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Studies have highlighted the importance of context-specific research when exploring reasons behind utilisation or non-utilisation of health facilities [ 20- 22].
Both utilisation and non-utilisation of healthcare are associated with costs; in our study, 20%% of people with unmet needs had lost revenues (data not shown).
Utilisation of agro-industrial residues as substrates in SSF processes provides an alternative avenue and value-addition to these otherwise under- or non-utilised residues.
Perception of low quality has been reported as a major factor in non-utilisation or bypassing of health services [ 6- 11].
Much of the work on utilisation of healthcare explicitly or implicitly assumes that non-utilisation is a direct reflection of non-offer.
Globally, nearly all (99%) maternal deaths occur in low-income countries, mainly caused by non-utilisation of available delivery services or delays in accessing such services.
Conversely, the prevalence of non-utilisation of health facility for childbirth reduced with increasing number of service components received during ANC visits (OR: 0.72; 95% CI 0.64 to 0.80).
But Mustapha, 62, who is also chairman of Maiduguri's sharia implementation committee, gave a direct translation as: "A dislike of the non-utilisation of those who are educated".
Regarding factors that determine the utilisation of maternal healthcare services, we observed that primiparity, grand multiparity, and unwanted pregnancies issues associated with the non-utilisation of antenatal visits.
Similarly, significant association was evident between lower wealth status and non-utilisation of facility for childbirth.
The high non-utilisation rate is intriguing and warrants further investigation.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com