Onyetulem, Daniel U. S.2026-05-102026-05-102026-03Onyetulem, Daniel U. S. (2026). Utilization of healthcare facilities among selected communities in Rivers State, Nigeria [Unpublished Master's Thesis]. Federal University of Technology, Owerri, Nigeriahttps://repository.futo.edu.ng/handle/20.500.14562/2730This thesis is for the award of Master of Public Health (MPH) in Environmental Health and SafetyThis study examined the utilization of healthcare facilities in selected rural communities of Rivers State, Nigeria, with emphasis on patterns of use, determinants of underutilization, and the influence of socioeconomic factors. A cross-sectional descriptive design was adopted. Data were collected using structured questionnaires administered to 400 respondents across 10 Local Government Areas, of which 366 valid responses (91.5%) were analyzed using descriptive and inferential statistics. Results revealed that alternative medical centres were the most commonly utilized first point of care (35.2%), followed by patent medicine stores (27.9%), while only 12.3% and 7.6% of respondents patronized basic health centres and primary health care centres, respectively. A substantial proportion of respondents reported underutilization of modern health facilities to a very large (28%) and large extent (30%). Key reasons for non-utilization included unkempt facility environments (52.9%), lack of equipment and laboratory services (50.3%), poor staff–patient relationships (39.5%), and absenteeism of doctors (35.7%). Poverty emerged as the most significant barrier to utilization (98%), followed by high cost of modern healthcare services (90%). Nearly half of the respondents (49%) earned between ₦200,001 and ₦300,000 per annum, while 38% earned below ₦200,000, underscoring the role of low income in healthcare decisions. Statistical analysis demonstrated a strong positive relationship between underutilization of health facilities and poor health status (r = 0.98), as well as between low income and underutilization (r = .96). The study concludes that underutilization of modern healthcare facilities in rural Rivers State is driven largely by economic constraints and systemic deficiencies. Strengthening primary healthcare services through improved infrastructure, staffing, affordability, and service quality is essential to enhance utilization and health outcomes.enAttribution-NonCommercial-ShareAlike 4.0 InternationalUtilizationhealthcare facilitiescommunitiesRivers StateNigeriaDepartment of Public HealthMaster’s Thesis