Chinyere Celine NWOKEKE, John Lekan OYEFARA


This study investigated the socio-cultural factors influencing health-seeking behaviour (HSB) among bone fracture patients in Lagos State, Nigeria. Literature reviewed indicated that many socio-cultural factors influence health-seeking behaviour of bone fracture patients including the differences in the methods used by Medical orthopaedic Surgeons (MOS) and Traditional bone Setters (TBS). However, this study focused on such socio-cultural factors as education, income, residence (rural or urban) and belief in supernatural causes of accidents. The health belief model and the theory of reasoned action and planned behaviour are the theories adopted for the study. The non-experimental research design was adopted and comprised both quantitative and qualitative approaches. Cross-sectional survey and in-depth interview (IDI) were utilized to gather data. A sample of 300 respondents was drawn among bone fracture patients from orthopaedic hospitals and traditional bone setting (tbs) homes using the multi-stage stratified, random and purposive sampling technique in four LGAs of Lagos state. Data were collected in 2016. The Statistical Package for Social Sciences (SPSS) was used to analyze the data and test the hypotheses. Chi-square results showed that higher educational attainment, higher monthly income and urban residence are positively related to the utilization of medical orthopaedic services (mos) with (p=0.000), (p=0.006) and p=0.000 respectively, while there is no relationship between belief in supernatural causes of accidents and HSB with (p= 0.098).Strength of association test using eta coefficient (η) yielded a little association between the independent and the dependent variables in the four hypotheses as η = .267, η = .096, η = .238 and η = .222 respectively and in all η < 0.3.Recommendations were made for health policy makers, MOS, TBS and the general public for improved health-seeking behaviour, skills of the practitioners and bone fracture care in general.


Bone fracture patients, Health-seeking behaviour, orthopaedic services, bone setting.

Full Text:



Abolarin, A. A. (2010). Knowledge and Attitude of Health workers at the National Orthopaedic Hospital, Igbobi, Lagos towards the National Health Insurance Scheme (NHIS). Retrieved from http://www. on 09/03/15.

Abubakar, A., Van Baar, A., Fischer, R., Bomu, G., Gona, J. K. and Newton, C.R. (2013) Socio-Cultural Determinants of Health-Seeking Behaviour on the Kenyan Coast: A Qualitative Study. PLoS ONE 8(11): e71998. doi:10.1371/journal.pone.0071998 accessed 10/01/16.

Ademiluyi, I. A. and Aluko-Arowolo, S. O. (2009). Infrastructural distribution of healthcare services in Nigeria: An overview. Journal of Geography and Regional Planning Vol. 2 (5), pp. 104-110.

Aderibigbe, S. A., Agaja, S. R., and Bamidele, J. o. (2013). Determinants of Utilization of Traditional Bone Setters in Ilorin, North Central Nigeria. Journal of Preventive Medicine and Hygiene, .54 (1), 35- 40.

Alonge, T.O., Dongo, A.E., Nottidge, T.E., Omololu, A.B. and Ogunlade, S.O. (2004) Traditional bonesetters in South Western Nigeria – Friends or Foes? West African Journal of Medicine. 23(1), 81-84.

Babar, T., Shaikh and Hatcher, J. (2004) Health-seeking Behaviour and Health service utilization in Pakistan: Challenging the policy makers. Journal of Public Health 27, (1), 49–54.

Bassey, R., Aquaisua, A., Edagha, Peters, A. and Bassey, E. (2009). The Practice of Traditional Bone Setting In The South-South Region of Nigeria. The Internet Journal of Alternative Medicine. 8 (2) pp. 1- 6.

Champion, V. L. and Skinner, C. S. (2008). The health Belief Model: In Glanz, K., Rimer, B. K. & Lewis, F.M. Eds. (2008). Health Behavior and Health Education. Theory, Research and Practice (4th ed.). San Francisco, Wiley & Sons.

Dada, A., Giwa, S. O., Yinusa, W., Ugbeye, M. and Gbadegesin, S. (2009). Complications of Treatment of Musculoskeletal Injuries by Bone Setters. West African Journal of Medicine. 28 (1), 333–337.

Ekere, A. U. and Echem, R. C. (2011). Complications of Fracture and Dislocation Treatment by Traditional Bone Setters: A Private Practice Experience. The Nigerian Health Journal. 11(4), 131-138.

Emiogun, F. E., Faduyile, F. A., Soyemi, S.S. and Oyewole O. O. (2016). Motorcycle Accident Mortality in Lagos. Nigeria: Impact of a traffic law. African Journal of Trauma 5:43-7.

Encyclopaedia History of Lagos State (2012). Retrieved from l#.VdRg2dhATmI. Accessed 4/2/15.

Eshete M. (2005). The Prevention of Traditional bone Setter’s gangrene. Journal of Bone Joint Surgery:.86-b, (1), 102–103.

Federal Ministry of Health (1988). The National Health Policy And Strategy To Achieve Health For All Nigerians.

Federal Ministry of Health (2007). Traditional Medicine Policy for Nigeria; World Health Organization WHO Publication.

Federal Road Safety Corps Annual Report 2011and 2013, Nigeria.

Glanz, K., Rimer, B. K. & Lewis, F.M. Eds. (2008). Health Behavior and Health Education. Theory, Research and Practice (4th ed.). San Fransisco, Wiley & Sons.

Gravetter, F. J. & Forzano, L. B. (2012). (4th ed.). Research Methods for the Behavioral Sciences, New York, Wadsworth Cengage Learning.

Idris S.A., Mohammed, O. B. and Basheer, E. S. (2009). Why Do People Prefer Traditional Bonesetters in Sudan? Retrieved from fer%20traditional%20bonesetters%20in%20Sudan.pdf assessed 25/02/15. Accessed 2/4/15.

Lawal, Y. Z., Ajibade, A., Maitama, M. I., Dahiru, I. L., Ogirima, M. O. and Ejagwulu, F. S. (2012). Challenges of Managing Severe Open Lower Limb Fractures in Northern Nigeria. Nigerian Journal of Orthopaedics and Trauma. 11 (2), 68 – 74.

Mackian, S. (2003). A Review of Healthcare seeking Behaviour: Problems and prospects. University of Manchester Health Systems Development Programme. Retrieved from /pdf /outputs/healthsysdev_kp/0503_health_seeking_behaviour.pdf on 15/04/15.

Ministry of Economic Planning and Budget, Abstract of local government statistics (2012). Lagos Bureau of statistics, Secretariat, Alausa, Ikeja.

Montano, D. E. and Kasprzyk, D. (2008). Theory of Reasoned Action, Theory of Planned Behaviour and Theory of the Integrated Behavioural Model; In Glanz et al. Health Behaviour and Health Education, Theory, Research and Practice (4th ed.). San Francisco, Wiley & Sons. Pp. 66-96.

National bureau of statistics, Lagos state Information (2010) mation/details/Lagos, accessed 20/2/2015.

National Population Commission (NPC) [Nigeria] and ICF Macro. (2009). Nigeria Demographic and Health Survey 2008. Abuja, Nigeria: National Population Commission and ICF Macro.

National Population Commission (NPC). 1991 Population census of the Federal Republic of Nigeria (1998). Analytical Report at the National level, Abuja, Nigeria.

Nwachukwu, B. U., Okwesili, I. C., Harris, M. B. and Katz, J. N. (2010). Traditional Bonesetters and Contemporary Orthopaedic Fracture Care in a Developing Nation: Historical Aspects, Contemporary Status and Future Directions. The Open Orthopaedics Journal. 5, 20-26.

Odunubi, O. O. (2015). National Orthopaedic Hospital Igbobi; Profile. =national+orthopaedic+hospital+igbobi, assessed 24/3/15.

Ogbeidi, M.M. (2012). Political Leadership and Corruption in Nigeria Since 1960: A Socio-economic Analysis. Journal of Nigeria Studies 1 (2), 1- 25

Ogunlusi, J. D., Okem, I. C. and Oginni L. M. (2007). Why Patients Patronize TBSs. The Internet Journal of Orthopaedic Surgery,. 4, (2), 1-7.

Olenja, J. (2003). Health Seeking Behaviour in Context, East African Medical Journal, 80, (2), 61- 62.

Onuminya J. E. (2004). The role of traditional bonesetter in primary fracture care in Nigeria. South African Medical Journal, 94 (8) 652-658.

Onuminya J. E. (2006) Performance of a Trained Traditional Bonesetter in primary fracture care. South African Medical Journal; 96, (4), 320–2.

Onyemaechi N, Lasebikan O, Elachi I, Popoola S, Oluwadiya K. (2014). Patronage of traditional bonesetters in Makurdi, north-central Nigeria, Volume2015:9 275—279. Retrieved from on 4/7/2017

Owoseni, J. S., Taiwo, O. C. and Ayodele, I.M. (2014). Traditional Bone Setters and Fracture Care in Nigeria, Merit Research Journals (ISSN: 2350-2358), 2 (6), 74-80

Owumi, B.E., Taiwo, P. A. and Olorunnisola, A. S. (2013). Utilization of traditional bone-setters in the treatment of bone fracture in Ibadan North Local Government. International Journal of Humanities and Social Science Invention ISSN (Online): 2319 – 7722, ISSN (Print): 2319 – 7714 pp47-57

Oyefara, J. L. (2011), Sociocultural context of Adolescent Fertility in Yoruba Society: Insight from Osun State, Nigeria, Concept Publications.

Peng, Y., Chang, W., Zhou, H., Hu, H. and Liang, W. (2010). Factors associated with health-seeking behavior among migrant workers in Beijing, China. BMC Health Services Research, 10:69 doi:10.1186/1472-6963-10-69 http://licenses/2.0). Accessed 16/12/15.

Prosser, T. B. (2007). Utilization of health and medical services: factors influencing health care seeking behaviour and unmet health needs in rural areas of Kenya. Retrieved from Accessed 16/12/15.

Robertson, I. (1988). Sociology: New York, Worth Publishers, INC.

Rosenstock, I. M., Stretcher V. J. and Becher, M. H. (1988). Social Learning Theory and the Health Belief Model: /2/5/15.

Residency Training Committee (n.d.), Residents Training Manual, National Orthopaedic Hospital, Enugu %2520TRAI NING%2520MANUAL%25201..doc&ei, accessed 3/4/15.

Sarosa, S. (2009). Information Technology Adoption Research: A Proposed Theoretical Guide. Atma Jaya Yogyakarta University, Jl. Babarsari 43 Yogyakarta 55281 Indonesia ISSN 2085-1944, PP. 177- 18.

Shaikh,B. T. (2008). Understanding Social Determinants of Health-seeking Behaviours, Providing a Rational Framework for Health Policy and Systems Development. Journal of Pakistan Medical Association, 58(1)

Sofowora, A. (1993, 2006). Medicinal Plants and Traditional Medicine in Africa; Ibadan, Nigeria, Spectrum Books Ltd,

Solagberu, B. A. I. (2016). “Of Broken Bones and Broken Dreams; a Bone Carpenter to the Rescue”

Inaugural Lecture; Department of Surgery, Faculty of Clinical Sciences, Lagos State University College of Medicine, Ikeja.

Thanni, L. O. A. (2000). Factors influencing patronage of traditional bone setters. West African Journal of Medicine, 19 (3), 220-224.

Udebunu, C. (2011). Nigeria and the Dialectics of Multiculturalism. Ogirisi: A New Journal of African studies 8, (1).


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 3.0 License.