Community perceptions of primary health care in Oyo State, Nigeria: a cross-sectional study

Primary Health Care (PHC) is central to achieving equitable and cost-effective health systems, yet its potential in Nigeria remains underutilised. Despite the extensive network of PHC centres in Oyo State, utilisation remains low, partly due to misconceptions about PHC functions and varying community experiences. This study assessed awareness, perceptions, and predictors of PHC utilisation among residents of Oyo State.

A cross-sectional descriptive study was conducted between July and August 2025 across 16 purposively selected Local Government Areas (LGAs) in Oyo State to ensure urban-rural representation. Data were collected through online and interviewer-administered questionnaires. Descriptive statistics summarised sociodemographic characteristics and awareness patterns. Chi-square tests assessed associations between sociodemographic variables and PHC awareness. Logistic regression identified predictors of PHC utilisation, with significance set at p < 0.05.

A total of 694 respondents participated. Overall, 80.9% reported awareness of a PHC centre in their locality, although awareness differed significantly by age (χ²=44.99, p < 0.001), marital status (χ²=29.77, p < 0.001), and number of children (χ²=9.69, p = 0.021). Knowledge of PHC functions revealed notable gaps. Routine immunisation (54.5%) and treatment of uncomplicated malaria (48.7%) were widely recognised, whereas awareness of emergency care (30.4%), hypertension management (15.0%), and diabetes care (6.8%) was low. In the multivariable model, older age groups showed reduced odds of PHC utilisation compared with those under 20 years, particularly respondents aged 31-40 years (AOR = 0.34; 95% CI: 0.16-0.75), 41-50 years (AOR = 0.22; 95% CI: 0.09-0.54), and 51-60 years (AOR = 0.32; 95% CI: 0.12-0.82). Married respondents were more likely to use PHC services (AOR = 3.26; 95% CI: 1.75-6.10). Higher income was associated with lower utilisation, especially among those earning above ₦300,000 (AOR = 0.25; 95% CI: 0.10-0.66). Awareness of PHC centres was the strongest predictor of utilisation (AOR = 7.12; 95% CI: 4.37-11.61).

Although awareness of PHC centres is high, substantial gaps remain regarding the breadth of PHC services. Age, marital status, income, and PHC awareness significantly influenced utilisation. Strengthening health education and implementing targeted communication strategies, particularly for young adults, older persons, and higher-income earners, may enhance PHC uptake and contribute to more equitable utilisation of primary healthcare services in Oyo State.