Socio-Cultural Determinants of Women’s Health Information Opportunities in Nsukka, Southeast Nigeria

Introduction

Over time, studies have indicated wide disparities in the level of access and use of health information by various individuals and groups (Abel & Frohlich, 2012; Gagnè, Ghenadenik, Abel & Frohlich, 2018; Osamor & Grady, 2018; Wang, Viswanath, Lam, Wang, & Chan, 2013). Several studies also indicate that women have a greater tendency than men to seek health information (Gollop, 1997; Nangsangna & Vroom, 2019; Wang et al., 2013). However, due to demographic, personal, and cultural factors in many developing countries, the likelihood that a woman will eventually obtain the health information she needs seems to be inversely related to the desire for such information (Bustreo, 2015; Ononokpono & Odimegwu, 2014; Osamor & Grady, 2018). For instance, child rearing, age, access to media and hospitals, income, and spousal attitudes may affect the possibility of access to health information. There is a growing link between women’s susceptibility to health risk factors and women’s opportunities to seek health information in Nigeria (Bustreo, 2015; Ononokpono & Odimegwu, 2014).

The World Health Organization (WHO, 2019) observes that living circumstances and environments are more decisive in determining the health of individuals and communities than actual information access and use. The present study thus focuses on the socio-cultural determinants of health information opportunities among women. Studies on health information seeking have explored terms such as information autonomy and decision-making autonomy as factors of health behavior (Bourdieu, 1986; Gagnè et al., 2018; Ononokpono & Odimegwu, 2014; Sorensen et al., 2012; Wang et al., 2013).

However, we posit that while information autonomy can be viewed as an absolute state, information opportunity is a broader term that explains the reasons for, or steps to, information autonomy. Information opportunity can also be explored as a non-drug measure, which can contribute significantly in reducing maternal morbidity and mortality rates in Nigeria. This is in view of nationwide problems of the inadequacy of health facilities, their irregular use, shortage of (qualified) medical personnel, sickness complications, and inaccurate diagnosis (Ononokpono & Odimegwu, 2014). Unfortunately, the country has experienced alarming rates of preventable maternal morbidity (illnesses) and mortality as can be seen from Tables 1 and 2. The maternal mortality ratio (MMR) for Nigeria is 814 per 100,000 live births, one of the highest in the world (Ntoimo et al., 2018). As used in the study, the term “health information opportunity” refers to the relative extent to which women have the chance to access health information, how they initiate/create the chance to obtain health information, how they are allowed the chance to access information, and how they use information about health. This is in the context of women’s position in the family as low-income subordinates in the African context, where many factors determine the decisions and opportunities open to women (African Population and Health Research Center, 2017). In the study, we classified the socio-cultural factors affecting women’s health information opportunities into demographic, cultural, personal/individual, facility-related, and social factors. Social factors were further subdivided into interpersonal, media, and household factors. The subdivisions were construed as social agents, which are more open to the control of individuals than facility-related and cultural factors, which are respectively less easy to control and more normative.

Table 1

Causes of Maternal Deaths in Nigeria

Table 2

Sickness to Death-Prevalence Rate

Information opportunities obtain at the basic level of health information seeking, where questions should be asked about the likelihood that a person will have access to information (Gagnè et al., 2018). This is the crux of the United Nations Sustainable Development Goal 5, which seeks to entrench gender equality as a way to improve on women’s opportunities to take responsibility for their health and other issues (Bankole et al., 2015). Studies show that information autonomy, freedom to seek information, and financial freedom are important factors in healthcare use among women (Fikree & Pasha, 2004; Ononokpono & Odimegwu, 2014; Osamor & Grady, 2018; Singh, Singh, Singh, & Pathak, 2014).

Other causes of maternal deaths are given in Table 2 below, which also summarizes maternal death incidences/prevalence (generally) relative to types of sickness. The data were sourced from different studies (Adeloye, Basquill, Aderemi, Thompson, & Obi, 2015; Adinma, Umeononihu, & Umeh, 2017; Akarolo-Anthony, Willett, Spiegelman, & Adebamowo, 2014; Bankole et al., 2015; Dahiru, Aliyu, & Shehu, 2016; Morounke et al., 2017; Obinna, 2017; Ogundipe, 2017; Premium Times, 2019; WHO, 2016; WHO, 2017).

From Health Information-seeking Behavior to Health Information-seeking Opportunities

Health information-seeking behavior (HISB) describes the different behavioral dispositions of individuals toward seeking and identifying information related to healthcare, health risks, and health-protective behaviors (Jacobs, Amuta, & Jeon, 2017; Lambert & Loiselle, 2007). Surveys and in-depth interviews are often adopted in HISB studies to ask respondents to self-report their general information-seeking habits, sources for, contents of, and constraints on information seeking, and the health information preferences of patients with different conditions (e.g., cardiovascular, infectious) (Marton & Wei, 2012). Many such studies have made useful findings on the importance of health information as well as factors influencing health information-seeking behavior (Jacobs et al., 2017; Lambert & Loiselle, 2007; Li & Hu, 2012; Marton & Wei, 2012). However, these studies did not consider health information seeking as a function of health information opportunities.

Generally, HISB is subject to unequally-distributed health-promoting opportunities and resources (Gagnè et al., 2018; Wang et al., 2013). Research shows that social factors are important predictors of health disparities, some of which are linked to health information (Bourdieu, 1986; Gagnè et al., 2018; Viswanath, 2006; Viswanath et al., 2012; Wang et al., 2013). Citing other authors (Marmot, 2005; Viswanath, 2006) Wang et al. (2013, p. 3) define inequalities in health communication as “the difference in accessing, seeking, processing and acting on information by different groups in a society.”

For instance, most studies on disease prevalence among Nigerian women indicate disparities in information awareness, knowledge of health risk factors and health status, and susceptibility to chronic illnesses and deaths (Adeloye et al., 2015; Balogun, Odukoya, Oyediran, & Ujomu, 2012; Bello, 2013; Bustreo, 2015; Obinna, 2017; Ogundipe, 2017; Uchendu, 2008). Researchers further observe that women experience higher morbidity and mortality rates than men because too many of them (women) do not get the opportunity to be educated, provide self-support, or obtain the health services they need (Bustreo, 2015; Ntoimo et al., 2018; Obinna, 2017). Although the numerous women’s groups throughout Igboland, such as Umuada, usually engage in social work designed to alleviate the sufferings of less privileged, sick, and aged women, their efforts are still limited by the opportunities they have as women (Amaechi & Muoh, 2018).

Even health literacy, which is a core determinant of health behavior, is itself determined by contextual and societal forces which limit or boost health information opportunities (Gagnè et al., 2018; Sorensen et al., 2012;). A study by Gagnè et al. (2018, p. 1) shows that unhealthy behavior among young adults such as smoking, sedentary lifestyle, unhealthy eating, alcohol abuse, and sexual promiscuity are unequally distributed, “with higher rates evidenced among the socioeconomically disadvantaged.” The WHO (2019) notes that rather than blaming individuals for having poor health or praising them for good health, researchers should instead focus on contexts that determine health status. Consequently, studying the contextual determinants of health information seeking is fundamental to understanding the disparities in people’s capacities to adopt healthy behavior (Gagnè et al., 2018; Sorensen et al., 2012).

Specifically, the factors or contexts include (Gagnè et al., 2018, p. 391) “social (resources accessible through social networks based on principles of recognition and reciprocity), economic (financial and material resources) and cultural (i.e., knowledge, skills and preferences accumulated through socialization in the family and school environments) capitals for avoiding health-deterring behavior.” As argued by Abel (2007, as cited in Gagnè et al., 2018, p. 391):

Inequalities in health literacy could be understood as the result of unequal chances to acquire socially-valued knowledge (values, norms and preferences related to health information) through friends, peers, education and media. This knowledge provides individuals with different capacities to use health information directly and indirectly through the application of other forms of capital (e.g., buying and reading books, access to support groups), and ultimately contributes to the reproduction of social inequalities in health.

The present study categorizes the socio-cultural factors as follows: Demographic factors (age, education, marital status, the number of children in a household, socio-economic status), cultural factors (customs, cultural values, lifestyle), individual/personal factors (women’s individual efforts and initiatives, knowledge of health risk factors), facility-related factors (use of healthcare services, access of hospitals, availability of time, and availability of experts) and social factors, subdivided into (1) household factors (influences of spouses and family members), (2) media factors (women’s exposure to information sources and influences of the media), and (3) non-familial interpersonal factors (influence of friends, religious teachers, faith doctors, herbal healers, and professional healthcare providers). Significant opportunities to seek and to use quality information may reduce exposure and susceptibility to morbidities and comorbidities in women, who do not just care for themselves health wise, but also for their girl children (Bello, 2013). This study focuses on a micro unit of Nigeria’s health and demographic system —Nsukka—which is among the localities not covered in the national demographic and health surveys.

Study Context

As of 2018, women constituted 51.8% (713, 286) of the total population of 1,377,001 in Nsukka Local Government Area, a political and cultural zone in Enugu State, Southeast Nigeria (Ezema, 2016; Ugwu, 2018). According to Ugwu (2018, p. 85):

Nsukka Local Government Area is in Enugu North senatorial zone of Enugu state in the Southeast part of Nigeria. It is made up of eleven rural communities-Nsukka Town which is the headquarters, Obukpa, Obimo, Alor Uno, Ibagwa-Ani, Okpuje, Okutu/Anuka, Lejja, Eha-Alumona, Ede-Oballa and Opi. Nsukka is bounded by Kogi State in the North [Figs. 1 & 2]. The headquarters is a University town. This educational institution has impacted positively on the communities and beyond especially on the younger generation. The main occupation is farming and petty trading. Nsukka women are very industrious and hardworking as they are confronted by challenges of family responsibilities and survival.

Figure 1.

Map of Nsukka. Adapted from the Department of Geography, University of Nigeria, Nsukka as first uploaded by Raymond Taziwa (2018).

Figure 2.

Nsukka Environs from 2019 Google Maps at https://nsukkaigbonation.com/map

Nsukka is mainly populated by the Igbo ethnic group, one of the three major ethnic groups in Nigeria, the others being Hausa and Yoruba. Though slightly less developed than many state capitals in Nigeria, Nsukka is one of the fastest-growing urban areas in Southeast Nigeria, with women experiencing continually increasing stress levels, nutrition problems, and exposure to health risk factors (Ugwu, 2018). Researchers have therefore underscored the need to examine women’s health information access in Nsukka (Ezema, 2016; Taziwa, 2018; Ugwu, 2018). As host of the University of Nigeria, the nation’s premier university and one of the largest institutions in West Africa, Nsukka, as an urban center, still has many agrarian suburbs and lacks basic amenities, including good local roads, well-equipped health facilities, a regular power supply, and modern libraries (Ugwu, 2018). Nsukka is home to two radio stations, the university’s Lion FM and a Federal Radio Corporation of Nigeria-owned Voice FM. There are three government-owned hospitals and seven private hospitals. There is also a cluster of small private clinics and maternity units, while each of the surrounding rural areas has at least one government-owned health center (Ukonu, Anorue, & Uji, 2016).

Ezema (2016) found that the main reproductive health information needs of women in Nsukka were related to infertility, use of contraception, abortion, prevention of sexually transmitted diseases, antenatal care, and postnatal care. The study recommended improved information access through new technologies, rural libraries, and literacy campaigns. While these may boost health information access, they may not automatically address some of the factors that affect its use. The present study attempts to ascertain the opportunity factors that impinge on efforts to boost women’s access to health information in Nsukka.

Methods

The study adopted a survey method, which was conducted in four main primary hospitals used by the residents of Nsukka, namely, (1) General Hospital, Nsukka, (2) Bishop Shanahan Hospital, Nsukka, (3) University of Nigeria Medical Center, Nsukka, and (4) Health Center, Nsukka. Approvals were secured from the hospitals’ ethics committees and, in some cases, the Chief Medical Director. The four hospitals are the biggest primary healthcare centers used by Nsukka as a socio-cultural area. The hospitals, within their capacities and limitations, are attested to as the best equipped within Nsukka (personal interview).

The first of these hospitals is a state government-owned hospital, where government-sponsored health screening for women often takes place. The second is a private hospital owned by the Catholic mission in Nsukka and largely attended by locals around the area, especially those in remote areas, for whom it serves as a referral hospital. The third hospital is owned by the University of Nigeria, Nsukka and attends to the university community. The fourth is a state-owned hospital, specializing in maternal care and also offers free medical services for women.

Women visiting hospitals were selected because data for the study would best be offered by those in the frame of either illness or maternity care. This helped to obviate the problem of recall bias that may arise when questions relating to communications with the doctor are asked women who did not consult a doctor. Respondents were all the reproductive-age women met at the out-patient departments of the hospitals and those who had been admitted. Altogether, a total of 591 women were contacted in the four hospitals, distributed as shown in Table 3. Approximately 53% and 21% of the women were on antenatal and immunization visits respectively. The rest were in-patients.

Table 3

Respondent Distribution by Hospital

The research team visited each of the selected hospitals from 8 am to 4 pm, Monday to Friday, for a two-week period in May 2019. The questionnaire served as the instrument for data collection. Three research experts validated the questionnaire; its reliability was verified using a test re-test approach and a coefficiency value of 0.78 was realized.

In order to measure information-seeking opportunities, the respondents were simply asked to indicate whether the opportunities they have in seeking health information were “high” or “low.” Factors considered in the study to have influence on information-seeking opportunities were demographic factors, cultural factors, interpersonal (non-familial) factors, and opportunity-level factors (household factors, media factors, personal factors, and environmental factors). While demographic variables were measured with nominal scales, others were measured using ordinal scales calibrated as follows: very large extent –5; large extent –4; moderate extent –3; low extent –2; not at all –1.

Statements relating to cultural factors were posed as: “It is our culture to consult traditional sources of treatment at the time of an illness”; “It is customary in my community to seek the origins of an illness through traditional sources.” Personal or individual factors as a variable were tested with statements such as: “I make a personal effort to acquire health information”; “I have consulted a specialist doctor”; “I am knowledgeable about my health condition.” Statements such as the following were used to test facility-related factors: “I have access to hospitals.” Respondents were also asked to rank facility-related factors (use of healthcare services, access of hospitals, availability of time and availability of experts) according to how they were seen as important to accessing health information. Social factors (e.g., interpersonal factors) were addressed with statements such as: “My doctor asked me questions relating to my lifestyle”; “my religious teacher helps in deciding my health information choices”; “I usually inquire about healthcare information sources from friends.” Statements relating to household factors were posed as: “My spouse is a significant factor in what I know about my health”; “access to healthcare information in my home is dependent on the resources provided by my spouse”; “I cannot spend my own money to seek health information without my spouse’s approval.” Media factors were tested with statements asking respondents to list the main sources of information on different medical conditions.

Correlation analysis was used to examine the association between informationseeking opportunities and the social-cultural variables such as demographic factors, cultural factors, interpersonal factors, facility-related factors, and social factors. Means and standard deviation were used to rank the negative influencers of information-seeking opportunities. The demographic factors were age (15–25, 26–35, 36–45), occupation (civil service, business, no occupation), number of children (1–4, above 4), educational level (no formal education, primary, secondary, tertiary) and marital status (married, never married, widowed, divorced). Data analysis was carried out using SPSS version 23.

Results

A total of 573 copies of the questionnaire were considered fit for analysis out of a total of 591 copies administered to the respondents. There was a 97% validity rate. This high response rate may be attributed to the fact that the instrument was administered and retrieved immediately due to the temporary nature of the women’s stay in the hospitals. The mean age of the respondents was 41 years (range 36– 45). Most of the respondents were married. This could be attributed to their age because in Africa, as may be the case elsewhere, most people in their 20s are married. The respondents were mostly people of low educational status, ranging from no formal educational level to primary level, and the majority were petty traders, typical of the Igbo people of the area who are mostly traders. Most of the samples reported having between 1–4 children. The majority (69.2%) of respondents reported that they did not have the freedom in their homes to take full responsibility for their healthcare. However, 72.1% indicated that they made an effort to seek information about their health. A little more than half (53.7%) indicated that their spouses were significant factors in the actions they (the women) took about their healthcare, and another 48.3% said that they would have more opportunity to access health information if their spouses provided the funds.

Approximately 22% indicated that they depended on resources (such as the internet and pay television access) provided by their spouses to access information generally, not only health information. However, 92% said their spouses did not have any negative effect on their health awareness and care. The majority (61%) of the respondents reported that they belonged to low-income households. Analysis of the relationships between the respondents’ demographic attributes and information- seeking opportunities is presented in the table below:

Table 4

Relationship between Demographics and Information-seeking Opportunities

The essence of the table above was to ascertain the association between demographics like age, educational level, marital status, and number of children and the information-seeking opportunities of the respondents studied. The results show that all the demographics are significantly associated with information-seeking opportunities. Therefore, the first assumption was supported and the researchers conclude that demographics are significantly associated with information-seeking opportunities. In particular, women aged 26–35 reported higher information-seeking opportunities while their counterparts aged 14–25 years reported lower health information-seeking opportunities. Also, respondents with tertiary education reported higher information-seeking opportunities than their counterparts with no formal education. Seventy-three percent (73.2%) of the higher education women were found at the University of Nigeria Medical Center. Also, civil servants reported higher information-seeking opportunities than other occupational categories. Married women and those with four (4) children or fewer reported higher information-seeking opportunities.

In Table 5 above, the researchers sought to ascertain the relationship between cultural factors and information-seeking opportunities. The results show that they were significantly associated. Therefore, the second assumption was supported. Civil servants were more likely to have information opportunities than either business people or people with no occupation. Income was also associated with information opportunities, where more than half of the respondents reported not having financial autonomy, which significantly affected their chances and initiative to seek information on health. Financial autonomy was also less likely to affect women with tertiary-level education.

Table 5

Cultural Determinants and Information-seeking Behavior

In Table 6, the researchers sought to ascertain the association between opportunity-level factors and health information seeking. It was found that all four dimensions of opportunity significantly correlate with health information seeking. Therefore, the third assumption was supported and the researchers conclude that opportunity-level factors are significantly associated with information-seeking behavior. Comparatively, household opportunities scored higher (r =.981) than all the other dimensions.

Table 6

Relationship between Social Factors and Health Information Seeking

In Table 7 above, the researchers sought to ascertain the relationship between personal and environmental factors and information-seeking opportunities, and found that they were significantly associated. Therefore, the fourth assumption was supported. Domestic autonomy, health information awareness, access to health facilities, and knowledge of health condition significantly affect the chances of the women in seeking health information.

Table 7

Personal and Facility-related Factors and Information-seeking Behavior

In Table 8 above, the researchers sought to ascertain the relationship between health condition and sources of information, and found a significant correlation. Therefore, the last assumption was also supported. To examine each of the health conditions relative to the sources of information, a correlation matrix was used and the result is presented in Table 9 below.

Table 8

Health Condition and Sources of Information

Table 9

Correlation Matrix between Health Condition and Sources of Information

The correlation matrix above was computed to ascertain the association between the individual health conditions and sources of information. The women were more likely to get information on pregnancy-related health conditions from family and friends, while the mass media were more likely to be the sources for cancer-related issues. Information on high blood pressure was received more from family, friends, and the mass media, while information on stress factors came more from books and social media. Also, information on diet and nutrition was acquired from family and friends as well as trained medical doctors. Information on diabetes and arthritis was obtained from places of worship, medical doctors, and herbal healers.

The bar chart above (Figure 3) presents the results of the overall information-seeking opportunities of women measured on a scale of “low” and “high,” with the majority of the women (70.5%) reporting low information-seeking opportunities. The respondents were requested to rank items regarded as negative influences on their information-seeking opportunities. The results of the ranking are presented in the following table.

Figure 3.

Information-seeking Opportunities

The table above (Table 10) shows in descending order the ranking of negative influencers on information-seeking opportunities. As may be seen from the table, finance ranked first followed by time, religious belief, advice from religious teachers, spousal attitudes, availability of experts, and advice from friends in that order. This coincided with an earlier indication that the majority of the women reported finance as a major problem and that they were more likely to come from the lower economic class.

Table 10

Respondents’ Ranking of Negative Influencers of Information-seeking Opportunities

Discussion

The study examines the socio-cultural determinants of information-seeking opportunities among women in Nsukka, Southeast Nigeria. It seeks to promote non-drug based, pre-sickness health solutions against a backdrop of Nigeria’s critically ailing health system.

We found that information-seeking opportunities among women in Nsukka were low. Although all the opportunity dimensions were associated with information- seeking opportunities, household opportunities scored higher (r =.981) than all the other dimensions. Household factors such as the influence of husbands and poor information autonomy negatively affected the chance and initiative to access health information. The difference between reported low information opportunity and the high number of those who made an effort to seek information about their health shows that household autonomy may be an obstacle to that self-conscious effort (Bustreo, 2015; Ezema, 2016; Ugwu, 2018). This corroborated an earlier mentioned inverse relationship between women’s proven high tendency to health information seeking and the likelihood that they will eventually obtain the information they need (Jacobs et al., 2017; Wang et al., 2013).

Curiously, the majority of the women reported that their spouses did not have any negative influence on their (women’s) effort to seek health information despite also reporting significant dependence on them (their spouses) for financial help to obtain that information. This could imply an appreciation of the help already being offered by the men. Another implication is the cultural belief in many parts of Nigeria that men should make key decisions on healthcare for everyone in the family, thus limiting women’s opportunity for self-support (Bustreo, 2015; Ononokpono & Odimegwu, 2014; Osamor & Grady, 2018). The foregoing supports the findings of other studies, which found disparities between men and women in health-promoting opportunities and resources (Gagnè et al., 2018; Marmot, 2005; Ononokpono & Odimegwu, 2014; Osamor & Grady, 2018; Viswanath, 2006; Wang et al., 2013).

Demographics were significantly associated with information-seeking opportunities. While younger women had lower information opportunities, those with higher educational attainments were more likely to have higher information opportunities. Younger women still bear the burden of child-rearing and this may explain their lower information opportunities than women with fewer than four children. Therefore, the association between marital status/number of children and information-seeking opportunities points to the fact that population controls may be needed to increase women’s information-seeking opportunities.

These findings correspond with other studies which found that demographic attributes such as age, gender, education, and marital status were linked with (women’s) information autonomy (Gagnè et al., 2018; Gollop, 1997; Jacobs et al., 2017; Tichenor et al., 1970; Wang et al., 2013). Wang et al. (2013, p. 4) found that “being female, increasing age, never-smoking and physically active were associated with frequent health information seeking.”

The present study also found that health information awareness, access to hospitals, and knowledge of health condition significantly affect the chances women have in seeking health information. The result aligns with other studies which found that cultural capital such as higher education was associated with the likelihood of individuals seeking information from multiple sources (Abel, 2007; Gagnè et al., 2018; Moorman & Matulich, 1993). Similarly, Shieh et al. (2010) found that low health literacy was linked with the likelihood that pregnant women will depend on “powerful others’” to care for their unborn babies instead of depending primarily on their self-efficacy. The present study upholds the suggestion by Shieh et al. (2010, p. 436) that when developing interventions to facilitate low-income women’s health information seeking, “increasing their self-efficacy may need to be the first priority.” The authors point to studies (Campbell, 2009), which reported successes with some efforts to increase the information-seeking self-efficacy of minority women such as the respondents in the present study. They also suggest that skills (impacting a sense of control over one’s health) are needed to overcome barriers such as financial constraints in self-efficacy interventions.

Apart from alerting women to health threats and risk factors, improving information consciousness and autonomy would boost information-seeking opportunities, especially the capacity of women to consciously work on individual and household factors affecting those opportunities. The women may have less capacity to influence environmental conditions such as access to hospitals. However, higher information opportunities and information-seeking habits may reduce susceptibility to health risk factors and actual morbidities, because health measures will be taken before the onset of illness. Knowledge gaps can be bridged through information alerting people to threats such as poor lifestyle (Tichenor et al., 1970).

Type of occupation was associated with information opportunities, with finance foremost among household factors predicting information opportunities. Financial autonomy was also less likely to affect women with tertiary-level education, further corroborating Moorman and Matulich’s (1993) model on the effects of economic and cultural capital on consumers’ preventive health behaviors. Similarly, Gagnè et al. (2018, p. 397) found that economic capital leads to “higher odds of seeking information sources outside the family.”

The study found that respondents used multiple sources of information. Apart from the finding that health condition and sources of information significantly correlate, the study also aligns with others reporting multiple sources of information and disparities in how they are distributed (Gagnè et al., 2018; Jacobs et al., 2017; Wang et al., 2013). Family and friends scored higher than other sources of information seeking. This finding also supports studies reporting the declining role of the mass media as primary sources of health information (Jacobs et al., 2017; Wang et al., 2013). However, while the present study found that respondents looked more to the mass media for information related to cancer, Jacobs et al. (2017) found that health professionals were the primary sources of information on chronic diseases such as cancer. The reliance on friends and family may be explained by the low literacy and income level of the majority of respondents in the present study. This may also account for why social media and the internet did not play significant roles as sources of information despite their rise as reported in some studies on HISB (Gollop, 1997; Jacobs et al., 2017; Marmot, 2005; Viswanath, 2006).

Although the study aimed to reach out to minority women who are rarely covered in national health surveys, the limited nature of the study population also makes its findings not generalizable to every woman in Southeast Nigeria. Future studies can relate information opportunities to specific illnesses and/or women of given socio-economic groups such as working-class women in Nigeria. Comparative studies involving other minority groups in the Southeast or other regions of the country are necessary to highlight the information-seeking opportunities in these areas since health needs are similar across Nigeria, where the health system is generally in crisis.

Conclusion

The study found low health information-seeking opportunities among women in Nsukka. This correlated with the low literacy level of the majority of respondents. The influence of economic status, household opportunities, and the number of children in a household tended to show the importance of the influence of familial conditions on information-seeking opportunities. The factors also highlighted the link between the need for population controls, family health support initiatives, and women’s health. A majority of women who had more than four children also reported having a lower chance of seeking health information.

The danger of relying more on family and friends than on health professionals has been reported in several studies (Ononokpono & Odimegwu, 2014; Osamor & Grady, 2018). Government and women’s groups should launch family support initiatives to boost women’s domestic autonomy, health information awareness, and financial autonomy, and highlight the best ways to use health information from family and friends. Indeed, information opportunities open up a vista of concerns that make it worth studying as a health issue and as a health risk factor. However, if significantly boosted, information-seeking opportunities may become a cost-effective, non-drug measure that can considerably offset the challenge of access to health facilities and services by women in Nsukka, Nigeria.

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