Factors Influencing the Uptake of Non-Communicable Disease Preventive Services Among Adults in Kano State: A Mixed-Methods Investigation

Background: Preventive services for non-communicable diseases remain underutilised across Nigeria despite evidence of their cost-effectiveness in reducing disease burden. This study empirically investigates the determinants of preventive service uptake among adults in the North West geopolitical zone, specifically in Kano State. Methods: A convergent mixed-methods design was employed. A cross-sectional survey enrolled 400 adults through multistage stratified sampling, and 24 purposively selected participants engaged in four focus group discussions. Logistic regression and thematic analysis were used for quantitative and qualitative data respectively. Results: Health insurance coverage, perceived susceptibility to non-communicable diseases, and prior healthcare provider recommendation were the strongest predictors of preventive service uptake. Qualitative findings revealed fatalistic health beliefs, cultural gender norms restricting female healthcare autonomy, and lack of awareness of available services as key barriers. Conclusion: Preventive service uptake in Kano State is shaped by interacting individual, sociocultural, and health system factors. Family medicine programmes should integrate preventive counselling into all routine consultations and leverage community-based platforms, including mosques, to reach underserved adults. Keywords: non-communicable disease, preventive services, uptake, Kano State, mixed methods