Urbanization is the movement of people from rural areas and hinterlands to cities and the steady increase in the proportion of urban residents (Eckert and Kohler, 2014, Adewoyin, Chukwu and Sanni, 2018). The proportion of people living in cities around the world has steadily increased from 13% in 1900 to 29% in 1950 to 49% in 2005, and by 2030, 60% of the population will be urban residents. (Aliyu et al., 2017, Aliyu and Amadou, 2017). This trend reflects the growth in urban population from 220 million in 1900 to 732 million in 1950. Over time, urban areas have served as global hubs of industry, commerce, and economic growth. If managed correctly, urban areas not only provide important opportunities for social and technological progress, but also facilitate the spread of information through cross-cultural exchange. They have served as centers of political activity, legal frameworks, effective government, employment, and social and physical infrastructure facilities such as roads, water pipes, hospitals, and medical centers. In Nigeria, there is a difference of more than 5% between the urbanization rate and the natural population growth rate. This is due to the idea that urban areas offer better opportunities for health services, education, work, and research, acting as a “pull” factor. Research shows that compared to urban communities, rural areas experience worse health outcomes, including issues such as mental health, substance abuse, physical health, and sexual health. For example, the study of Liu et al. (2018) found that factors such as severity of illness, availability of medicines, medical staff, and transportation accessibility all play important roles when selecting health facilities in urban areas of China. We have proven that we can accomplish this. However, proportionately strengthening primary care may be beneficial in promoting primary care utilization in rural areas. Oladapo et al.'s study was conducted using a descriptive, cross-sectional, random sample survey. (2010) advocated better health services for the management of cardiovascular disease CVD and other chronic non-communicable diseases. This is because it shows that cardiometabolic risk factors are significantly prevalent in rural areas of Nigeria. This was reiterated in the study of Nwankwo et al. (2007). This study found that rural areas in Nigeria have a higher prevalence of cardiovascular disease risk factors compared to metropolitan areas of Nigeria, and preventive and interventional measures to reduce the burden of these risk factors. The necessity of
Considering this, Sivakumar et al. (2020) study found that all types of health facilities are not available in rural areas of India. Additionally, Mariolis et al. (2008) found that the three most common reasons people choose urban health centers are short waiting times, proximity to residence, and satisfaction with the services provided on previous visits. I discovered. Erlyana, Damrongplasit, and Melnick (2011) also show that urban residents consider both distance and fee-for-service costs when deciding which health care provider to see. I did. Using bivariate analysis and logistic regression, a study by Lutfiyya et al. (2013) found that among adults aged 40 and older living in rural areas of the United States, the prevalence of arthritis and other health care deficiencies among patients with arthritis was high. revealed to be expensive. This study showed that many individuals with arthritis experience a lack of health care services, and rural residents experience a lack of health care services. They are at greater risk compared to urban areas. A study by Banerjee (2021) found that rural-urban inequality and lack of health infrastructure contributed to a 7 percentage point higher healthcare utilization rate among older people in urban compared to rural India. I discovered that there is. A study by Thakur, Banerjee, and Nikumb (2013) found that rural areas and marginalized populations have unmet health requirements such as untreated cataracts, uncontrolled hypertension, uncorrected hearing loss, and smoking. It turns out that there are many. In poor countries, health interventions are needed and prevention programs, such as efforts to help older people quit smoking, should also be prioritized.
In a cross-sectional study, Miao et al. (2021) found that older adults living in remote communities have high demands for chronic disease management as a result of low motivation and lack of local crisis response personnel. . Rural residents are less sensitive to medical costs, but more sensitive to non-medical costs determined by travel distance. Effiong et al. (2021) demonstrated that urbanization has a negative and significant impact on mortality, while it has a positive and significant impact on life expectancy. Nnadi and Ezeh's (2023) study highlighted that older people experience problems such as loneliness, isolation, and abandonment in rural health systems, while Mbam et al. He emphasized the importance of introducing efficient government policy interventions for the training of gerontology professionals to support the elderly in Nigeria. Ogidigo et al. (2023) found that geographic disparities and structural inequalities in rural Nigeria contribute to poor recognition, diagnosis, and care of older adults with Alzheimer's disease and related dementias (ADRD).
Furthermore, there has been a series of debates about access to healthcare by citizens of different countries, and despite the increase in the number of private healthcare facilities, the provision of quality healthcare facilities and access to healthcare has been lost. Research shows that there remains a concern that Therefore, there is a need to provide and/or equip rural areas with health centers to reduce the impact of traveling long distances to access health facilities in Nigeria (Mbam and Emma-Echiegu, 2018; Olasehinde et al., 2023). A thorough study on healthcare access found that 43.3% of the world's population (or 3.16 billion people) cannot walk to a healthcare facility within an hour, and 8.9% of the population (or 646 million people) cannot walk to a healthcare facility within an hour. I realized I couldn't get to a medical facility within an hour, even if I walked. They have access to motorized transportation (Weiss et al., 2020). According to Khakh and Fast (2017), urban environments need to be improved to increase access to healthcare for all residents, and Loera (2008) argues that telemedicine can improve access to healthcare services for both users and residents. We proposed that it could have a positive impact on enhancing access. provider. Access to health care is even more needed in rural areas, where the majority of older people live who are not part of the workforce needed in urban areas. According to Ramanadhan et al. (2022), the provision of services for tobacco control in India is often influenced by socio-demographic characteristics. Nevertheless, guidance is often lacking in systems with few resources. According to Santamaría-Ulloa et al. (2019), achieving the Sustainable Development Goals requires universal access to health services, regardless of location.
In Nigeria, accessibility and utilization of health facilities go hand in hand as most community health initiatives focus on raising awareness of the importance of utilizing the delivery services provided by health facilities. (Arogundade et al., 2021). According to Chukwani et al. (2005), currently available facilities do not provide all expected services, are not well maintained, and lack sufficient qualified health workers. And we don't have a budget. According to a poll, the two biggest challenges facing public health facilities in Nigeria are low PHC utilization and substandard service delivery. Additionally, a study by Ekenna et al. (2020) demonstrated that at least 50% of the recommended infrastructure/basic services and health worker presence are related to the urban location of the facility. More specifically, Onwujekwe et al. (2021) highlighted key ideas that support social inclusion and equitable access to health services, with the provision of functioning and upgraded health infrastructure being of paramount importance. Other issues with the health facilities available in Nigeria include lack of skills, substandard care, questionable perception, and tremendous difficulties in managing a diverse health system (Onwujekwe et al., 2022) . According to Kabir (2022), more than 55% of women had access to media, but only 26.9% of women used mobile to receive health services. Media access has a strong correlation with prenatal and postnatal care. Chun and Nam (2019) proposed that patient welfare should be given top priority to promote social equity. Research on access to health care facilities among older adults has primarily focused on the barriers that prevent access to quality health care facilities. Studies such as those by Akanji et al. (2002) advise that more attention needs to be paid to the health of older people through better budget allocation, changes in training curricula for all health staff cadres, including geriatrics, and better use of existing health resources. (Correia et al., 2022).
Khakh and Fast (2017) found that healthcare access for older adults is lacking in four dimensions: availability, appropriateness, familiarity, and affordability. The main obstacles are: The current financial situation and pension cuts. Inadequate provision and increased user fees in primary care. Shortage of long-term care facilities. Increased out-of-pocket costs. and poor and unadapted housing conditions for the elderly. Other studies have shown that there is a gap between older people and younger people in health care services. recommended to use. Through the telephone internet, you will be provided with enough information to help you make informed decisions about your health. The use of information through computers and the Internet appears to have expanded in recent years (Lorence and Park, 2006; Lothian and Philp, 2001). Spatial optimization of residential care facility locations is urgently needed to ensure equitable access to residential care resources among the elderly (Tao et al., 2014). According to (Thorpe et al., 2011), older people who live in rural areas and do not receive a pension are more likely to face barriers to accessing health facilities. This is why Wu et al. (2002) in the areas of services for older people, including the adequacy of health services, accessibility, affordability, coordination of health and social care, quality of long-term care, adverse perceptions, and training requirements. He said improvements were needed. .
The majority of studies indicate that older people living in rural areas have difficulty accessing health care facilities, as functional public health facilities are mostly concentrated in urban areas. Although the issue of healthcare access for elderly patients has been widely discussed in previous studies, only a limited number of studies have recognized urbanization as a barrier to accessing healthcare services, which is the focus of this study. It is.