Barriers faced by sub-Saharan African consumers in accessing everyday healthcare: A four-stage consumption-journey approach

Purpose: The citizens of developing nations often make use of one or more formal or informal health service and they do so sequentially or concurrently. People in Africa face many barriers to accessing healthcare, with most research focusing on single components such as circumstances, illnesses or demographics. This study uses the lived experiences of healthcare seekers to build in integrated journey model.Method: Semi-structured interviews were conducted with 58 participants from five sub-Saharan countries (Nigeria, Mozambique, Kenya, Malawi, and Lesotho). In addition, 15 healthcare workers (doctors, nurses, and pharmacists) from the same countries were also interviewed. A qualitative analysis with a deductive approach was used to investigate the collected data.Results: The main findings of this study supported the use of medical pluralism, as well as the barriers of affordability (treatment, insurance and opportunity costs), availability (medicines, equipment, staff, and specialists), acceptability (wait time, hygiene, staff negligence, corruption, governance, commercialization and user attitude) and awareness. These barriers all had impacts on the prevention, information, action and reflection stages of the consumer journey.Conclusion: While healthcare delivery in Africa still falls far short of acceptable norms, this research provides a framework to understand decision-making and barriers to access.