Patients Barrier to Ear, Nose and Throat Surgical Care in Nigeria


  • Waheed Atilade Adegbiji ENT Department, Ekiti State University Teaching Hospital, Ado Ekiti
  • Shuaib Kayode Aremu ENT Department, Federal Teaching Hospital Ido-Ekiti, Ekiti State/Afe-Babalola University Ado-Ekiti
  • Akeem O Lasisi ENT Department, Ladoke Akintola University of Technology Teaching Hospital, Osogbo


Barriers, Surgical, ear, nose, throat care, Otorhinolaryngology.


There is high prevalence of ear, nose and throat surgical conditions in our community. Ekiti state government funded facility is available and yet the rate of utilization is low. Therefore, there is need to study the barriers to and surgical uptake.The aim of the study is to identify barriers to both minor and major surgical uptake in Ekiti State, South-Western Nigeria.It is a prospective study of all patients who had attended our Ear,Nose and Throat clinics and scheduled for either minor or major surgery. The study was done between January and December 2016. The patients who consented to be included in the study were enrolled and interviewed. Relevant additional information from their case notes were coded and recorded in the software SPSS version 16. The data was collated and then analyzed.Seven hundred and two (702) consented respondents were enrolled into the study, this comprises of 368 females and 334 males. Majority of the respondents (61.6%) resided in Ado Ekiti while minority of our respondents 2.4% resided outside Ekiti state.Majority of our cases, 87.5% were booked for minor procedure. Only 44.9% of our study population was gainfully employed and 42.7% of the respondents were self-sponsored for the surgical cares.Only minority 13.2% of our studied population did not encountered any form of barrier and 19.2% were able to overcome their encountered barrier. Hospital based barrier, hospital staff based barrier and patient based barrier were found to be 53.8%, 43.6% and 33.8% respectively in the studied population.

Hospital-based barriers were noticed to be 42.3% high cost of surgical services, 28.9% hospital accessibility, 37.5% long waiting hour to access surgeon, lack of accommodation for escort, and 41.2% cumbersome tests in our study. Patients-based barriers were responsible for 48.1% fear of surgery, 52.3% fear of anaesthesia for the surgery, 57.8% complications from surgery and 44.9% dislike age of surgery in our studied group. Hospital-worker based barriers occurred in 36.2% bad attitude of hospital workers, and 9.8% frequently strike by the health workers among our respondent.In conclusions,the barriers to ear, nose and throat surgical care in this study are preventable. There is an urgent need to ensure affordable and sustainable otorhinolaryngological surgical care, in our community.


[1] Mock CN, Donkor P, Gawande A, et al. Essential surgery: key messages from Disease Control Priorities, 3rd edition. Lancet. 2015;385(9983):2209–19.
[2] Carlson LC, Lin JA, Ameh EA, et al. Moving from data collection to application: a systematic literature review of surgical capacity assessments and their applications. World J Surg. 2015;39(4):813–21.
[3] Petroze RT, Groen RS, Niyonkuru F, et al. Estimating operative disease prevalence in a low-income country: results of a nationwide population survey in Rwanda. Surgery. 2013;153(4):457–64.
[4]Stewart BT, Pathak J, Gupta S, et al. An estimate of hernia prevalence in Nepal from a countrywide community survey. Int J Surg. 2015;13:111–4.
[5] Alkire BC, Raykar NP, Shrime MG, et al. Global access to surgical care: a modelling study. Lancet Global Health. 2015;3(6):e316–23.
[6] Stewart BT, Gyedu A, Abantanga F, et al. Barriers to essential surgical care in low- and middle-income countries: a pilot study of a comprehensive assessment tool in Ghana. World J Surg. 2015;39:2613–21.
[7] Irfan FB, Irfan BB, Spiegel DA. Barriers to accessing surgical care in Pakistan: healthcare barrier model and quantitative systematic review. J Surg Res. 2012;176(1):84–94.
[8] Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Surgery. 2015;158:3–6.
[9]Grimes CE, Bowman KG, Dodgion CM, Lavy CB. Systematic review of barriers to surgical care in low-income and middle-income countries. World J Surg. 2011;35(5):941–50.
[10] Ukaegbe OC, Umedum NG, Chime EN, Orji FT. Assessment of common otolaryngological diseases among children in rural primary schools in south eastern Nigeria. Int J Pediatr Otorhinolaryngol. 2016 Oct;89:169-72.
[11] Onotai L, Lilly-Tariah Od. Adenoid and tonsil surgeries in children: how relevant is pre-operative blood grouping and cross-matching? Afr J Paediatr Surg. 2013 Jul-Sep;10(3):231-4.
[12] Oladeji S, Nwawolo C, Adewole O Allergic rhinitis among adult bronchial asthmatic patients in Lagos, Nigeria. J West Afr Coll Surg. 2013 Apr;3(2):1-14.
[13] Adoga AA, Adoga AS, Nwaorgu OG. Experience with rigid esophagoscopy in Jos, north-central Nigeria.Niger J Clin Pract. 2009 Sep;12(3):237-9.
[14] Irfan BF, Irfan BB, Spiegel DA. Barriers to Accessing Surgical Care in Pakistan: Healthcare Barrier Model and Quantitative Systematic Review. Journal of Surgical Research. July 2012, Vol.176(1):84–94.
[15] Samad L1, Jawed F, Sajun SZ, Arshad MH, Baig-Ansari N. Barriers to accessing surgical care: a cross-sectional survey conducted at a tertiary care hospital in Karachi, Pakistan. World J Surg. 2013 Oct;37(10):2313-21.
[15] Kiwanuka SN, Ekirapa EK, Peterson S et al. Access to and utilisation of health services for the poor in Uganda: a systematic review of available evidence. Trans R Soc Trop Med Hyg. 2008 102:1067–1074.
[17] Gyasi ME, Amoaku WMK, Asamany DK. Barriers to cataract surgical uptake in upper east region of Ghana. Ghana Med J. 2007;41(4):167–170.
[18 Sammour T, Hill AG. Access to Surgical Care in Developing Countries. JAMA Surg. 2016;151(3):263-264.
[19 Jadoon Cataract prevalence, cataract surgical coverage and barriers to uptake of cataract surgical services in Pakistan. The Pakistan National Blindness and visual impairment survey. Br J Ophthalmol. 2007;91:1269–1273.
[20 Ntim-Amponsah, C.T., Amoaku, W.M.K., and Ofosu-Amaah, S. “Alternate Eye Care Services in a Ghanaian District.” Ghana Medical Journal. 39.1 (2005): 19-23. Accessed on 8 January 2009.
[21] Seljeskog L, Sundby J, Chimango J. Factors influencing women’s choice of place of delivery in rural Malawi--an explorative study. Afr J Reprod Health. 2006;10(3):66–75.
[22] Geneau, R., Massae, P., Courtight, et al. “Using qualitative methods to understand the determinants of patients’ willingness to pay for cataract surgery: A study in Tanzania.” Social Science & Medicine. 66.3 (2008) 558-568. Accessed on 8 January 2009.




How to Cite

Adegbiji, W. A., Aremu, S. K., & O Lasisi, A. (2017). Patients Barrier to Ear, Nose and Throat Surgical Care in Nigeria. American Scientific Research Journal for Engineering, Technology, and Sciences, 32(1), 96–104. Retrieved from