Submission ID 131740
| Issue/Objective | Urban health systems can amplify inequities when cost, insurance gaps, and service availability push people toward informal care or no care. Faith context may shape care pathways and interact with socioeconomic barriers. Evidence on these intersections is critical for strengthening equitable health systems. Objectives: (1) To describe patterns of healthcare utilisation, usual place of care, and barriers among members of three Christian denominations in Abuja. (2) To examine how insurance coverage and socio economic factors relate to formal versus informal/no care pathways, accounting for denominational context. |
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| Methodology/Approach | We conducted a comparative mixed methods study among 1,329 adults: Anglican Communion (n=455), RCCG (n=442), and CCC (n=432). Surveys assessed utilisation patterns, place of care, insurance coverage, and barriers; qualitative interviews explored illness interpretations and decision making pathways. Quantitative comparisons across denominations used chi square tests and regression models to examine associations with formal versus informal/no care pathways. |
| Results | More than one third reported no usual place of care when ill (36.5%). Public hospitals were the most common source of care (36.2%), followed by private hospitals (14.1%) and pharmacies/PPMVs (9.5%). Prayer houses (1.7%) and traditional healers (2.0%) were less common overall but more prominent among CCC respondents. Barriers were dominated by cost (62.9%) and distance/service availability constraints, particularly among CCC. Insurance coverage was 61.4% overall but lowest in CCC (38.4%) compared with RCCG (75.3%) and Anglican (69.7%). Key reasons for lacking insurance included cost (40.5%) and limited awareness (27.0%). Education, income, and occupation were associated with formal versus informal/no care pathways. Qualitative findings indicated prayer and medicine were often viewed as complementary, but spiritual interpretations could influence the timing of biomedical care. |
| Discussion/Conclusion | Denominational context and socioeconomic constraints jointly drive inequities in access and financial protection in Abuja. Integrating faith platforms into insurance literacy, navigation support, and referral linkages may reduce "no care" patterns and strengthen equitable access. |
| Presenters and Affiliations | Stella Atema Ijioma Global Fund N THRIP, Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria Evaezi Okpokoro Institute of Human Virology, Nigeria. Charity Sanni Global Fund N THRIP, Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria Kazeem Ayodeji Global Fund N THRIP, Institute of Human Virology Nigeria (IHVN), Abuja, Nigeria Agatha Nwachkwu Institute of Human Virology, Nigeria. Abimbola Nwoko Institute of Human Virology, Nigeria. Afolabi Sunbo Institute of Human Virology, Nigeria. Alabere Ibidabo School of Public Health, University of Port Harcourt, Nigeria Maduka Ijioma School of Public Health, University of Port Harcourt, Nigeria Miriam Bathnna Institute of Human Virology, Nigeria. Opeyemi Adebayo Institute of Human Virology, Nigeria. Olayemi Oolupitan Institute of Human Virology, Nigeria. Temitope Eyitayo Adetiba Institute of Human Virology, Nigeria. Aderonke Agbaje Vivan Institute of Human Virology, Nigeria. Patrick Dakum Institute of Human Virology, Nigeria. Janet Kineu The Global Fund to Fight AIDS, Tuberculosis and Malaria, Global Health Campus, Geneva, Switzerland |
