Utilization of primary healthcare services in Nasarawa state, Nigeria: addressing structural and sociocultural barriers

Yonah E. Waryit; Ehiemere C. Chibuisi; Akyala I. Adamu; Changkat L. Lohnan; Anzaku P. Joseph; Bem Jimmy; Ogundipe B. Adetuyi; Kpason E. Ephraim

doi:10.18203/2394-6040.ijcmph20261445

Authors

Yonah E. Waryit Global Health and Infectious Disease Control Institute, Nasarawa State University, Keffi, Nasarawa State, Nigeria
Ehiemere C. Chibuisi Global Health and Infectious Disease Control Institute, Nasarawa State University, Keffi, Nasarawa State, Nigeria
Akyala I. Adamu Global Health and Infectious Disease Control Institute, Nasarawa State University, Keffi, Nasarawa State, Nigeria
Changkat L. Lohnan Department of Obstetrics and Gynaecology, Federal University Teaching Hospital, Lafia, Nasarawa State, Nigeria
Anzaku P. Joseph Global Health and Infectious Disease Control Institute, Nasarawa State University, Keffi, Nasarawa State, Nigeria
Bem Jimmy Global Health and Infectious Disease Control Institute, Nasarawa State University, Keffi, Nasarawa State, Nigeria
Ogundipe B. Adetuyi Global Health and Infectious Disease Control Institute, Nasarawa State University, Keffi, Nasarawa State, Nigeria
Kpason E. Ephraim Global Health and Infectious Disease Control Institute, Nasarawa State University, Keffi, Nasarawa State, Nigeria

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20261445

Keywords:

Barriers, Nasarawa state, Nigeria, PHC, Services, Utilization

Abstract

Primary healthcare (PHC) forms the backbone of Nigeria’s health system, particularly in rural states like Nasarawa. Despite increased policy focus and infrastructure development, utilization of PHC services remains low, contributing to persistent maternal and child health challenges. Barriers such as cultural norms, inadequate manpower, and weak infrastructure continue to undermine effective service uptake. This study employed a narrative review methodology to synthesize over 30 peer-reviewed publications, national health reports, and global policy documents from 2019 to 2024. The Andersen Behavioural Model of Health Services use was applied as a conceptual framework to categorize factors influencing PHC utilization into predisposing, enabling, and need-based components. Findings reveal that cultural beliefs, gender dynamics, poor health literacy, poverty and limited community engagement significantly hinder service utilization, even when facilities are geographically accessible. Structural issues, including the chronic shortage of healthcare workers, drug stock-outs, and poor facility infrastructure, further limit PHC effectiveness. Only 30-45% of residents in Nasarawa utilize PHC services regularly. While policy reforms such as the Basic Health Care Provision Fund (BHCPF) have yielded some gains, implementation bottlenecks, underfunding, and weak accountability mechanisms persist. Improving PHC utilization in Nasarawa State requires an integrated, equity-focused approach that goes beyond infrastructure provision. Addressing both demand- and supply-side barriers is essential to enhance service uptake and public trust. Key policy recommendations include increased domestic health funding, targeted recruitment and retention of PHC staff, culturally adapted health education campaigns, and strengthened community participation in health governance. Operationalizing these interventions within a behavioural framework offers a path toward achieving universal health coverage and improving population health outcomes in underserved regions of Nigeria.

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