Healthcare seeking behavior of citizens during pandemics: A case study of COVID-19 in Nigeria


The COVID-19 virus is rapidly crossing borders and spreading across countries and the globe, with 212 countries currently affected as of May 2020, 6 months since reports of the first case in November 2019 in Wuhan, China. Global efforts to lessen the impact of COVID-19 pandemic span across surveillance, preparedness, response, prevention, testing, contact tracing, and treatment. Co-creation Hub (CcHUB) in collaboration with the Nigerian Institute of Medical Research (NIMR) and LifeBank developed a digital system to support the process of free testing of suspected COVID-19 cases to respond to the pandemic in Nigeria and deployed it in Lagos. An average of 25% of suspected cases presented for testing after scheduling appointments, meaning only a fourth of the highrisk cases as defined by the system were tested, revealing a drop-out rate of 74%. Preliminary analysis seeking to check which factors are associated with patients who presented themselves for testing yielded no significant factors, forming the rationale for our study.

The study was a cross sectional study, seeking to 1) Understand determinants of healthcare seeking behaviors and healthcare utilization during a pandemic, 2) Provide information and guide health planners, administrators and policy makers on factors that enhance effective utilization of structures and platforms for service delivery. The variables collected were: demography and socioeconomic status, health status, satisfaction with healthcare system, satisfaction with NIMR service, mode of transport used/to be used and general feedback.

Data collection was done using a close-ended survey and social media analysis - analysing twitter sentiments around COVID-19 testing in Nigeria. 300 study participants from a target population of 566 were selected using a simple random sampling for a finite population. Descriptive statistics and analysis looking for association (odds ratios (OR) with 95% confidence interval (CI), including bivariate and multivariate unconditional logistic regression) were conducted using STATA 16.

Our results show that distance to facility, preexisting health conditions, knowledge of COVID-19 symptoms, previous healthcare experience, type of and frequency of communication influence healthcare seeking behavior of Nigerians, specifically during COVID-19. We recommend that the strategic placement of testing centers and increasing knowledge of disease could enhance service utilization.

Acta Scientific Microbiology 2020; 3(9):137-152