Barriers and Enablers of Health Services Utilisation in Rural Communities of Nkomazi Sub-District in Mpumalanga Province, South Africa: A Quantitative Community Survey.

Abstract

Background: The utilisation of healthcare services is critical to maintaining and improving the health status of communities, however, numerous barriers and enablers can either hinder or facilitate an individual's ability to access and benefit from these services, and this is the case in South Africa.

Objective: This study aimed to identify and describe barriers to and enablers of healthcare service utilisation in a rural village of Mpumalanga province, South Africa.

Methods: A quantitative descriptive survey design was conducted with 415 adults who met the inclusion criteria, selected using a systematic sampling technique. Data were gathered through a researcher-administered questionnaire. Descriptive statistics were conducted, using the IBM SPSS version 29 software, to explain and summarise the data. The study was guided by Andersen and Newman's Behavioural Model, focusing on barriers and enabling factors to Health services utilisation.

Results: Key barriers identified in this study included cultural beliefs (58.7%), treatment shortages (54.4%), staff shortages (45.6%), negative staff attitudes (88%), long wait times (84.1%), lack of grievance mechanisms (77.8%), and poor interpersonal skills from nurses (88.5%), leading to low patient satisfaction. Men showed disengagement from chronic care (13%) compared to women (2.9%). A significant portion (20%) had no education, impacting health literacy. Enabling factors included a preference for the local clinic (98.8%) due to its proximity (69.3%) and confidence in nurses' abilities (88.7%).

Conclusion: The study highlighted that healthcare access is hindered by resource limitations, staff issues, attitude and communication problems, and cultural factors. Women, young adults, and less educated individuals underutilise services. This necessitates age and gender targeted programs, culturally sensitive strategies, and improved service delivery and quality assurance policies. Counselling for healthcare workers and accessible feedback mechanisms can enhance patient interactions and satisfaction. Further research is recommended to comprehensively address these barriers to healthcare access and utilisation.