Factors Influencing Information and Accessibility of Tuberculosis Prevention Services Among Nomadic Fulani and Host Communities, Nigeria

Authors

Abolaji Azeez, Fairfield School of Business, Birmingham, EnglandFollow
Kabiru Salami, University of Ibadan, Ibadan, NigeriaFollow

ORCID

0000-0002-7449-9778

Abstract

Despite efforts to curtail tuberculosis (TB) in Nigeria, the country has not yet attained the global target. This study explored the dynamics of access to information about TB control and prevention among nomadic Fulani and their host communities. We used a mixed-methods approach and multistage sampling technique to recruit 812 respondents for the survey, and we conducted 18 in-depth interviews across six local government areas. The results indicated generally low access to TB information and services, with only 2% of nomadic Fulani engaging in TB prevention activities compared to 6.7% of host community members. Yoruba respondents had significantly higher odds of relying on television (odds ratio [OR] = 1.763, p = 0.003) and health workers (OR = 0.643, p = 0.036) for TB information. Marital status influenced access, with married individuals more likely to rely on billboards (OR = 15.290, p < 0.05) but less likely to participate in free counseling (b = –16.256, p < 0.05). Ethnicity significantly impacted reliance on sources such as religious leaders (p = 0.049) and television (p = 0.020). Qualitative analysis highlighted additional barriers for nomadic Fulani, such as distrust of health workers and geographic isolation, limiting their access to TB education and services. Furthermore, nomadic Fulani reported lower access to free TB counseling (15.9%), education (14.5%), and medicine (5.5%). Equitable access to TB control information and services remains unmet, with nomadic Fulani disproportionately underserved. Therefore, we recommend culturally sensitive, community-based interventions. These include leveraging trusted religious leaders, recruiting community health volunteers, and employing targeted media campaigns. Addressing sociocultural barriers holistically will enhance TB control efforts and health outcomes for nomadic Fulani and host communities in Nigeria.