Factors and Impact of Access to Primary Health Care Services on Tuberculosis Awareness among Women in Rural Communities in Orlu, Imo State

Abstract

Background: Equitable access to healthcare is a core principle of national health systems globally. However, individuals living in rural communities continue to face substantial informational, geographical, and financial barriers to primary health care (PHC) services. These barriers contribute to poorer health outcomes and widen rural–urban health disparities. Aim: This study assessed factors associated with access to PHC services and examined the influence of PHC access on tuberculosis (TB) awareness among adult women residing in rural communities in Orlu, Imo State. Methods: A community-based descriptive cross-sectional study was conducted using a convenience sampling approach to select the study area based on proximity, security, and accessibility. A simple random sampling technique was then used to recruit 430 women. Data were collected using a semi-structured questionnaire administered through self-report and interviewer assistance, encoded using Open Data Kit (ODK), and analysed with SPSS version 28. Descriptive statistics (frequencies and percentages) and chi-square tests were used, with significance set at p < 0.05. Results: Most respondents (60%) demonstrated poor knowledge or awareness of pulmonary TB. More than half (51%) reported poor to moderate health status, and 47% had poor access to PHC services. TB awareness/knowledge was significantly associated with educational level (p = 0.002), occupation (p = 0.020), and household room density (p = 0.002). However, TB awareness was not significantly associated with access to PHC services (p = 0.119). Conclusion: Despite limited TB awareness and restricted access to PHC services, women in these rural communities reported generally good perceived health status, suggesting notable resilience. The findings highlight the need for holistic, strengthened PHC systems that ensure equitable, accessible, and high-quality care for rural women, alongside targeted interventions to improve TB knowledge.