Health needs assessment and determinants of health-seeking behaviour among elderly Nigerians: a house-hold survey.
BACKGROUND
In the last decade the number of elderly citizens in Nigeria has increased and their health needs are becoming popularly recognized. A number of factors have also been recognized to determine health care seeking behaviour in these elderly.


METHODS
The sample consisted of 756 households that had at least one resident who was aged 60 years and above (35% of 2160 households). Multistage and proportionate sampling techniques were employed to select the study subjects. Structured interview were conducted to elicit information on health needs and determinants of health care seeking behaviour of household members aged 60 years and above.


RESULTS
The most frequently reported illnesses were body pain (89.5%), joint pain (86.4%), generalized body weakness and fatigue (81.5%), poor sight (78.2%), fever (71.3%), irritability, anger, and nervous tension (70%), listlessness, depression, and headaches (60%),and decreased mobility (65.8%). More than two-thirds (68.8%) of respondents had never visited health facilities in the last one year even for ordinary medical check-up. Family care/Family consultation was the first choice (44.6%) of treatment for the most frequently reported illnesses irrespective of age group and sex. Less than one-third (28.7%) of the subjects were aware of their health needs. Receiving treatment when sick was the health needs mentioned by the majority (89.4%) of the elderly. Poverty emerged as a major (50.3%) determinant of health care seeking behaviour followed by nature of illness (28.5%). The odds ratio that elderly from poor households will seek health care from unqualified health care practitioners was 0.7 (95% confidence interval (CI) = 0.38-0.67); while the odds ratio that elderly from poor households will seek health care from qualified health care practitioners was 0.8 (95% CI = 0.57-0.89). Self treatment had odds ratio of 1.7 (95% CI = 0.38-0.67). After controlling the household's poverty status, there was still a significance difference (P < 0.05) in age group and gender in terms of health care seeking behaviour.


CONCLUSIONS
Socio-economic indicators and nature of illness were the most pervasive determinants of health care seeking behaviour among the elderly, overriding age and sex, and in terms of health-care expenditure, the nature of illness and quality of service provided ranked the major determinants.
Abdulraheem
I S
IS
Department of Epidemiology and Community Health, College of Medicine, University of Ilorin, Ilorin, Nigeria. ibroraheem@yahoo.com
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006301:Health Services Needs and Demand; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D011203:Poverty; D011787:Quality of Health Care; D012959:Socioeconomic Factors