Utilization of speech-language pathology services among parents of children with speech and language disorders in Ibadan, Nigeria.
Keywords:
Speech-Language Pathology, Service Utilization, Healthcare Barriers, Socio-cultural Factors, Speech-Language Disorders, ChildrenAbstract
Background: Pediatric speech-language disorders present a global health challenge, yet service utilization remains suboptimal in developing contexts. This study investigated the determinants of Speech-Language Pathology (SLP) service utilization among parents in Ibadan, Nigeria, specifically examining the interplay between healthcare system barriers and socio-cultural factors.
Methods: Using a quantitative, cross-sectional design derived from a larger sequential exploratory mixed-methods study, 211 parents were recruited via multi-stage sampling from 10 urban and rural schools. Data were collected through an interviewer-administered questionnaire (Cronbach's α = .81) developed from preliminary qualitative themes. Binary logistic regression was employed to identify sociodemographic predictors of service utilization and perceived barriers.
Results: Only 37.4% (n = 79) of parents had utilized SLP services. Logistic regression identified post-secondary education (OR = 3.16, p = .001) and urban residence (OR = 2.56, p = .003) as the strongest predictors of service use. Financial constraints (90.0%) and accessibility issues (85.7%) were the most prevalent systemic barriers; rural residents were significantly more likely to report financial hurdles (OR = 3.06, p = .004) and long hospital wait times (OR = 2.18, p = .018). Socio-cultural barriers were prominent, with 77.7% of parents citing ignorance and 60.1% reporting psychological denial. While ignorance was linked to rurality (p = .005), parental denial was significantly higher among urban residents (OR = 1.99, p = .033). Gender did not significantly predict utilization or barrier perception (p > .05).
Conclusion: Service utilization is driven by educational awareness and geographical proximity, but hindered by a complex paradox: rural parents face structural and financial exclusion, while urban parents are deterred by psychological denial. Interventions must move beyond infrastructure to include targeted public health campaigns that address diagnostic denial and improve community-level awareness.
Keywords: Speech-Language Pathology, Service Utilization, Healthcare Barriers, Socio-cultural Factors, Speech-Language Disorders, Children
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