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Impact of Healthcare Service Directories on Knowledge of Available Health Facilities among Rural Residents in Nigeria

Abstract

Knowledge of available health facilities is essential for appropriate healthcare-seeking, timely access to treatment, effective referral, and improved utilization of health services. Rural residents in Nigeria may have limited information about the location, types, operating hours, available services, and levels of care provided by nearby health facilities. This lack of information may contribute to delays in seeking appropriate care, unnecessary travel, inappropriate facility selection, and underutilization of available healthcare resources. Healthcare service directories provide organized information about health facilities and may include details such as facility locations, services offered, operating hours, contact information, referral pathways, and available healthcare personnel. Providing such information in accessible formats may improve residents' ability to identify and select appropriate health facilities. Against this background, this study investigates the impact of healthcare service directories on knowledge of available health facilities among rural residents in Nigeria. The study will be anchored on the Health Literacy Framework, Andersen's Behavioral Model of Health Services Use, and the Social Ecological Model. The Health Literacy Framework emphasizes the ability of individuals to access, understand, evaluate, and apply healthcare information when making decisions about available health services. Andersen's Behavioral Model explains healthcare utilization through predisposing characteristics, enabling resources, and healthcare needs, providing a framework for understanding how information about available facilities may influence healthcare-seeking decisions. The Social Ecological Model recognizes the influence of individual, household, community, organizational, and environmental factors on access to healthcare information and services. Collectively, these theoretical perspectives provide a suitable framework for explaining how healthcare service directories may influence knowledge of available health facilities among rural residents in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adults aged 18 years and above residing in selected rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, rural communities, households, and eligible participants. Healthcare service directories will be assessed using indicators such as availability, accessibility, frequency of distribution or updating, completeness of facility information, accuracy of facility locations, coverage of healthcare services, operating-hour information, contact details, referral information, language accessibility, readability, use of maps or visual indicators, and availability in printed or digital formats. Knowledge of available health facilities will be assessed using indicators such as ability to identify nearby primary healthcare centres, hospitals, specialist facilities, diagnostic centres, pharmacies where relevant, emergency facilities, maternity services, facilities providing specific preventive services, facility locations, services offered, operating hours, and appropriate facility levels for different healthcare needs. Data will be collected using structured questionnaires, healthcare-facility knowledge assessment tools, copies or digital versions of service directories, facility registers, community health records, and relevant programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to healthcare service directories, and facility-knowledge scores. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of healthcare service directories on knowledge of available health facilities. Where a quasi-experimental design is adopted, knowledge scores before and after distribution of healthcare service directories may be compared with those of a comparison community to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that healthcare service directories have a significant positive impact on knowledge of available health facilities among rural residents in Nigeria. Residents exposed to accurate and regularly updated healthcare service directories are expected to demonstrate greater knowledge of nearby facilities, the services they provide, their locations, operating hours, and appropriate points of access than residents without comparable exposure. Clear facility listings, maps, contact details, service descriptions, and referral information may make it easier for residents to identify suitable healthcare facilities according to their health needs. Directories may also reduce uncertainty and unnecessary movement when residents need healthcare services, particularly when information is presented in simple language and locally understandable formats. However, poor distribution, outdated information, limited literacy, language barriers, lack of electricity or internet access for digital directories, inaccurate facility information, and changes in facility services may reduce their effectiveness. The study therefore expects accessible, accurate, regularly updated, and locally appropriate healthcare service directories to contribute significantly to improved knowledge of available health facilities among rural residents in Nigeria. The study is expected to contribute to the literature on healthcare service directories, health-facility awareness, health literacy, healthcare navigation, rural healthcare access, healthcare utilization, community health information, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, local government health authorities, primary healthcare centres, hospitals, community health workers, community leaders, development partners, and policymakers regarding strategies for improving access to information about healthcare facilities. The study will also provide evidence-based recommendations for developing comprehensive healthcare service directories, regularly verifying and updating facility information, incorporating local languages and simple visual maps, distributing directories through community health structures, and integrating printed and digital directories into primary healthcare and community health-information systems across rural Nigeria.

Keywords: Healthcare service directories, health facilities, facility awareness, rural residents, health literacy, healthcare navigation, healthcare access, healthcare utilization, community health information, primary healthcare, Nigeria, public health.