Factors Influencing Environmental Health Service Utilization in Rural Communities in Benue State, North Central Nigeria

Understanding the factors that drive or inhibit utilization of environmental health services in rural Nigerian communities is essential for designing effective and equitable service delivery systems. This study analyzed factors influencing the utilization of environmental health services, including safe water, sanitation, vector control, and food safety inspections, in rural communities in Gwer West and Ukum local government areas of Benue State, North Central Nigeria. A cross-sectional mixed-methods study design was employed. Structured household surveys were administered to 480 respondents, and twenty-four focus group discussions were held across six communities. Environmental health service utilization was assessed using a composite index covering knowledge of available services, physical access, frequency of use, and satisfaction. Multilevel logistic regression identified determinants of high versus low utilization. Results showed that only thirty-eight percent of respondents demonstrated high utilization of available environmental health services. Distance from the nearest primary healthcare center, household income, and educational attainment were significant positive predictors. Social trust in local government environmental health institutions negatively affected utilization in two communities that had experienced prior service failures. Gender disparities were significant, with women demonstrating lower utilization due to mobility and decision-making constraints. The study identifies that demand-side and supply-side barriers simultaneously undermine service utilization. Recommendations include community health worker deployment, demand-creation campaigns, and improvement of LGA-level service delivery quality and accountability. Keywords: environmental health services, utilization, rural communities, Benue State, determinants.