Healthcare Financing Options for Under-Five Child Care and Their Implications for Primary Healthcare Utilization in Oyo State, Nigeria

Abstract

Under-five morbidity and mortality remain major public health challenges in Nigeria. Timely utilization of primary healthcare (PHC) is essential for preventing and managing common childhood illnesses. Caregivers’ socio-demographic characteristics, education, and household income strongly influence PHC utilization. Out-of-pocket payments dominate healthcare financing, limiting timely utilization of PHC services, while enrolment in health insurance schemes remains low, particularly among informal and low-income households. Understanding how caregiver factors interact with financing methods is critical for improving PHC access and child health outcomes. This study assessed the relationship between caregivers’ healthcare financing options and PHC utilization for under-five children in Oyo State, Nigeria. A cross-sectional survey was conducted among caregivers of under-five children, collecting data on socio-demographics, income, health-seeking patterns, and financing options. Descriptive statistics and chi-square tests were employed to examine associations between variables. The mean age of caregivers was 31.0 years (SD ± 8.5), with 91.7% female and 77.5% married. Informal employment was predominant (56.2%), and the majority earned below ₦100,000 per month. Out-of-pocket payment was the most common financing method (44.5%). PHC utilization was suboptimal, with only 22.7% of caregivers seeking care from PHC facilities during child illness and 53.1% delaying care by more than five days. Socio-demographic characteristics, particularly age, education, and income, significantly influenced financing choices and uptake of PHC. (p<0.001). Expanding affordable insurance coverage, promoting caregiver-targeted health education, and strengthening PHC service delivery and governance are essential to enhance timely utilization and equitable access, contributing to improved child health and progress toward universal health coverage in Nigeria.