Students’ perception of healthcare services and factors affecting their utilization at a Nigerian University: a cross-sectional study

Healthcare service utilization among university students is critical for ensuring their health and academic success. This study was performed to determine the level of utilization as well as the perception and factors influencing the utilization of healthcare services by students at Afe Babalola University, Ado-Ekiti (ABUAD). This research involved a cross-sectional survey in which a semi-structured online questionnaire was used to collect data and a multistage sampling technique was used to sample the students. The students' perceptions were converted to scores by summing their responses across the questions. The total score for each student was compared against the midpoint of the possible score range. Perceptions with a total score greater than or equal to 12.5 were categorized as positive, while those with a total score less than 12.5 were categorized as negative. Logistic regression analysis was used to identify predictors of healthcare service utilization. Utilization of healthcare services, the key outcome variable, was defined as the frequency with which students accessed available health services. All analyses were carried out using Statistical Product and Service Solutions (SPSS) software. A total of 429 students participated in this study, majority of whom were females (304, 70.9%), with a mean age of 18.9 ± 1.7 years. Three hundred and seventy-five students (87.4%) reported utilizing healthcare services at the university of which 186 (43.4%) reported to occasionally utilize healthcare services in the university. A total of 33.1% perceived that the attitude of staff was poor, while 12.6% strongly disagreed that the healthcare staff were incompetent. Overall, the majority (287, 66.9%) of the students had a negative perception of the utilization of healthcare services. Approximately 16% agreed that the high cost of drugs affects their utilization, while 35.9% agreed that the services provided were too expensive. Predictors of healthcare service utilization included being over 20 years old (AOR = 3.6, 95% CI: 1.1-11.6), study level, with fourth-year students having the highest likelihood of utilization (AOR = 13.8, 95% CI: 5.1-37.4), and positive perception of healthcare staff attitude (AOR = 2.5, 95% CI: 1.1-5.9). Students from lower-income families (< 200,000 Naira) were significantly more likely to utilize healthcare services (AOR = 39.2, 95% CI: 12.6-121.5). The study revealed that, despite widespread usage of healthcare services, students have a predominantly negative perception of these services. Key factors influencing healthcare utilization include age, study level, attitude of staff and family income. Addressing these barriers through targeted interventions can improve health outcomes and promote equitable access to quality healthcare.