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

Abstract

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.