to use informal than formal healthcare, while controlling for individual characteristics.

Conclusions: Health programmes in urban slums should consider engaging community members so, when consulted within their networks, they are able to deliver reliable information about health and treatment-seeking.

Citing Articles

Navigating the Lay Referral System for Treatment-Seeking Decisions During Illness in the Digital Age: A Qualitative Study of Adults Living in Slums in Nigeria.

Onuegbu C, Harlock J, Griffiths F Sociol Health Illn. 2024; 47(2):e13863.

PMID: 39614807 PMC: 11851050. DOI: 10.1111/1467-9566.13863.

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