PERCEIVED FACTORS CONTRIBUTING TO

DELAY IN SEEKING HEALTH CARE SERVICES

AMONG MEN ATTENDING EMBU LEVEL V
TEACHING AND REFERRAL HOSPITAL

BY: MARY ANN WAKIO KINYUA

BSN-1-8770-3/2019
 Background information
• Health is a state of physical, mental, and social wellbeing and not merely the
absence of disease or infirmity. (WHO 2020).
• A report by World health organization shows that 897.2 per 100,000 males
die each year globally (WHO 2020).
• One of the reasons according to WHO that accounts for the difference in
mortality rate is that men delay in health reporting. (WHO, 2020)

• According to National Pharmacy Association research, men on average visit a

hospital four times a year while average for women is 18 times per year
( N.P.A,2017).

• According to the adult mortality rate in South Africa, women mortality rate
was 248.82 per 1000 female while men was 376.4 per 1000 male (South
Africa – adult mortality rate 2008-2018 by gender).
 Background information
• In Kenya, the mortality rate for men was 264.72 per 1000 male adults
while the female mortality rate was 194.51 per 1000 adults (Kenya-adult
mortality rate 2008-2018, by gender. (nod)statista).

• Research done on utilization of health services in coastal Kenya showed

that out of the 76% of men who reported to be sick only 51% utilized
health services (Antony, Marcfarlane, Agoi 2017)

• This study therefore aims at identifying the factors associated with delay in
health care seeking by men attending Embu level 5 hospital in Embu
County.
 Statement of problem
• Globally, 5 million males die every year due to low utilization of healthcare
services (WHO, 2022).
• Developing countries account for 54% of these death where they are faced
with low socioeconomic status and inadequate knowledge on seeking
healthcare services. For instance, in 2022 approximately 5.2 million males died
globally due to low utilization of healthcare services(WHO,2022)
• In Africa, according to UNICEF (2022), almost 2 million men die every year due
to poor utilization of healthcare services. For instance, the delay in health care
seeking of men presented with sickness was 23.1% in Durban, South
Africa(Dravin et al.,2020)
• In Kenya, the mortality rate for men was 264.72 per 1000 male adults while the
female mortality rate was 194.51 per 1000 adults (Kenya-adult mortality rate
2008-2018, by gender). Research done on utilization of health services in
coastal Kenya showed that out of the 76% of men who reported to be sick only
51% utilized healthcare services (Marcus et al.,2017)
 Statement of problem
• According to records obtained from Embu level 5, in February 2023, a total
of 1929 came to seek healthcare in outpatient department and amongst
them men were 977 while women were 952 and amongst them those who
were admitted were 304 with men standing at highest number of 169 while
women were 133,mortality rate of men and women that month stood at
59% and 41% respectively.
• In March 2023, hospital recorded total number of 1799 patients who came
to outpatient facility and amongst them men were 912 while women were
887,those who were admitted were 275 of which men were 141 while
women were 134, mortality rate of men and women stood at 69% and 31%
respectively.
• Therefore, this study is aimed at assessing factors contributing to the delay
in health care seeking among men attending outpatient facility in Embu
level Five hospital.
Broad objective

• To determine the perceived factors contributing to delay in

seeking health care services among males attending care at
Embu level 5 hospital
Specific Objectives

1. To explore socioeconomic factors influencing timely seeking

healthcare among men attending Embu level 5 hospital

2. To determine the knowledge on the importance of seeking timely

health care among males attending Embu level V hospital.

3. To assess attitudes towards timely seeking of healthcare services

among males attending Embu level V hospital.
 Research Questions

1. What are the socioeconomic factors influencing timely seeking of

healthcare among men attending Embu level 5 hospital?

2. What knowledge do men seeking healthcare at Embu level V hospital have

on the importance of timely healthcare?

3. What are the attitudes of males attending Embu level 5 hospital towards
timely seeking of healthcare?
 LITERATURE REVIEW

The literature review has the following subheading;

• Introduction

• Socio-Economic Characteristics

• Knowledge on the importance of seeking timely health care

• Personal attitudes
 Conceptual Framework
• .Attitude
Values concerning Knowledge
health and illness. Awareness of healthcare
Attitudes towards services
health services. Knowledge on signs and
Attitude toward symptoms
healthcare workers Importance of seeking
Perception of illnesses services

SEEKING
HEALTHCARE
SERVICES

Socioeconomic
Age
Sex
Marital status
Education
Occupation
 METHODOLOGY

• Study Site
• The study will be carried out in Embu Level 5 Hospital at the outpatient
department
• Study Design.
• The study will utilize descriptive cross-sectional study design.
Study Population
• The study population will target Male patients attending Embu Level 5 Hospital
outpatient department
• The department receives an average of 182 patients in a day. Out of these, the
male population makes 40 %( 73). Therefore, the researcher will consider 146
as the study population since the study will be carried out in two days
 METHODOLOGY
Inclusion Criteria.
• All male patients attending the outpatient department and above 18 years of
age
• Those who will consent to take part in the study
Exclusion Criteria
• Very sick patients and emergency cases will be excluded from the study.
• Those who will not consent to take part in the study.
 METHODOLOGY
Sample Size Determination
Fischer's Formula will be utilized to determine the sample size.
n = z2pq
d2
Where:
n = the desired sample size (if the target population is greater than 10,000)
Z = the standard normal deviation at 95% hence the confidence level is 1.96
p = Proportion of the target group that have a particular characteristic of interest estimate at 50%
or 0.5 (Apanga et al., 2020)
q = 1 – p hence 1- 0.5=0.5
d = is the level of statistical significance set at 0.05
Therefore, n = (1.96)2 *0.5*0.5
(0.05)2
Approximately 384
Since the target population is less than 10,000, the sample adjustment
will be done using the formula:
nf= n/ (1+ (n/N))
Where nf-desired sample size
n- Calculated sample size which is 384
N- Total population size
nf= 384/ 1+ (384/182))
nf=384/ (1+2.1)
nf= 384/ (3.1)
nf= 123.9~ 124
Therefore, the number of will be 124 male patients
 METHODOLOGY

• Sampling procedure.
• Simple random sampling technique will be used in selecting participant among
the male patients seeking services at the Outpatient department
Pretesting of Data Collection Tools.
• Pre-test will be done in Meru teaching and Referral hospital among male
patients at the outpatient department to assess whether data collection tools
will be appropriate using 10%(12) of sample size.
Data collection Tools.
• Structured questionnaire will be used to collect quantitative data.
• They consist of both open and closed ended questionnaires
 METHODOLOGY

Data collection
• The researcher will collect data for 2 days
• The researcher will approach participants and obtain consent before administering
questionnaire

• Data Analysis.
• After data collection, the data will be checked for errors and entered manually into
the computer for analysis
• Data will then be coded analyzed using Microsoft excel 2016.
• Quantitative data will be presented in form of bars, pie-chart and frequency table.
 METHODOLOGY

Ethical considerations.
• This research proposal will be submitted for ethical approval at Kenya
Methodist University.
• Permission will be sought from the Embu hospital administration
• Confidentiality of the respondents will be maintained at all times.
• The identity of the participants will be protected in that no names or any
identifying information will be solicited in the questionnaire.
• Informed consent will be obtained from all the respondents to ensure that
they participate voluntarily.
.
 WORKPLAN
MAY 2022 JUNE 2023 JULY 2023 AUG 2023 SEPT 2023

PROPOSAL
DEVELOPMENT

PROPOSAL
PRESENTSTION

DATA COLLECTION AND

ANALYSIS

PROJECT
PRESENTATION
 BUDGET
ITEMS Quantity Unit Cost COST (KSHS)

Stationary
Foolscap (1 ream) @ 550 500.00
Pens 4 @ 20 80.00
Pocket folder 1 @ 100 100
Proposal writing
Printing edited copies 70 pages 3 @10 990.00
Photocopy 70 pages 3 @5 495.00
Binding 3 @60 150.00
Photocopying of questionnaires 70 1pages @5 350.00

Researcher
Transport 1 days @2500 2500.00
Meals 10 days @200 2000.00
Research assistants
Transport 10 days @200 2400.00
Meals 10 days @200 2400.00
Fee 5 days @300 3600.00
Miscellaneous 10% of total 1651
TOTAL 18,166.00
THE END