The Influence of Social Support on the Utilization of Health Care Services by Patients with Chronic Lymphatic Filariasis in Goshi location, Malindi Sub-County, Kenya

Abstract

Background: Lymphatic filariasis (LF) caused by filarial worms and transmitted by mosquitoes is ranked as the second largest cause of disability in the world. Infection leads clinical manifestations; lymphoedema of limbs and genitalia and elephantiasis. The disease causes considerable morbidity to affected individuals with consequent loss of income and social and psychological stress. To determine the influence of social support on the utilization of healthcare services by patients with chronic clinical signs of LF, a cross-sectional study was conducted in Goshi location, Malindi Sub-County, Kenya.

Methods: A total of 220 patients with chronic (LF) were purposively selected and interviewer-based questionnaires administered to them for quantitative data. Four focus group discussions (FGDs) with single sex adult and youth groups and 16 key informant interviews with purposively selected opinion leaders were conducted for qualitative data. The quantitative data was analyzed by SPSS version 16 and the qualitative data manually by study themes.

Results: Encouragement received by patients from family and friends was significantly associated with health care services utilization (P<0.001). Most (68.2%) of patients who received such encouragement compared to 31.8% who did not, utilized health care services. Similarly, receiving encouragement from other patients with chronic LF was significantly associated with frequency of visiting health care facilities (P<0.001). Majority (81.8%) of respondents who received encouragement from fellow patients compared to 18.2% who did not, visited the health facility more frequently. Feeling of being a burden to the family was significantly associated with utilization of health care services (P<0.05). More than one half (57.1%) of those who felt that they were a burden to their family compared to 42.9% who did not, utilized health care services. Being affiliated to a support group was also significantly associated with utilization of health care services (P<0.001). Most (85.7%) of respondents who indicated that they were affiliated to a support group compared to 14.3% who were not, utilized health care services.

Conclusion: Patients with chronic LF require encouragement from community members and fellow patients to remove the feeling of rejection and to seek health care services. Being a member of a support groups is an important contributor of increased health care services utilization and authorities should support patients to form such groups.