Urban–Rural Differences in Preventive Medical Screening Uptake and Associated Factors among Adults in Nigeria: A Comparative Cross-Sectional Study
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Abstract
Background: Health screening and routine medical check-ups are fundamental to preventive healthcare. They identify and address potential health issues on time, limiting complications and healthcare costs. However, utilization of these services remains suboptimal in Nigeria with notable urban–rural disparities. This study assessed urban–rural differences in preventive health services uptake and identified factors associated with utilization among adults in Enugu State, Nigeria.
Methods: A comparative cross-sectional study was conducted among 1,558 adults selected from urban and rural communities in Enugu State using time-location sampling. Data were collected using a pretested interviewer-administered questionnaire. Information on socio-demographic characteristics, services uptake and barriers obtained. Data was analyzed using IBM SPSS version 25. Associations were assessed using Chi-square tests, while binary logistic regression was used to identify predictors of services uptake. Statistical significance was set at p<0.05.
Results: A significantly higher proportion of urban respondents had ever utilized preventive services compared with rural respondents (92.7% vs. 71.8%; p<0.001). Overall good uptake was significantly higher among urban respondents (56.7% vs. 45.2%; p<0.001). Blood pressure measurement was the most utilized service in both settings. Cost of screening was the leading barrier, particularly among rural respondents (80.0% versus 67.0%; p<0.001). Identified predictors for urban respondents were; age, education and knowledge. Identified predictors for rural respondents were; exercise, knowledge and perception.
Conclusion: Significant urban–rural disparities exist in preventive health services uptake. Improving knowledge, addressing financial barriers, and strengthening access to preventive services, particularly in rural communities, are essential for increasing services utilization and reducing health inequalities.
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