Factors Influencing Uptake of Elective Hernia Surgery in Rural Communities of Niger State

Hernia disease is a leading cause of preventable surgical morbidity globally, with a disproportionate burden in rural Nigerian communities where elective hernia repair uptake remains low despite the known risks of delayed treatment including strangulation and obstruction. This study investigates the factors influencing uptake of elective hernia surgery among adult males with confirmed inguinal hernia in rural communities of Niger State, North Central Nigeria, from 2022 to 2023. A community-based analytical cross-sectional study recruited 320 men with symptomatic inguinal hernia through community health workers. A validated interviewer-administered questionnaire assessed knowledge of hernia complications, healthcare-seeking attitudes, financial barriers, cultural beliefs, and prior healthcare encounters. Logistic regression identified independent predictors of surgical uptake. Only 23% of eligible men had undergone or were scheduled for elective hernia surgery. Financial cost (OR 4.1), distance from surgical facility (OR 3.2), fear of anaesthesia (OR 2.5), and cultural preference for traditional healers (OR 2.9) were the strongest barriers. Community health worker recommendation was the most significant positive predictor (OR 3.8). The study recommends subsidized elective hernia surgery programs, mobile surgical outreach units, and targeted community health education campaigns in Niger State to address modifiable barriers and prevent the avoidable burden of emergency hernia surgery. Keywords: inguinal hernia, surgical uptake, rural health, Niger State, barriers to surgery