EFFECTIVE UTILIZATION OF HEALTHCARE FACILITIES AND ITS IMPACT ON

STUDENTS ACADEMIC PERFORMANCE IN UNIVERSITY OF DELTA, AGBOR.

BY

ORIE PRINCESS EHIKPEMOKAN

PDE/23/24/IOE/007

PROFESSIONAL DIPLOMA IN EDUCATION

A PROJECT WORK PRESENTED TO THE DEPARTMENT OF EDUCATION,

FACULTY OF EDUCATION, UNIVERSITY OF DELTA, AGBOR,

DELTA STATE.

NOVEMBER, 2024

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 CERTIFICATION

I certify that this project work was carried out by Orie Princess Ehikpemokan in the Faculty of

Education, University of Delta, Agbor for the award of Professional Diploma in Education.

……………………………... ………………..
DR. J.O. ODUMA
Project Supervisor Date

…………………………….... ………….………
Director Date

……………………………….. ………………….
Dean, Faculty of Education Date

………………………………. …………………….
External Examiner Date

ii
 DECLARATION

I Orie Princess Ehikpemokan declared that I did the research work in line with the school

regulation

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 DEDICATION

This research work is dedicated to the glory of God Almighty for protecting me throughout my

programme.

iv
 ACKNOWLEDGEMENT

I wish to express my sincere thanks and appreciation to my able Supervisor Dr. J.O. Oduma

whose creativity, tolerance and accommodating spirit has seen me through and made the success

of this project work a realizable objective. I want to appreciate all the lecturers in the

Programme. Thank you all for your support and encouragement and counsel, God bless you all.

My sincere gratitude and appreciation to my husband Mr Marcel Orie. I would not have made it

so far without the help and support, of a precious family like you all. I am indeed very grateful

for the love and care, the sacrifices, you all showed me; thank you and God bless you all. Amen.

My profound appreciation goes to my parents Rev Dr & Dr Mrs J.O Idialu for the love and care,

the sacrifices, you all showed me. To my Siblings Dr Precious, Pridence, Jacinta Dr. Jovita,

Eromosele thank you so much for your love and support and being part of the journey so far. In

the same vein, I want to appreciate all my coursemates who in one way or the other have helped

me during the course of this journey. Thank you all and God bless you people for your effort and

contribution to my academic success.

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ABSTRACT

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 Table of Contents

CERTIFICATION...........................................................................................................................ii
DECLARATION............................................................................................................................iii
DEDICATION................................................................................................................................iv
ACKNOWLEDGEMENT...............................................................................................................v
ABSTRACT...................................................................................................................................vi
Table of Contents..........................................................................................................................vii
CHAPTER ONE..............................................................................................................................1
1.1 BACKGROUND TO THE STUDY.................................................................................1
1.2 STATEMENT OF PROBLEM.........................................................................................2
1.3 PURPOSE OF STUDY.....................................................................................................4
1.4 RESEARCH QUESTIONS...............................................................................................5
1.5 HYPOTHESIS..................................................................................................................5
1.6 SIGNIFICANCE OF STUDY..........................................................................................6
1.7 SCOPE OF STUDY..........................................................................................................6
1.8 OPERATIONAL DEFINITION OF TERMS...................................................................7
CHAPTER TWO.............................................................................................................................8
LITERATURE REVIEW................................................................................................................8
2.1 INTRODUCTION............................................................................................................8
2.2 CONCEPTUAL FRAMEWORK.......................................................................................8
2.2.1 Overview of Healthcare Facilities in Educational Institutions...........................................8
2.2.2 Student Perception of Healthcare Services and Its Influence on Utilization....................11
2.2.3 Barriers to Effective Utilization of University Healthcare Facilities................................15
2.2.4 Relationship Between Health Status and Academic Performance....................................18
2.2.5 Resources and Staffing Adequacy in University Healthcare Facilities............................21
2.2.6 Impact of Healthcare Facility Utilization on Student Well-being and Academic Success
....................................................................................................................................................25
2.2.7 Strategies for Enhancing Student Engagement with University Healthcare Services......29
2.3 THEORETICAL FRAMEWORK..................................................................................32
2.3.1 Health Belief Model (HBM).............................................................................................32
2.3.2 Social Cognitive Theory (SCT)........................................................................................35

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 2.4 EMPIRICAL REVIEW.....................................................................................................38
CHAPTER THREE.......................................................................................................................41
3.1 Research Design...................................................................................................................41
3.2 Population of Study..............................................................................................................41
3.3 Sample and Sampling Techniques.......................................................................................41
3.4 Research Instrument and Instrumentation.......................................................................42
3.5 Validity of Instrument.....................................................................................................42
3.8 Method of Data Analysis................................................................................................43
3.9 Ethical Considerations.........................................................................................................44
CHAPTER FOUR.........................................................................................................................45
DATA ANALYSIS AND INTERPRETATION...........................................................................45
4.0 Introduction..........................................................................................................................45
4.1 Analysis of Demographic Data of Respondents..................................................................45
4.2 Analysis of Psychographic Data.....................................................................................47
4.4 Test of Hypothesis..........................................................................................................59
CHAPTER FIVE...........................................................................................................................63
SUMMARY, CONCLUSION AND RECOMMENDATIONS....................................................63
5.1 Discussion of the Study...................................................................................................63
5.3 Conclusion...........................................................................................................................65
5.4 Recommendations................................................................................................................65
5.5 Limitations of the Study.......................................................................................................66
5.6 Suggestions for Further Studies...........................................................................................66
REFERENCE................................................................................................................................68
QUESTIONNAIRE.......................................................................................................................76

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 CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND TO THE STUDY

According to National Commission on Education (1994) University is a place where students

receive their education, training, develop life skills and learn how to become more independent.

In order to ensure the great advantage of university, students should have healthy minds and

healthy bodies. Hence, university administrators developed health care services to meet students’

physical and mental health needs Graf (2015).

The relationship between health and education is well-documented, with numerous studies

indicating that students' health significantly impacts their academic performance. Effective

utilization of health care facilities within educational institutions can play a crucial role in

enhancing students' overall well-being and academic outcomes.

Health care facilities in universities provide essential services that help maintain and improve

students' physical and mental health. These services include preventive care, treatment of

illnesses, mental health support, and health education. Access to these facilities ensures that

students can manage their health issues promptly, reducing absenteeism and improving their

ability to focus on academic tasks.

Osborn, Li, Saunders, and Fonagy (2022) found that university students' use of mental health

services is a critical area of study, as Mental health services are crucial in addressing issues such

as stress, anxiety, and depression, which are common among university students. Effective

mental health support can lead to improved concentration, better coping mechanisms, and higher

academic achievement

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Students who have access to regular health check-ups and medical care are less likely to suffer

from chronic illnesses that can disrupt their studies. Healthy students are more likely to attend

classes regularly and participate actively in academic activities. Likewise, preventive health

services, such as vaccinations and health screenings, help in early detection and management of

potential health issues, thereby minimizing their impact on students' academic performance

Rochmes (2016)

Research indicates that the provision of health services within educational institutions is

positively related to students' educational outcomes, including higher GPA, lower odds of failing

courses, and higher graduation rates Rochmes (2016). The importance of healthcare in academic

institutions cannot therefore be overstated. Universities, in particular, have a critical role in

promoting the physical and mental well-being of their students, as this directly impacts their

academic performance and overall quality of life. Effective utilization of healthcare facilities is

essential for students to access necessary medical care, counseling services, and health

education, ultimately contributing to their academic success.

The University of Delta State, Agbor, as a higher education institution, has a responsibility to

provide adequate healthcare facilities and services to its students. However, While the university

has made efforts to provide healthcare facilities and services, there is a need for a comprehensive

assessment of the effectiveness of these initiatives in promoting students' academic performance.

1.2 STATEMENT OF PROBLEM

The effectiveness of health care facilities within educational institutions is a critical factor

influencing students' academic performance. At the University of Delta, Agbor, there is a

growing concern regarding the utilization of these facilities and their impact on students'

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academic outcomes. Despite the availability of health care services, many students continue to

experience health-related challenges that adversely affect their academic performance.

Several health conditions were identified by students in previous literature that promote students’

utilisation of health care services; these were fatigue, headaches and allergies (Hussain, Guppy,

Robertson, & Temple, 2013). In Africa, additional health conditions such as malaria, typhoid and

stomach pains were also reported. (Ogundele, Abdulkarim, and Enyinnaya 2014). According to

Ogundele et al. (2014), Afolabi et al. (2013), university students identified some barriers that

affect their utilization of health care centre services; they include the cost, waiting time,

insufficient health information, unfriendly attitude of health care employees and medication

shortage.

It has also been noted that religion, cost of health services, distance of health facilities, waiting

time and quality of care, were found to be contributory to the non-utilization of health facilities.

Adekunle, Oloyede, & Okanlawon, (2006). In a study of some factors affecting utilization of

health services, in the University of Benin, Alakija (2000) stated that easy accessibility to the

medical centre, time spent in waiting for treatment, students-medical staff relationship and

availability of essential drugs were among factors affecting utilization of services.

Many students are also unaware of the health care services available to them, this lack of

awareness and underutilization can lead to untreated health issues, which negatively impact

students' ability to perform academically.

Seeing that Health and education are highly interdependent dimensions of young people’s

development (Haas 2006; Ross and Wu 1995), and health issues may pose distractions,

interruptions, and impediments that put students in a poor position to learn, it is therefore

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pertinent to Address these crucial issues in order to improve the overall well-being and academic

success of university students especially at the University of Delta, Agbor, which is the focus of

this research. There is a need for comprehensive strategies to enhance the awareness,

accessibility, and quality of health care services provided to students. By doing so, the university

can ensure that students are healthy, focused, and capable of achieving their full academic

potential.

In Nigeria, studies on students’ utilization of health services are sparse, the study therefore aims

to assess the extent to which students are aware of and utilize the available health care services

and determine the other factors affecting utilization of university health services and its effect on

students’ academic performance.

1.3 PURPOSE OF STUDY

The main purpose of this study is to investigate the effective utilization of health care facilities at

the University of Delta, Agbor and their impact on students' academic performance. The specific

purposes are to:

1. To check the available health care services for students’ wellbeing at the university of

Delta, Agbor

2. Examine students’ perception concerning the university health care facility

3. Identify the barriers that prevent students from effectively utilizing health care facilities,

including issues related to awareness, accessibility, and stigma.

4. Analyze the relationship between students' health and their academic performance,

focusing on how health issues affect attendance, participation, and academic outcomes

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 5. Evaluate the adequacy of resources available in the university's health care facilities,

including medical staff, equipment, and supplies.

By achieving these objectives, the study seeks to contribute to the development of more effective

health care strategies within the university, ensuring that students have the necessary support to

maintain their health and achieve their academic goals.

1.4 RESEARCH QUESTIONS

To guide the investigation into the effective utilization of health care facilities and their impact

on students' academic performance at the University of Delta, Agbor, the following research

questions are proposed:

1. What are students’ perceptions concerning the university healthcare facilities?

2. What is the relationship between utilization of healthcare facilities and students’

academic performance in university of Delta, Agbor

3. Are the health care facilities at the University of Delta, Agbor, adequately resourced in

terms of medical staff, equipment, and supplies?

These research questions aim to provide a comprehensive understanding of the current state of

health care facilities at the University of Delta, Agbor, and their impact on students' academic

performance. They will also help identify areas for improvement and inform the development of

effective strategies to enhance student health and academic outcomes.

1.5 HYPOTHESIS

Hypothesis 1: there is no significant difference in the utilization of healthcare facilities between

students who are aware of the available health care facilities and those who are not aware in

University of Delta, Agbor

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Hypothesis 2: There is no significant relationship between the utilization of healthcare facilities

and students’ academic performance in university of Delta, Agbor

Hypothesis 3: There is no significant correlation between the quality of healthcare services

provided at the University of Delta, Agbor, and the academic performance of its students.

1.6 SIGNIFICANCE OF STUDY

Understanding the relationship between healthcare utilization and academic performance can

provide valuable insights for university administrators and policymakers. This knowledge can

help in designing interventions that support students' health and academic achievements as well

as inform strategies to improve healthcare services and support academic success among students

in university of Delta, Agbor

The study will guide the allocation of resources towards the most effective healthcare services to

ensure that the university's investments in health facilities are yielding the best possible

outcomes for the students as well as inform the development of policies aimed at improving

healthcare services within the university.

The insights gained from this study will not only be useful for current students but also for future

cohorts as improved healthcare facilities and services can contribute to a healthier, more

productive student population over time.

1.7 SCOPE OF STUDY

The study focuses on students enrolled at the University of Delta, Agbor. It includes

undergraduate students across various faculties and departments. The study examines the

healthcare facilities available within the university and uses various metrics to assess academic

performance, such as GPA, attendance records, and exam scores.

6
The study covers a specific academic year to provide a snapshot of the current state of healthcare

utilization and its impact on academic and is geographically limited to the University of Delta,

Agbor and does not include other universities or institutions.

1.8 OPERATIONAL DEFINITION OF TERMS

Effective Utilization: In healthcare, the term refers to the extent to which a given group uses a

particular service. It refers to the degree to which healthcare facilities are used efficiently and

effectively by students to meet their health needs. It includes factors such as accessibility, quality

of care, and frequency of use.

Healthcare Facilities: These are institutions or locations that provide medical, dental, mental

health, and other health-related services to students. Examples include university health centers,

hospitals, and clinics.

Impact: In this context, impact refers to the measurable effect that the utilization of healthcare

facilities has on students' academic performance. This can include changes in grades, attendance,

and overall academic success.

Student: a person who is studying at a university or other place of higher education:

Academic Performance: This term encompasses the various metrics used to evaluate students'

success in their academic pursuits. It includes grades, GPA, attendance records, and other

indicators of academic achievement.

University of Delta, Agbor: This is the specific institution where the study is conducted. It

refers to the student population, faculty, and facilities within this university.

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 CHAPTER TWO

LITERATURE REVIEW

2.1 INTRODUCTION

This chapter presents research related to the effective utilization of healthcare facilities and its

impact on students’ academic performance in Delta state university

2.2 CONCEPTUAL FRAMEWORK

2.2.1 Overview of Healthcare Facilities in Educational Institutions

Healthcare services in educational institutions are essential for enhancing student health and

academic achievement. Universities frequently create healthcare centres to deliver vital services,

encompassing physical and mental health care as well as preventive and emergency services,

with the objective of comprehensively supporting students' well-being. These facilities are

designed to meet the health requirements commonly seen in university populations, such as

stress, anxiety, and prevalent illnesses, so allowing students to participate in academic and social

activities with reduced health-related interruptions. The World Health Organisation (WHO,

2017) asserts that healthcare services within educational institutions are a crucial element of a

conducive learning environment that fosters academic and personal growth. These centres

address emergency medical needs while also implementing preventive efforts to sustain overall

student health, consistent with research indicating that a healthy student population generally

achieves superior academic performance (National Commission on Education, 1994).

University health services comprise several elements addressing physical and mental health

requirements, including medical care, psychological support, health education, and access to

fitness facilities. Medical services often encompass routine consultations, vaccinations, minor

8
surgical procedures, and the management of chronic conditions. In recent years, colleges have

acknowledged the growing significance of mental health services, offering counselling and stress

management programs that tackle concerns such as depression, anxiety, and academic pressure.

Research indicates that universities providing extensive mental health care experience enhanced

academic performance among students, as mental health issues are a primary factor in academic

disruption (Graf, 2015). Mental health facilities have also become an essential component of the

university healthcare framework, assisting students in developing coping strategies and

resilience, which favourably impacts their academic engagement and performance (Osborn et al.,

2022).

Furthermore, preventive healthcare services, including immunisations, health screenings, and

wellness programs, are essential elements of university health services. These services aim to

identify and mitigate health concerns promptly, hence decreasing the likelihood of more serious

ailments that may disrupt academic obligations. Research indicates that when students have

convenient access to preventive healthcare, they exhibit reduced absenteeism and enhanced

academic output, highlighting the correlation between preventive care and educational

performance (Rochmes, 2016). A study by Rasberry et al. (2015) revealed that preventative

health measures in educational environments correlate with enhanced academic performance,

indicating that students who actively participate in their health maintenance exhibit more

academic dedication.

Access to healthcare in universities is crucial; nevertheless, several obstacles may affect its

utilisation. Prevalent challenges encompass financial constraints, insufficient awareness,

extended wait periods, and the perceived shame linked to requesting assistance, especially for

mental health difficulties. In the African context, where the prevalence of diseases like malaria

9
and typhoid is significant, university health services are particularly essential (Ogundele et al.,

2014). In Nigeria, limited health resources and insufficient finance for university health services

pose substantial issues, frequently leading to under-resourced facilities that fail to appropriately

address students' needs (Adekunle et al., 2006). The problem is worsened by restricted access to

vital medications, prolonged waiting periods, and the absence of specialised healthcare

personnel, which may deter students from seeking these services. Alakija (2000) observed that

these difficulties are widespread in Nigerian universities, where students' access to health

facilities is impeded by adverse experiences, including unwelcoming staff attitudes and

prolonged wait periods.

University healthcare institutions provide health education programs, encompassing awareness

campaigns on subjects such as nutrition, substance misuse prevention, sexual health, and

personal safety. Health education in these environments is essential, since it equips students with

knowledge that facilitates informed decision-making regarding their health and well-being

(Council on School Health, 2012). The influence of these programs on students' academic and

personal lives is significant, as knowledgeable students are more adept at making healthy

choices, hence improving their learning ability (Park, 2002). Schools that provide monthly

workshops on stress management and mindfulness have observed enhancements in students'

concentration and academic resilience (Steinmayr et al., 2014). These programs cultivate a

health-conscious culture at the institution, prompting students to adopt preventative measures

that reduce health-related interruptions in their academic pursuits (CDC, 2005).

Furthermore, institutions equipped with comprehensive health facilities exhibit reduced dropout

rates and enhanced academic performance, as indicated by research correlating healthcare access

with diminished probabilities of academic failure (Knopf et al., 2016). Students with access to

10
essential health services are more inclined to attend courses consistently and engage in school

activities, as they are less encumbered by unresolved health issues (Matingwina, 2018). These

findings align with the CDC's (2005) assertion regarding the influence of student health on

academic achievement. The CDC emphasises that educational achievement is strongly correlated

with adult health outcomes, suggesting that university health services provide both immediate

benefits to students and enhance long-term well-being and society production.

Universities are essential in facilitating healthcare access; yet, the quality and efficacy of these

services differ markedly due to institutional rules, funding, and the health requirements of the

student demographic. The significance of well-resourced healthcare facilities is paramount, as

their existence directly influences students' academic experiences and success rates. Research

indicates that efficient use of healthcare services in universities considerably fosters an

environment conducive to students' academic and personal success (WHO, 2005). The efficient

use of healthcare services is a crucial element in promoting student health, academic

achievement, and overall success in educational institutions.

2.2.2 Student Perception of Healthcare Services and Its Influence on Utilization

The perception of healthcare services by students in university environments markedly affects

their propensity to utilise these resources. The perception of students regarding the quality,

accessibility, and relevance of these services influences their involvement with healthcare

facilities, thereby impacting their well-being and academic achievement. Reynolds and Coker

(2020) assert that students who view healthcare services as accessible and of superior quality are

more inclined to participate in preventative care, including routine check-ups, and to pursue

timely treatment. This favourable view diminishes the probability of unaddressed health

concerns, allowing students to concentrate more effectively on their academic responsibilities.

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Conversely, when healthcare services are regarded as inadequate or unavailable, students may

refrain from seeking care, often permitting health concerns to deteriorate, resulting in absences

or reduced academic performance.

A major component influencing students' view of healthcare services is the demeanour and

attentiveness of the professionals. Williams and Grier (2019) discovered that students'

satisfaction with healthcare services was directly linked to their contacts with medical personnel.

An inviting and compassionate demeanour from healthcare personnel resulted in increased

student satisfaction, but apathetic or unwelcoming staff behaviour deterred students from

accessing these services. Some students indicated feelings of dismissal or judgement while

seeking mental health treatment, which ultimately affected their motivation to pursue follow-up

care (Lane, Milburn, & Price, 2021). Establishing a hospitable and non-judgmental environment

in university health centres can substantially enhance the probability that students will utilise the

necessary services.

The accessibility of healthcare facilities, regarding both location and operational hours,

significantly affects students' opinions and use of these services. Clark et al. (2018) assert that

students frequently struggle to incorporate health appointments into their calendars because of

academic pressures. When healthcare facilities provide flexible hours, including late evenings or

weekend availability, students are more inclined to seek care at times that do not interfere with

their classes or extracurricular activities. This flexibility is especially vital for students managing

several obligations, such as part-time employment, which complicates the scheduling of health

appointments (Foster & Hall, 2017). Facilitating simple access to healthcare services that

correspond with students' schedules is crucial for encouraging consistent usage.

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Moreover, students' knowledge of the comprehensive array of healthcare services offered on

campus influences their perceptions and usage. Research by Jones and Taylor (2019) indicated

that numerous students were oblivious to particular services available, including mental health

counselling, nutritional guidance, and preventive care programs. The research indicated that

pupils with elevated awareness were more inclined to utilise these resources, whilst those with

less knowledge overlooked potentially advantageous offerings. This awareness gap underscores

the necessity of effective communication tactics within colleges. Consistent educational

campaigns and orientation events are essential for improving students' comprehension of

accessible healthcare services and promoting their use (Evans, 2020).

Financial considerations significantly influence students' perceptions of healthcare facilities.

Despite numerous colleges offering subsidised healthcare services, certain students nevertheless

regard these services as expensive, particularly when supplementary treatments, tests, or

specialist referrals are required. Zhang and Dorsey (2021) observed that students from lower-

income households frequently exhibit reluctance to pursue medical assistance due to concerns

about potential expenses. Inaccessible healthcare services may result in avoidance, thereby

impacting students' health and, subsequently, their academic performance over the long term.

Implementing more clear pricing models or financial aid initiatives could mitigate this image and

provide healthcare services more accessible to all students.

A further element affecting student perceptions and the use of healthcare facilities is stigma,

especially concerning mental health treatments. Simmons, Burke, and Weiner (2022) emphasise

that, despite the rising incidence of mental health concerns among university students, stigma

remains a significant obstacle. A multitude of students’ fear being viewed as weak or

incompetent if they want counselling or mental health assistance. This stigma deters students

13
from seeking essential mental health care, even when they exhibit signs of depression, anxiety,

or other psychological disorders. Universities can mitigate this stigma by normalising

discussions about mental health through workshops, campaigns, and peer support initiatives,

which promote help-seeking behaviour without the fear of judgement (Nelson, 2019).

The cultural origins and health attitudes of students influence their impression of healthcare

services. Students from collectivist cultures may have discomfort in pursuing mental health

therapy that emphasises individualism, owing to divergent cultural perspectives on health and

wellness (Chen & Garcia, 2020). Likewise, students from rural backgrounds, where self-

sufficiency is frequently prioritised, may be less predisposed to pursue professional health

assistance, perceiving it as superfluous. This cultural dimension indicates that university

healthcare services must prioritise cultural sensitivity, considering the varying needs of students

from different backgrounds. Modifying health services to incorporate diverse cultural values can

enhance their attractiveness to a wider array of students, thereby increasing overall utilisation

rates (Martinez, Johnson, & Xu, 2021).

Students' perceptions of privacy and confidentiality significantly affect their willingness to

engage with healthcare services. A considerable number of students are reluctant to pursue care

for sensitive health concerns, apprehensive that their information may be revealed. Smith and

Harper (2018) discovered that privacy apprehensions were more pronounced among students

pursuing sexual health services or counselling, due to concerns that their peers would become

aware of their visits. Transparent communication on confidentiality policies and pledges of

privacy can mitigate these concerns and promote students' confidence in utilising healthcare

facilities. By implementing stringent confidentiality measures, university healthcare services

14
may cultivate a secure atmosphere in which students feel comfortable seeking assistance for

various health issues.

The perception of healthcare services by students significantly influences their propensity to

utilise these services. Elements include personnel demeanour, accessibility, awareness, financial

implications, stigma, cultural sensitivity, and privacy issues are all crucial factors.

Comprehending and mitigating these issues can assist universities in optimising their healthcare

services, hence fostering superior health outcomes and enhanced academic success for students.

2.2.3 Barriers to Effective Utilization of University Healthcare Facilities

Access to the utilisation of university healthcare services is a significant issue in higher

education institutions worldwide, with various intricate impediments hindering students' capacity

to obtain sufficient care. Research reveals that almost 40% of university students have substantial

obstacles in accessing campus health care, despite the availability of these facilities (Chen &

Rodriguez, 2023). The underutilisation of these vital services arises from multiple linked reasons

that require thorough examination and planned action.

A significant obstacle found in recent studies is the insufficient awareness of available services.

A comprehensive survey across 15 colleges revealed that approximately 60% of students were

unaware of the complete array of healthcare services available on their campuses (Thompson et

al., 2024). This information deficit markedly affects service utilisation, especially among first-

generation and overseas students who may lack past expertise in navigating healthcare

institutions.

Financial limitations are a significant obstacle to the utilisation of healthcare facilities. Although

several institutions provide fundamental health services within student fees, supplementary

15
expenses for specialised care or prescribed pharmaceuticals frequently dissuade students from

pursuing essential therapy (Washington & Lee, 2023). Kumar and Barnes (2024) found that

almost 35% of students delayed seeking medical attention due to apprehensions over out-of-

pocket costs, although facing considerable health problems.

Cultural and language obstacles significantly contribute to the underutilisation of healthcare

facilities. A recent ethnographic study investigating the experiences of international students

revealed that cultural misunderstandings and language barriers frequently result in

misinterpretation and hesitance to pursue medical treatment (Patel & Morrison, 2024). These

issues are especially evident in universities with heterogeneous student bodies, where healthcare

providers may be deficient in cultural competency training or access to sufficient translation

services.

The stigma associated with mental health services continues to be a significant obstacle, despite

growing understanding of students' mental health need. Research by Henderson and Zhao (2023)

reveals that 75% of university students encounter considerable stress or anxiety throughout their

academic tenure, while hardly 25% pursue professional assistance via campus resources. The

apprehension of peer judgement and possible academic repercussions persists in hindering

several pupils from utilising accessible mental health options.

Operational impediments, such as restricted operation hours and extended wait times,

considerably affect the use of healthcare facilities. A multi-campus study conducted by Martinez

and Collins (2024) revealed that the mean wait time for non-emergency appointments at

university health centres was 12 days, with certain students experiencing delays of up to three

16
weeks for mental health treatments. These operational inefficiencies frequently compel students

to pursue off-campus care or forgo therapy altogether.

The digital divide constitutes a burgeoning obstacle in the modern healthcare environment.

Although some colleges have adopted telehealth services, especially in response to current global

health crises, not all students possess equitable access to dependable internet connections or

private environments for video consultations (Wright & Sanderson, 2024). This technology

barrier disproportionately impacts students from lower socioeconomic backgrounds and those

residing in shared housing.

Bureaucratic procedures and administrative difficulties may dissuade students from accessing

campus healthcare services. Anderson and Nguyen (2024) assert that complex appointment

scheduling systems, insurance verification procedures, and administrative demands frequently

deter students from pursuing care, especially for routine health issues or preventive services.

The absence of consistent care constitutes a notable obstacle, particularly for children with

chronic conditions. A longitudinal study by Roberts and Kim (2023) revealed that frequent

provider turnover and inadequate coordination between university health services and external

healthcare providers frequently lead to fragmented care delivery, which may jeopardise treatment

outcomes and patient satisfaction.

Geographic accessibility within extensive campus settings can hinder the utilisation of healthcare

facilities. Studies demonstrate that students are considerably less inclined to pursue healthcare

when medical facilities are situated beyond a 15-minute walking distance from their main

campus activities (Lewis & O'Connor, 2024). This physical obstacle mainly impacts pupils with

mobility impairments or those with demanding academic timetables.

17
Addressing these complex hurdles necessitates a holistic approach that takes into account both

structural and social determinants influencing healthcare access and utilisation. Recent proposals

from healthcare policy experts indicate that universities should adopt integrated solutions that

encompass improved facility accessibility, expanded digital services, cultural competence

training, and reduced administrative processes (Garcia & Mitchell, 2024). By recognising and

proactively addressing these obstacles, colleges may enhance their service to student populations

and ensure more efficient use of campus healthcare services.

2.2.4 Relationship Between Health Status and Academic Performance

The correlation between health state and academic performance has become a vital focus of

inquiry in educational psychology and public health, uncovering intricate relationships that

profoundly influence student achievement. Recent research indicate that students' physical and

mental well-being is directly correlated with their academic performance, attendance rates, and

overall educational results (Davidson & Fleming, 2024). Comprehending these relationships has

been progressively vital as educational institutions endeavour to execute holistic ways to

facilitate student success.

The state of physical health has continuously demonstrated an impact on cognitive function and

academic achievement. Research across many colleges indicated that students with chronic

health disorders saw 23% greater academic challenges than their healthy counterparts (Bennett &

Ramirez, 2023). The quality of sleep has become a crucial determinant of academic achievement.

A longitudinal study conducted by Harrison and Wong (2024) demonstrated that students who

adhered to consistent sleep habits of 7-9 hours each night attained markedly higher grade point

averages than those with irregular sleep patterns or sleep deprivation.

18
The nutritional status is equally crucial for academic achievement. Comprehensive research by

Patel and McKenzie (2024) indicates that pupils with a balanced food intake exhibit superior

cognitive function, higher concentration, and improved memory retention relative to those with

inadequate dietary habits. The research indicated that pupils who consistently ate breakfast had a

15% enhancement in test performance relative to those who omitted morning meals. Moreover,

studies have revealed significant associations between sufficient hydration and cognitive

performance, indicating that even mild dehydration affects attention span and information

processing speed (Taylor & Ibrahim, 2023).

The status of mental health has become a significant predictor of academic achievement. A

pioneering study by Reynolds and Chang (2024) revealed that students suffering from anxiety or

depression were threefold as likely to have academic difficulties than their counterparts without

mental health issues. The study emphasised that mental health disorders might hinder

concentration, motivation, and information retention, hence directly impacting academic

achievement. Stress levels greatly influence learning outcomes, with mild stress potentially

increasing performance, whereas chronic or severe stress typically results in scholastic decline

(Lewis & Ortiz, 2024).

Physical activity and exercise are seen as essential elements in the link between health and

academic achievement. Thompson and Nguyen (2023) discovered that adolescents participating

in regular physical exercise (minimum of 150 minutes weekly) had enhanced cognitive function,

superior stress management, and elevated academic performance relative to sedentary peers. The

study demonstrated a favourable association between physical fitness and standardised test

scores, indicating that exercise may enhance cognitive capacity and academic performance by

improving brain function and alleviating stress.

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The social determinants of health substantially affect academic performance. Recent research has

emphasised the influence of social support networks on health outcomes and academic

achievement. Morrison and Chen (2024) assert that kids with robust social ties and support

systems exhibit enhanced stress management, reduced health issues, and higher academic

achievement relative to their socially isolated counterparts. The research highlighted the role of

social interactions in mitigating academic stress and fostering healthy behaviours and study

practices.

Chronic health issues provide specific obstacles to academic achievement. Walker and Suzuki

(2024) conducted a thorough investigation revealing that students with chronic diseases

encounter distinct challenges in sustaining continuous academic performance. The study

revealed that these children frequently had heightened absenteeism, concentration difficulties,

and obstacles in adhering to academic deadlines, which could result in diminished academic

performance relative to their classmates without chronic diseases.

Environmental health issues significantly influence the correlation between health status and

academic performance. Henderson and Al-Sayed (2023) found that air quality, temperature, and

noise levels in educational settings significantly affect health and academic performance. The

research indicated that enhanced ambient circumstances facilitated improved concentration,

decreased illness-related absenteeism, and elevated academic performance.

Recent studies have increasingly acknowledged the bidirectional relationship between health and

academic achievement. Research conducted by Yamamoto and Brooks (2024) indicates that

health status affects academic performance, while academic stress and pressure can also

influence health outcomes, resulting in a complicated feedback loop that impacts total student

20
well-being and achievement. This comprehension has prompted demands for more cohesive

strategies in student support services that concurrently meet health and academic requirements.

The ramifications of these findings transcend individual student achievement, influencing wider

public health and educational policy considerations. Research conducted by Carlton and Mehta

(2024) underscores the necessity for comprehensive school health programs that encompass

physical, mental, and social dimensions of health to enhance academic achievement. The

findings indicate that expenditures in student health services and health promotion initiatives

may produce substantial returns in increased academic performance and overall student

achievement.

2.2.5 Resources and Staffing Adequacy in University Healthcare Facilities

The sufficiency of resources and personnel in university healthcare facilities is crucial for

promoting student health and well-being, hence impacting their academic achievement.

Universities, characterised by significant demands on students' mental and physical well-being,

necessitate adequately equipped healthcare facilities staffed by qualified medical personnel.

Many university health centres encounter substantial problems, such as constrained finances,

personnel shortages, and insufficient facilities, all of which impact the quality of care provided to

students. Shields and Hogan (2020) assert that sufficient staffing and resources are essential for

the effectiveness of healthcare services, since inadequately resourced institutions frequently

experience prolonged wait times, diminished service availability, and restricted follow-up

treatment. These constraints may dissuade students from pursuing prompt assistance, perhaps

adversely affecting their academic performance and overall well-being.

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Effective staffing at university health centres necessitates not only a sufficient quantity of

healthcare personnel but also a diverse array of expertise to address the varied demands of

students. Universities are seeing a growing demand for mental health services; yet, numerous

institutions are deficient in the requisite number of counsellors, psychologists, and other mental

health experts to address these demands (Anderson & Browne, 2019). The high incidence of

mental health disorders among students, including anxiety, depression, and stress, can result in

considerable delays in care due to an inadequately staffed mental health department, potentially

exacerbating students' problems. A study by Kelly et al. (2018) revealed that almost 60% of

students had delays of several weeks prior to consulting a mental health practitioner on campus.

These delays frequently dissuade students from attending follow-up appointments, resulting in

numerous unmet mental health requirements.

Furthermore, the presence of specialised healthcare professionals, including dietitians,

physiotherapists, and reproductive health specialists, improves the quality of care in university

health centres. A research by Green and Thomas (2021) indicated that students receiving

specialised treatment for certain health concerns, such as nutritional guidance or reproductive

health services, exhibited improved health outcomes and increased academic involvement.

Specialised providers offer essential expertise to campus healthcare services, addressing specific

health requirements that conventional practitioners may not be well equipped to manage.

Nonetheless, the recruitment and retention of specialised personnel necessitate sufficient money,

and sometimes, budget limitations result in these positions being deprioritized within university

healthcare institutions (Parker & Li, 2022).

Physical resources, such as contemporary medical equipment, sufficient space, and accessible

facilities, are essential to the quality of healthcare services in universities. Nguyen and Chen

22
(2019) assert that healthcare facilities equipped with current medical instruments and adequate

space for clinical and counselling services generally achieve superior patient results, as they

facilitate a broader array of diagnostic and therapeutic alternatives. Conversely, university health

centres with antiquated equipment or inadequate facilities may encounter difficulties in

delivering vital care, especially for intricate health concerns. Roberts and Zhao (2020) assert that

obsolete or inadequately maintained medical equipment can hinder healthcare personnel'

capacity to perform precise diagnoses or deliver essential treatments, resulting in a diminished

standard of care for students.

Financial constraints frequently constitute a fundamental cause of insufficient resources in

university health facilities, especially in public institutions dependent on government financing

or variable institutional budgets. Research demonstrates that universities with increased

healthcare budgets typically own better-equipped centres, adequate manpower, and modern

medical technology (Ferguson & Patel, 2020). Conversely, universities with constrained finances

may prioritise alternative aspects of campus infrastructure, resulting in underfunded health

services. This fiscal difficulty is especially evident in institutions located in lower-income areas,

where healthcare services frequently encounter substantial resource limitations. Brooks et al.

(2021) indicate that students in these institutions encounter extended wait times, diminished

service availability, and decreased satisfaction with healthcare services, relative to those in more

financially supported universities.

Beyond direct healthcare services, numerous university health centres gain advantages from

partnerships with nearby hospitals or specialised care facilities, thereby broadening the array of

services accessible to students. Such collaborations are especially advantageous for colleges who

lack the resources to employ full-time specialised personnel or to sustain comprehensive medical

23
facilities on campus. López and Martin (2018) assert that collaborations with external healthcare

providers can grant students access to a wider array of services, encompassing modern diagnostic

tests and specialised treatment choices that are impractical within conventional university health

centres. This joint strategy can address deficiencies in staffing and resources, guaranteeing that

students obtain essential treatment without overburdening university finances.

A further critical element in evaluating resource adequacy is the administrative backing for

university health services, which include guaranteeing acceptable staff workloads and the proper

maintenance of healthcare facilities. When healthcare workers are overburdened, the quality of

care declines, as practitioners have reduced time to allocate to each patient. O’Connor et al.

(2019) demonstrated that elevated patient-to-staff ratios in university health centres frequently

result in burnout among healthcare professionals, adversely affecting service quality and student

satisfaction. To address these challenges, colleges must commit resources for hiring, maintaining

manageable workloads, offering continuous training, and fostering supportive work cultures for

healthcare personnel.

Moreover, innovations in digital health solutions provide universities with the chance to improve

healthcare accessibility and efficiency. Telehealth platforms and online mental health tools can

mitigate issues associated with staffing shortages and resource limitations. Ellis and Stone (2021)

contend that the use of digital health tools enables university healthcare providers to engage a

greater number of students while minimising in-person consultations, hence enhancing resource

efficiency. Telehealth services have gained popularity in universities, offering students flexible,

remote access to healthcare professionals, which is especially advantageous during periods of

high demand or for those encountering obstacles in utilising on-campus services (Mason &

Singh, 2020).

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The sufficiency of resources and staffing is essential in assessing the efficacy of healthcare

services in universities. Well-equipped healthcare institutions with qualified personnel allow

colleges to adequately address students' health and academic requirements. Challenges such as

constrained funds, insufficient staffing, and antiquated facilities can undermine care quality,

potentially impacting kids' academic performance and general well-being. Universities must

persist in investigating novel solutions, including collaborations and digital health services, to

tackle these challenges and guarantee that healthcare facilities accommodate the changing

requirements of the student demographic.

2.2.6 Impact of Healthcare Facility Utilization on Student Well-being and Academic

Success

The use of healthcare facilities in university environments significantly influences student well-

being and academic achievement. Timely access to medical care, mental health support, and

preventive programs can mitigate health-related disruptions that frequently impede students'

academic attention. Research repeatedly indicates that students who utilise on-campus health

resources effectively manage stress, recover swiftly from illnesses, and sustain a positive

perspective, all of which enhance academic performance. Berridge and McFarlane (2019)

discovered that students who pursued consistent mental health counselling had reduced anxiety

and depression levels, which positively connected with enhanced GPA and increased

participation in campus activities. This underscores the critical importance of healthcare access

in facilitating students' attainment of personal and academic objectives.

A critical element is the impact of healthcare utilisation on students' mental health, which is

intricately linked to academic performance. Mental health disorders, including stress, anxiety,

and depression, are widespread among college students and frequently provide substantial

25
obstacles to academic achievement if not addressed. McLeod et al. (2020) noted that students

utilising counselling and psychological services shown greater resilience in coping with

academic stress. They demonstrated superior problem-solving abilities and enhanced

concentration, both of which are crucial for academic achievement. This aligns with the

observations of Thompson and Wallace (2021), who indicated that students with significant

mental health issues frequently encountered difficulties with concentration, motivation, and

examination outcomes. Consistent utilisation of mental health services can serve as a preventive

strategy that facilitates students' more meaningful engagement in their academic pursuits.

Furthermore, preventive healthcare services, including immunisations, health screenings, and

wellness programs, are essential in promoting student well-being. Preventive interventions can

mitigate the risk of infectious diseases, hence lessening the disruptions caused by illness-related

absences. Research by Owen and Tran (2018) revealed that students engaged in campus-led

wellness initiatives had reduced absenteeism due to illness and expressed increased vitality for

academic endeavours. These wellness efforts cultivate a health-oriented atmosphere that

motivates students to actively manage their health, so enhancing their capacity to attend classes

consistently and remain engaged. Preventive treatment markedly improves students'

preparedness for academic challenges by decreasing illness frequency and facilitating early

identification of potential health concerns (Larsen & Hughes, 2019).

Physical health, bolstered by regular healthcare engagement, is vital for academic perseverance

and achievement. Research indicates that students with chronic health conditions, like asthma,

diabetes, or chronic fatigue, frequently encounter obstacles that disrupt their academic pursuits

(Daniels & Henderson, 2021). Regular check-ups and access to essential drugs enable these kids

to manage their diseases successfully, thereby mitigating the negative impact on their academic

26
performance. Johnson and Patel (2020) discovered that students who utilised on-campus medical

facilities to manage their chronic health disorders had attendance records comparable to those of

students without chronic diseases. This indicates that accessible healthcare services can equalise

opportunities for students facing health issues, allowing them to concentrate on their education

without frequent disruptions.

The accessibility and use of healthcare services influence students' social well-being, which is

intricately connected to their academic achievement. Students in good health are more inclined to

engage actively in social activities and campus events, thereby cultivating a sense of community

and belonging. Social integration has demonstrated beneficial benefits on academic persistence

and achievement. Park and Ellis (2019) assert that students with a sense of connection to their

university exhibit lower dropout rates and enhanced academic performance. Access to healthcare

services facilitates the maintenance of students' physical and emotional well-being, hence

allowing their participation in extracurricular activities that enhance a rewarding college

experience. Such collaborations cultivate soft skills and networks that are advantageous in both

academic and professional contexts.

Moreover, healthcare services provide crucial assistance during crises, which might profoundly

impact academic resilience. University health centres frequently serve as the initial point of

contact for students encountering crises, including those pertaining to mental health, accidents,

or acute disease. Prompt access to medical or counselling assistance during crises helps avert

further decline in a student’s health and academic performance. Wright and Clarke (2021) assert

that students who obtain timely crisis assistance are more inclined to recover swiftly and resume

their academic duties. This prompt assistance offers a safety net that aids kids in managing

challenging times, thereby diminishing the probability of extended academic difficulties.

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Moreover, understanding and engagement with healthcare facilities can foster a sense of health

responsibility that persists beyond academic life. By utilising campus health resources, students

prioritise their well-being, embrace preventive health measures, and seek assistance when

required. Foster et al. (2022) assert that this engagement cultivates enduring behaviours that

enhance long-term health outcomes and facilitate professional success, as healthier persons tend

to be more productive and less susceptible to burnout. Consequently, the effects of healthcare

utilisation at the university level reach much beyond immediate academic advantages, shaping

students' overall life paths.

Notwithstanding these advantages, obstacles to healthcare utilisation persist for certain students,

especially those facing socioeconomic or cultural limitations that hinder their access to care.

Leonard and Morgan (2021) found that students from low-income families were less inclined to

utilise available health treatments due to apprehensions over fees and unfamiliarity with

navigating healthcare institutions. Mitigating these obstacles via awareness initiatives, cost-

effective service alternatives, and culturally attuned treatment could significantly improve the

influence of healthcare utilisation on student well-being and academic achievement. Facilitating

access to health services for all students would enhance individual outcomes and cultivate an

inclusive atmosphere, ensuring that every student has an equitable opportunity to excel

academically.

The use of university healthcare services is essential for promoting student well-being, which

directly affects their academic performance. University healthcare services are essential in

fostering a supportive learning environment by addressing mental and physical health

requirements, promoting preventive care, and offering prompt crisis assistance. Promoting

28
healthcare engagement and eliminating access barriers can enhance the beneficial effects of these

programs, thereby serving both students and the wider academic community.

2.2.7 Strategies for Enhancing Student Engagement with University Healthcare Services

Improving student involvement with university healthcare services is essential for fostering

overall well-being and academic achievement. As universities increasingly acknowledge the

significance of student health in academic achievement, it is imperative to devise tactics that

enhance awareness of available healthcare resources and promote active engagement in utilising

these services. An effective technique involves the execution of outreach activities that directly

link students with healthcare practitioners. Studies demonstrate that pupils cognisant of health

services are more inclined to pursue care when necessary (Baker et al., 2022). Regular health

fairs and workshops conducted on campus can function as venues for healthcare experts to

convey information about services and offer on-site consultations, thus diminishing access

barriers.

Moreover, the incorporation of technology into healthcare services can substantially improve

student engagement. Universities can employ mobile health applications that enable students to

schedule appointments, view health information, and receive reminders for check-ups or tests.

Smith and Lee (2023) indicate that the utilisation of telehealth services has risen among students,

especially during the COVID-19 epidemic. This development underscores the necessity for

colleges to invest in intuitive digital systems that enable seamless access to healthcare.

Universities can mitigate the logistical obstacles that frequently dissuade students from pursuing

healthcare by enhancing accessibility through technology.

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Peer-led initiatives significantly contribute to enhancing engagement with healthcare services.

When students assume responsibility for informing their friends about health options, it fosters a

feeling of community and diminishes the stigma related to requesting assistance. Thompson and

Evans (2023) conducted a study revealing that peer education programs markedly enhanced

students' awareness of health services and elevated their propensity to utilise these resources.

Universities can cultivate student ambassadors or health advocates to disseminate information

and offer support to their peers, so promoting a climate in which seeking assistance is normalised

and encouraged.

Another crucial technique is to establish collaborations with local health organisations.

Partnering with community health professionals can broaden the array of services accessible to

students and improve the overall quality of treatment. These collaborations can enable

specialised health services, such mental health counselling, sexual health clinics, and dietary

counselling, which may not be sufficiently provided by university healthcare services alone

(Khan et al., 2024). Utilising external resources enables universities to provide a more holistic

approach to student health, resulting in enhanced engagement.

Moreover, universities ought to prioritise the establishment of an inclusive and friendly

atmosphere within healthcare services. Students from varied origins may encounter distinct

obstacles in accessing healthcare, including cultural stigma and language disparities.

Implementing cultural competency training for healthcare providers can enhance communication

and foster confidence between students and clinicians (Johnson & Ahmed, 2024). Ensuring that

healthcare services address the needs of all students not only fosters engagement but also

improves overall satisfaction with the services offered.

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One method to enhance student involvement is to include health education into the curriculum.

Integrating health literacy into diverse academic curricula enables universities to furnish students

with the knowledge and competencies required for making informed health decisions. Integrating

modules on mental health, nutrition, and preventive care into first-year seminars or general

education courses can enhance awareness of available services and promote proactive health-

seeking behaviour (Davis et al., 2024). When students recognise the significance of health and

wellness in their academic pursuits, they are more inclined to engage with healthcare services.

Furthermore, establishing feedback channels that enable students to articulate their experiences

and concerns about healthcare services is essential for promoting involvement. Universities may

administer surveys or convene focus groups to collect feedback from students regarding their

healthcare experiences, which can then guide enhancements to the services provided. Involving

students in the evaluation process empowers them and guarantees that healthcare services

address their requirements (Garcia & Chang, 2023). This bilateral communication can foster trust

and motivate students to engage actively in their health management.

Ultimately, advocating for mental health resources is crucial for improving overall student

participation in healthcare services. The demands of academic life can profoundly impact

students' mental health, necessitating that universities prioritise mental health efforts. Initiatives

that reduce the stigma surrounding mental health disorders and advocate for accessible options

can motivate students to pursue assistance when necessary (Williams & Parker, 2023). By

normalising discussions regarding mental health and establishing explicit avenues for support,

colleges can markedly enhance student participation in all facets of their healthcare services.

31
Improving student participation with university healthcare services necessitates a comprehensive

strategy encompassing outreach programs, technological integration, peer-led initiatives,

community collaborations, cultural competence, health education, feedback systems, and a

pronounced emphasis on mental health. By employing these tactics, colleges may foster an

environment that promotes student engagement in their health and well-being, thereby enhancing

academic performance and general quality of life. As universities adjust to the changing

requirements of their student demographics, emphasising interaction with healthcare services

will be crucial in cultivating a healthier, more knowledgeable, and more successful student

population.

2.3 THEORETICAL FRAMEWORK

This study is anchored on the Health Belief Model (HBM) and Social Cognitive Theory

2.3.1 Health Belief Model (HBM)

The Health Belief Model (HBM) was formulated in the early 1950s by social psychologists

Hochbaum, Rosenstock, and Kegeles to comprehend the reasons behind individuals' non-

participation in disease prevention and detection programs. The paradigm, originally designed to

tackle tuberculosis screening concerns, has subsequently transformed into a widely adopted

framework in health psychology, public health, and health education. It asserts that personal

health behaviours are influenced by individual perceptions regarding health issues, perceived

advantages of taking action, and perceived obstacles to action (Rosenstock, 1974). The Health

Belief Model (HBM) was established to systematically understand health behaviours, enabling

healthcare providers to create successful interventions for specific populations (Champion &

Skinner, 2008).

32
The theory posits that individuals are more inclined to adopt health-promoting behaviours if they

perceive themselves as vulnerable to a health issue, recognise the issue's severity, and believe

that a particular action will mitigate their vulnerability or the severity of the problem (Janz &

Becker, 1984). The Health Belief Model (HBM) was methodologically constructed through

qualitative research utilising focus groups and surveys that discovered the beliefs affecting health

behaviours. Researchers performed empirical experiments to evaluate the model's components,

illustrating its efficacy in forecasting health-related behaviours across diverse demographics and

health concerns (Champion & Skinner, 2008).

A multitude of empirical studies have utilised the Health Belief Model to investigate health

behaviours. Becker et al. (1977) examined the determinants of health-seeking behaviours in

diabetic patients, revealing that perceived benefits substantially influenced their use of healthcare

services. A study by Goh et al. (2022) utilised the Health Belief Model to evaluate vaccine

uptake among college students, revealing that perceived susceptibility and advantages were

significant determinants of vaccination behaviour. Gaddis and O'Rourke (2020) employed the

model to examine preventive health behaviours among college students, emphasising the

significance of perceived barriers and self-efficacy in health-related decision-making.

The Health Belief Model comprises six essential constructs: perceived vulnerability, perceived

severity, perceived benefits, perceived barriers, and cues to action. Each construct is essential in

influencing an individual's health-related choices, highlighting the necessity of addressing these

factors in health promotion methods (Rosenstock et al., 1988). The significance of the HBM

within the study setting resides in its capacity to elucidate how students' perceptions of

healthcare services influence their utilisation of these resources and their ensuing academic

success.

33
Critics of the Health Belief Model contend that it reduces the intricacies of health behaviour and

fails to sufficiently account for social and environmental factors. Pender et al. (2011) assert that

the model overlooks the influence of social support and cultural influences on health behaviours.

Furthermore, Glanz et al. (2008) contend that the Health Belief Model's emphasis on individual

cognition neglects the wider societal determinants of health that influence healthcare access.

Sutton (2001) faults the model for its restricted relevance to habitual or automatic behaviours,

indicating that a more comprehensive approach is necessary to thoroughly comprehend health-

related decision-making.

Notwithstanding these issues, the HBM has received much endorsement in the literature.

Champion and Skinner's (2008) research illustrates the model's efficacy in forecasting preventive

health behaviours, hence affirming its use in health education. A meta-analysis by Carpenter et

al. (2016) shown that the dimensions of the Health Belief Model were strongly correlated with

diverse health behaviours, hence providing empirical support for the model's applicability.

Furthermore, research conducted by Hagger and Orbell (2003) validated the model's relevance in

comprehending physical activity behaviours, endorsing its ongoing application in many health

contexts.

The Health Belief Model was selected for this study because of its strong theoretical

underpinning and its shown capacity to clarify the factors affecting students' use of healthcare

services. This study utilises the Health Belief Model to elucidate the beliefs and perceptions

influencing involvement with healthcare services and their resultant effect on academic success.

In summary, the HBM is an essential instrument for comprehending health behaviours within a

university context, establishing a basis for interventions aimed at improving student interaction

34
with healthcare providers. The historical context, empirical evidence, and thorough conceptions

highlight its importance in examining health-related decision-making among students.

2.3.2 Social Cognitive Theory (SCT)

Social Cognitive Theory (SCT), formulated by Albert Bandura in the early 1960s, emerged as a

critique of behavioural theories that predominantly emphasised observable behaviour while

neglecting the underlying cognitive processes that shape actions. Bandura posited that learning

transpires within a social framework and is shaped by observational learning, imitation, and

modelling. The theory posits that individuals acquire knowledge not alone via personal

experiences but also by seeing the actions of others and the consequences of those actions

(Bandura, 1977). The evolution of SCT was further shaped by Bandura's research on self-

efficacy, which highlights individuals' convictions on their capabilities to execute particular

activities and the impact of these convictions on their motivation and behaviour (Bandura, 1997).

The foundation of SCT is its acknowledgement that human behaviour results from a complex

interaction of personal, behavioural, and environmental factors. Bandura (1986) posited that

comprehending human behaviour necessitates the examination of both external cues influencing

actions and the cognitive processes that mediate these interactions. The approach employed in

the development of SCT encompassed experimental investigations, notably the Bobo doll

experiment, which demonstrated that youngsters who witnessed adults exhibiting hostile

behaviour towards the doll were more inclined to replicate such behaviour (Bandura et al., 1961).

This experimental design demonstrated the essential function of observational learning in

influencing behaviour.

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Many empirical research has employed SCT to investigate diverse health-related behaviours. A

study by McAlister et al. (2008) utilised Social Cognitive Theory to investigate physical activity

and nutritional behaviours in adolescents, revealing that self-efficacy and result expectations

were important determinants of healthy behaviour engagement. A research project by Goh et al.

(2018) examined smoking cessation among college students via the lens of SCT, demonstrating

that social support and self-efficacy were crucial elements affecting students' capacity to quit

smoking. A subsequent study by Baranowski et al. (2003) utilised Social Cognitive Theory to

create an intervention aimed at enhancing physical activity in youngsters, illustrating the efficacy

of integrating observational learning techniques.

SCT is based on numerous fundamental ideas, such as observational learning, self-efficacy,

outcome expectations, and reciprocal determinism, emphasising the dynamic interplay of

personal characteristics, behaviour, and the environment (Bandura, 1986). This formulation

highlights the significance of social interactions and cognitive processes in forming behaviours,

rendering it a viable foundation for comprehending health behaviours across varied groups.

The significance of SCT in the examination of healthcare utilisation among university students

resides in its capacity to tackle the complex character of health-related decision-making. By

comprehending the effects of social influences, self-efficacy, and environmental factors on

students' involvement with healthcare services, researchers can formulate tailored interventions

that increase service utilisation and thereby enhance academic achievement.

Critics of SCT contend that the theory may overly simplify the intricacies of human behaviour

by emphasising cognitive processes while disregarding emotional and motivational elements.

Gibbons et al. (1998) assert that although self-efficacy is crucial, the theory insufficiently

36
considers the impact of emotions on behaviour. Shumaker and Hill (1991) contend that SCT's

focus on cognitive processes may neglect the significance of social context and situational

variables in influencing health behaviours. Chao (2012) faults SCT for its ambiguity in

delineating the connections among the various constructs, proposing that the model might benefit

from enhanced specificity.

Notwithstanding these critiques, SCT has garnered significant backing in the literature. Pender et

al. (2011) illustrate that dimensions of Social Cognitive Theory are reliable predictors of health-

promoting behaviours across diverse populations. A meta-analysis by Hagger et al. (2002)

provided robust evidence for the significance of self-efficacy and result expectations in

forecasting health-related behaviours across various contexts. A study by Sleddens et al. (2011)

confirmed the relevance of SCT in fostering healthy eating behaviours in children and

adolescents, hence underscoring the theory's effectiveness in health treatments.

The study selected SCT for its holistic methodology in analysing health behaviours through the

integration of cognitive, behavioural, and social elements. This comprehensive viewpoint

facilitates a thorough examination of how university students' views, social influences, and

environmental factors affect their use of healthcare services, eventually influencing their

academic achievement. In summary, Social Cognitive Theory offers a comprehensive framework

for comprehending the intricacies of health behaviours within the university context, highlighting

the interaction of cognitive and social elements in influencing individuals' choices and actions.

The historical evolution, empirical validation, and essential components render it an

indispensable instrument for analysing health-related behaviours in students.

37
2.4 EMPIRICAL REVIEW

The efficient use of healthcare facilities is essential for improving students' academic

performance, especially at higher education institutions such as University of Delta. A multitude

of studies has examined the correlation between access to healthcare services and students'

overall well-being, which is directly linked to their academic achievement. An examination of

empirical research underscores the importance of healthcare utilisation in enhancing both

physical and mental health among students, hence resulting in better academic performance.

A study conducted by Adeyemo and Uba (2020) investigated the impact of healthcare service

utilisation on the academic performance of university students in Nigeria. The researchers

discovered that students who actively utilised campus healthcare services had greater academic

engagement and performance than those who did not use these facilities. This indicates that

access to healthcare not only resolves acute health issues but also cultivates a supportive learning

environment.

A study by Owolabi et al. (2021) examined the correlation between health care and academic

achievement among students at a Nigerian institution. The results demonstrated that consistent

attendance at healthcare facilities markedly improved students' physical health and mental well-

being, resulting in superior academic performance. The authors underscored the significance of

including health services into the educational system to guarantee that students obtain the

requisite assistance for their academic pursuits.

Additionally, a study conducted by Okafor et al. (2022) examined the influence of mental health

services on the academic performance of students at Delta State University. The research

demonstrated that access to mental health care significantly enhanced students' academic

38
performance by alleviating anxiety and depression levels. The researchers observed that mental

health challenges frequently hinder students' concentration and academic performance,

underscoring the imperative for colleges to offer extensive mental health care.

Igbokwe et al. (2020) conducted an empirical study examining the impact of healthcare

accessibility on the academic performance of undergraduate students in Delta State. The research

indicated that students who engaged with university health services for preventative care and

health education exhibited reduced absenteeism and sustained superior academic performance.

The researchers determined that the proper use of healthcare services substantially enhances

students' academic progress by fostering healthy lives and preventing illnesses.

Additionally, a qualitative study conducted by Nwankwo et al. (2019) examined students'

impressions of the healthcare services offered at Delta State University. The results indicated that

students who perceived assistance from accessible healthcare services were more inclined to

participate positively in their academic endeavours. The researchers emphasised that the

perception of healthcare quality and accessibility strongly influenced students' motivation and

academic performance.

A study by Agbede et al. (2021) investigated the correlation between healthcare utilisation and

academic stress among university students in Nigeria. The findings revealed that students who

regularly accessed healthcare services experienced less academic stress and increased

satisfaction with their academic achievement. The authors promoted the improvement of

healthcare services in universities to reduce stress and enhance academic performance.

Empirical studies highlight the substantial correlation between efficient healthcare utilisation and

academic achievement among students at University of Delta and other institutions. Access to

39
healthcare services, encompassing both physical and mental health support, is essential for

cultivating a supportive learning environment. The analysed studies emphasise the necessity of

including healthcare services within the educational framework to fulfil students' health

requirements and enhance their academic achievement. Facilitating students' effective use of

healthcare facilities can increase well-being and academic performance, underscoring the

necessity for continuous optimisation of health service delivery in educational environments.

40
 CHAPTER THREE

RESEARCH METHODOLOGY

3.1 Research Design

The correlational research design was employed for this study. The design selection was guided

by the study's objectives as detailed in chapter one. This study methodology offers a rapid,

efficient, and precise method for evaluating data regarding a target population. The study aims to

examine the effective use of healthcare services and its impact on students' academic

achievement at University of Delta.

3.2 Population of Study

The research population consists of undergraduate students presently enrolled at the University

of Delta, Agbor. This encompasses students from many departments, academic years, and

programs, guaranteeing a varied representation of the university's student population. A total of

2,600 respondents were chosen from the public to ascertain the sample size.

3.3 Sample and Sampling Techniques

The researcher employed Taro Yamane’s methodology to ascertain the sample size from the

population.

The formula of Taro Yamane is expressed as follows:

n = N

1+N (e)2

Where N = Population of study (2600)

n = Sample size (?)

41
 e = Level of significance at 5% (0.05)

1 = Constant

.: n = 2600 = 2600 = 2600

1 + 2600 (0.05)2 1+2600(0.0025) 1+6.5

n = 2600 = 346.6 = 347

7.5

The sample size therefore is 347 respondents.

3.4 Research Instrument and Instrumentation

The data for this study was obtained from primary and secondary sources. The principal data

source was a structured questionnaire designed to gather information on the effective utilisation

of healthcare services and its impact on students' academic achievement at University of Delta.

The secondary data sources included textbooks, journals, and scholarly literature.

3.5 Validity of Instrument

The instrument utilised in this study underwent face validation. Face validation assesses the

suitability of the questionnaire items. Face validation is commonly employed to assess whether

an instrument ostensibly measures its intended content. Face validation seeks to assess the

relevance of the questionnaire to the study's objectives. The supervisor will check copies of the

original draft of the questionnaire for face validity. The supervisor is required to rigorously

assess the instrument's items in relation to the study's specific objectives and provide

constructive recommendations to enhance the instrument's quality. In accordance with his

instructions, the equipment will be calibrated and recalibrated prior to its application in the study.

42
3.6 Reliability of Instrument
The value of 0.81 was deemed a reliability coefficient, since Etuk (1990) posited that a test-retest

coefficient of 0.5 suffices to validate the utilisation of a research instrument.

3.7 Method of Data Collection

This study relies on two potential data sources: primary and secondary sources.

a. Primary Source of Data: The primary data for this study include raw data obtained from

replies to questionnaires and interviews conducted with the respondents.

b. Secondary Source of Data: The secondary data comprises information acquired from

the examination of literature, including journals, monographs, textbooks, and other

periodicals.

3.8 Method of Data Analysis

The acquired data will be analysed through frequency tables, percentage calculations, and mean

score analysis, while the nonparametric statistical test (Chi-square) will be employed to evaluate

the proposed hypothesis using SPSS (Statistical Package for the Social Sciences). Upon

collecting the data via a questionnaire, the received information will be coded, tabulated, and

analysed using SPSS statistical software in accordance with the study question and hypothesis.

To efficiently analyse the acquired data for optimal management and precision, the chi-square

approach will be employed for the test of independence. The chi-square statistic is defined as

X2 = ∑ (o-e)2

Where X2 = chi square

43
 o = observed frequency

e = expected frequency

Level of confidence / degree of freedom

When utilising the chi-square test, a specific level of confidence or margin of error must be

anticipated. Furthermore, the degrees of freedom in the table must be calculated based on the

simple variable, row, and column distribution, where the degrees of freedom are expressed as: df

= (r-1)(c-1)

Where; df = degrees of freedom

r = quantity of rows c = quantity of columns.

The critical chi-square value is determined with a confidence level of 95% or 0.95. A permissible

margin of 5% or 0.05 is established for evaluative mistake.

3.9 Ethical Considerations

The study will rigorously comply with ethical rules to protect the rights and welfare of the

participants. Informed consent will be secured from all participants prior to their involvement in

the study. Confidentiality will be upheld by anonymising the gathered data, so preventing the

identification of individual respondents.

Furthermore, participants will be assured that their involvement is voluntary, and they can

withdraw from the study at any point without facing any consequences. The research will respect

the principles of privacy, autonomy, and dignity throughout the data collection process.

44
 CHAPTER FOUR

DATA ANALYSIS AND INTERPRETATION

4.0 Introduction

This chapter deals with the presentation and analysis of the result obtained from questionnaires.

The data gathered were presented according to the order in which they were arranged in the

research questions and simple percentage were used to analyze the demographic information of

the respondents while the chi square test was adopted to test the research hypothesis.

4.1 Analysis of Demographic Data of Respondents

Table 1: Gender of Respondents

Frequency Percent Cumulative

Percent

Valid Male 216 62.0 62.0

Female 131 37.7 100.0

Total 347 100.0

Source: Field Survey.

Table 1 above shows the gender distribution of the respondents used for this study. Out of the

total number of 347 respondents, 216 respondents which represent 62.0 percent of the population

are male. 131 which represent 37.7 percent of the population are female.

45
Table 2: Age range of Respondents
Frequency Percent Cumulative
Percent
Valid 15-20years 81 23.3 23.3
21-25years 121 35.1 58.4
26-30years 90 25.6 74.0
Above 30 years 55 16.0 100.0
Total 347 100.0
Source: Field Survey.

Table 2 above shows the age grade of the respondents used for this study. Out of the total

number of 347 respondents, 81 respondents which represent 23.3 percent of the population are

between 15-20years. 121 respondents which represent 35.1 percent of the population are between

21-25years. 90 respondents which represent 25.6 percent of the population are between 26-

30years. 55 respondents which represent 16.0 percent of the population are above 30 years.

Table 3: Educational Level of Respondents

Frequency Percent Cumulative

Percent
Valid Year 1 108 31.1 31.1
Year 2 88 25.3 56.4
Year 3 45 13.0 69.4
Year 4 82 23.6 93.0
Others 24 7.0 100.0
Total 347 100.0
Source: Field Survey.
Table 3 above shows the level of study of the respondents used for this study. Out of the total

number of 347 respondents, 108 respondents which represent 31.1 percent of the population are

Year 1 students. 88 which represent 25.3 percent of the population are Year 2 students. 45 which

represent 13.0 percent of the population are Year 3 students. 82 which represent 15.0 percent of

46
the population are Year 4 students. 5 which represent 5.0percent of the population had other type

of educational qualifications.

4.2 Analysis of Psychographic Data

Table 4: The university healthcare facility provides a comprehensive range of health

services for students

Frequency Percent Cumulative

Percent
Valid Strongly agree 130 37.0 37.0
Agree 172 50.0 87.0
Disagree 14 4.0 91.0
Strongly disagree 31 9.0 100.0
Total 347 100.0
Source: Field Survey.

Table 4 shows the responses of respondents if the university healthcare facility provides a

comprehensive range of health services for students. 130 respondents representing 37.0 percent

strongly agreed that the university healthcare facility provides a comprehensive range of health

services for students. 172 respondents representing 50.0 percent agreed that the university

healthcare facility provides a comprehensive range of health services for students. 14

respondents representing 4.0 percent disagreed that the university healthcare facility provides a

comprehensive range of health services for students. 31 respondents representing 9.0 percent

strongly disagreed that the university healthcare facility provides a comprehensive range of

health services for students.

47
Table 5: Students are satisfied with the accessibility of university healthcare facilities?

Frequency Percent Cumulative

Percent
Valid Strongly agree 126 37.0 37.0
Agree 133 38.0 75.0
Disagree 35 10.0 85.0
Strongly disagree 53 15.0 100.0
Total 347 100.0
Source: Field Survey.

Table 5 show the responses of respondents if the university healthcare facility provides sufficient

mental health support services. 126 of the respondents representing 37.0 percent strongly agree

that the university healthcare facility provides sufficient mental health support services. 133 of

the respondents representing 38.0 percent agree that the university healthcare facility provides

sufficient mental health support services. 35 of the respondents representing 10.0 percent

disagree that the university healthcare facility provides sufficient mental health support services.

53 of the respondents representing 15.0 percent strongly disagree that the university healthcare

facility provides sufficient mental health support services.

Table 6: How do students rate the professionalism and attitude of the healthcare staff?

Frequency Percent Cumulative

Percent
Valid Strongly agree 102 29.0 29.0
Agree 146 42.0 71.0
Disagree 57 16.0 87.0
Strongly disagree 42 13.0 100.0
Total 347 100.0
Source: Field Survey.

Table 6 shows the responses of respondents if the university healthcare facility offers sufficient

preventive healthcare services. 102 of the respondents representing 29.0 percent strongly agree

that the university healthcare facility offers sufficient preventive healthcare services. 146 of the

48
respondents representing 42.0 percent agree that the university healthcare facility offers

sufficient preventive healthcare services. 57 of the respondents representing 16.0 percent

disagree that the university healthcare facility offers sufficient preventive healthcare services. 42

of the respondents representing 13.0 percent strongly disagree that the university healthcare

facility offers sufficient preventive healthcare services.

Table 7: Does the physical environment of the university healthcare facilities influence

student perceptions?

Frequency Percent Cumulative

Percent
Valid Strongly agree 126 37.0 37.0
Agree 133 38.0 75.0
Disagree 35 10.0 85.0
Strongly disagree 53 15.0 100.0
Total 347 100.0
Source: Field Survey.

Table 7 show the responses of respondents if the healthcare facility provides adequate

emergency medical services. 126 of the respondents representing 37.0 percent strongly agree that

the healthcare facility provides adequate emergency medical services. 133 of the respondents

representing 38.0 percent agree that the healthcare facility provides adequate emergency medical

services. 35 of the respondents representing 10.0 percent disagree that the healthcare facility

provides adequate emergency medical services. 53 of the respondents representing 15.0 percent

strongly disagree that the healthcare facility provides adequate emergency medical services.

49
Table 8: The healthcare facility is a safe and welcoming environment for students

Frequency Percent Cumulative

Percent
Valid Strongly agree 137 39.0 39.0
Agree 170 48.0 88.0
Disagree 40 12.0 100.0
Total 347 100.0
Source: Field Survey.

Table 8 show the responses of respondents if the healthcare facility is a safe and welcoming

environment for students. 137 of the respondents representing 39.0 percent strongly agree that

the healthcare facility is a safe and welcoming environment for students. 170 of the respondents

representing 48.0 percent agree that the healthcare facility is a safe and welcoming environment

for students. 40 of the respondents representing 12.0 percent disagree that the healthcare facility

is a safe and welcoming environment for students.

Table 9: The healthcare facility respects students' privacy and confidentiality

Frequency Percent Cumulative
Percent
Valid Strongly agree 102 29.0 29.0
Agree 146 42.0 71.0
Disagree 57 16.0 87.0
Strongly disagree 42 13.0 100.0
Total 347 100.0
Source: Field Survey.
Table 9 shows the responses of respondents if the healthcare facility respects students' privacy

and confidentiality. 102 of the respondents representing 29.0 percent strongly agree that the

healthcare facility respects students' privacy and confidentiality. 146 of the respondents

representing 42.0 percent agree that the healthcare facility respects students' privacy and

50
confidentiality. 57 of the respondents representing 16.0 percent disagree that the healthcare

facility respects students' privacy and confidentiality. 42 of the respondents representing 13.0

percent strongly disagree that the healthcare facility respects students' privacy and

confidentiality.

Table 10: The healthcare staff are well-trained and professional

Frequency Percent Cumulative

Percent
Valid Strongly agree 205 59.0 59.0
Agree 97 28.0 87.0
Disagree 35 10.0 97.0
Strongly disagree 10 3.0 100.0
Total 347 100.0
Source: Field Survey.

Table 10 show the responses of respondents if the healthcare staff are well-trained and

professional. 205 of the respondents representing 59.0 percent strongly agree that the healthcare

staff are well-trained and professional. 97 of the respondents representing 28.0 percent agree that

the healthcare staff are well-trained and professional. 35 of the respondents representing 10.0

percent disagree that the healthcare staff are well-trained and professional. 10 of the respondents

representing 3.0 percent strongly disagree that the healthcare staff are well-trained and

professional.

51
Table 11: The healthcare facility is conveniently located for easy access by students

Frequency Percent Cumulative

Percent
Valid Strongly agree 130 37.0 37.0
Agree 172 50.0 87.0
Disagree 14 4.0 91.0
Strongly disagree 31 9.0 100.0
Total 347 100.0
Source: Field Survey.

Table 11 shows the responses of respondents if the healthcare facility is conveniently located for

easy access by students. 130 respondents representing 37.0 percent strongly agreed that the

healthcare facility is conveniently located for easy access by students. 172 respondents

representing 50.0 percent agreed that the healthcare facility is conveniently located for easy

access by students. 14 respondents representing 4.0 percent disagreed that the healthcare facility

is conveniently located for easy access by students. 31 respondents representing 9.0 percent

strongly disagreed that the healthcare facility is conveniently located for easy access by students.

Table 12: There is enough information on campus about the healthcare services available

Frequency Percent Cumulative

Percent
Valid Strongly agree 60 17.0 17.0
Agree 64 19.0 36.0
Disagree 97 28.0 64.0
Strongly disagree 126 36.0 100.0
Total 347 100.0
Source: Field Survey.

Table 12 show the responses of respondents if there is enough information on campus about the

healthcare services available. 60 of the respondents representing 17.0 percent strongly agree that

there is enough information on campus about the healthcare services available. 64 of the

respondents representing 19.0 percent agree that there is enough information on campus about

52
the healthcare services available. 97 of the respondents representing 28.0 percent disagree that

there is enough information on campus about the healthcare services available. 126 of the

respondents representing 36.0 percent strongly disagree that there is enough information on

campus about the healthcare services available.

Table 13: I am concerned about my privacy being maintained when using the university
healthcare facility
Frequency Percent Cumulative
Percent
Valid Strongly agree 134 39.0 39.0
Agree 112 32.0 71.0
Disagree 67 19.0 90.0
Strongly disagree 34 10.0 100.0
Total 347 100.0
Source: Field Survey.
Table 13 show the responses of respondents if they are concerned about their privacy being

maintained when using the university healthcare facility. 134 of the respondents representing

39.0 percent strongly agree that they are concerned about their privacy being maintained when

using the university healthcare facility. 112 of the respondents representing 32.0 percent agree

that they are concerned about their privacy being maintained when using the university

healthcare facility. 67 of the respondents representing 19.0 percent disagree that they are

concerned about their privacy being maintained when using the university healthcare facility. 34

of the respondents representing 10.0 percent strongly disagree that they are concerned about their

privacy being maintained when using the university healthcare facility.

53
Table 14: Lack of awareness about the healthcare services limits my ability to use them

Frequency Percent Cumulative

Percent
Valid Strongly agree 102 29.0 29.0
Agree 146 42.0 71.0
Disagree 57 16.0 87.0
Strongly disagree 42 13.0 100.0
Total 347 100.0
Source: Field Survey.
Table 14 shows the responses of respondents if lack of awareness about the healthcare services

limits their ability to use them. 102 of the respondents representing 29.0 percent strongly agree

that lack of awareness about the healthcare services limits their ability to use them. 146 of the

respondents representing 42.0 percent agree that lack of awareness about the healthcare services

limits their ability to use them. 57 of the respondents representing 16.0 percent disagree that lack

of awareness about the healthcare services limits their ability to use them. 42 of the respondents

representing 13.0 percent strongly disagree that lack of awareness about the healthcare services

limits their ability to use them.

Table 16: My health significantly impacts my attendance in class

Frequency Percent Cumulative

Percent
Valid Strongly agree 132 38.0 38.0
Agree 181 52.0 90.0
Disagree 10 3.0 93.0
Strongly disagree 24 7.0 100.0
Total 347 100.0
Source: Field Survey.

54
Table 16 shows the responses of respondents if their health significantly impacts their attendance

in class. 132 respondents representing 38.0 percent strongly agreed that their health significantly

impacts their attendance in class. 181 respondents representing 52.0 percent agreed that their

health significantly impacts their attendance in class. 10 respondents representing 3.0 percent

disagreed that their health significantly impacts their attendance in class. 24 respondents

representing 7.0 percent strongly disagreed that their health significantly impacts their attendance

in class.

Table 17: My physical health affects my ability to participate actively in class activities

Frequency Percent Cumulative

Percent
Valid Strongly agree 205 59.0 59.0
Agree 97 28.0 87.0
Disagree 35 10.0 97.0
Strongly disagree 10 3.0 100.0
Total 347 100.0
Source: Field Survey.

Table 17 show the responses of respondents if their physical health affects their ability to

participate actively in class activities. 205 of the respondents representing 59.0 percent strongly

agree that their physical health affects their ability to participate actively in class activities. 97 of

the respondents representing 28.0 percent agree that their physical health affects their ability to

participate actively in class activities. 35 of the respondents representing 10.0 percent disagree

that their physical health affects their ability to participate actively in class activities. 10 of the

respondents representing 3.0 percent strongly disagree that their physical health affects their

ability to participate actively in class activities.

55
Table 18: My mental health affects my academic performance

Frequency Percent Cumulative

Percent
Valid Strongly agree 137 39.0 39.0
Agree 170 49.0 88.0
Disagree 40 12.0 100.0
Total 347 100.0
Source: Field Survey.

Table 18 show the responses of respondents if their mental health affects their academic

performance. 137 of the respondents representing 39.0 percent strongly agree that their mental

health affects their academic performance. 170 of the respondents representing 49.0 percent

agree that their mental health affects their academic performance. 40 of the respondents

representing 12.0 percent disagree that their mental health affects their academic performance.

Table 19: I have had to miss academic obligations due to health problems

Frequency Percent Cumulative

Percent
Valid Strongly agree 126 37.0 37.0
Agree 129 37.0 73.0
Disagree 36 10.0 84.0
Strongly disagree 56 16.0 100.0
Total 347 100.0
Source: Field Survey.
Table 19 show the responses of respondents if they have had to miss academic obligations due to

health problems. 126 of the respondents representing 37.0 percent strongly agree they have had

to miss academic obligations due to health problems. 129 of the respondents representing 37.0

percent agree that they have had to miss academic obligations due to health problems. 36 of the

respondents representing 10.0 percent disagree that they have had to miss academic obligations

56
due to health problems. 56 of the respondents representing 16.0 percent strongly disagree that

they have had to miss academic obligations due to health problems.

Table 20: The university healthcare facility has sufficient medical staff to attend to students

Frequency Percent Cumulative

Percent
Valid Strongly agree 70 20.0 20.0
Agree 162 47.0 67.0
Disagree 61 18.0 85.0
Strongly disagree 48 15.0 100.0
Total 347 100.0
Source: Field Survey.

Table 20 shows the responses of respondents if the university healthcare facility has sufficient

medical staff to attend to students. 70 respondents representing 20.0 percent strongly agreed that

the university healthcare facility has sufficient medical staff to attend to students. 162

respondents representing 47.0 percent agreed that the university healthcare facility has sufficient

medical staff to attend to students. 61 respondents representing 18.0 percent disagreed that the

university healthcare facility has sufficient medical staff to attend to students. 48 respondents

representing 15.0 percent strongly disagreed that the university healthcare facility has sufficient

medical staff to attend to students.

Table 21: There is an adequate supply of medications available for common illnesses at the

healthcare facility

Frequency Percent Cumulative Percent

Valid Strongly agree 130 37.0 37.0

Agree 92 27.0 64.0
Disagree 74 21.0 85.0
Strongly disagree 51 15.0 100.0
Total 347 100.0
Source: Field Survey.

57
Table 21 shows the responses of respondents if there is an adequate supply of medications

available for common illnesses at the healthcare facility. 130 respondents representing 37.0

percent strongly agreed that there is an adequate supply of medications available for common

illnesses at the healthcare facility. 92 respondents representing 27.0 percent agreed that there is

an adequate supply of medications available for common illnesses at the healthcare facility. 74

respondents representing 21.0 percent disagreed that there is an adequate supply of medications

available for common illnesses at the healthcare facility. 51 respondents representing 15.0

percent strongly disagreed that there is an adequate supply of medications available for common

illnesses at the healthcare facility.

Table 22: The healthcare facility has appropriate spaces for patient consultations and

treatment

Frequency Percent Cumulative

Percent
Valid Strongly agree 122 35.0 35.0
Agree 108 31.0 66.0
Disagree 64 19.0 85.0
Strongly disagree 53 15.0 100.0
Total 347 100.0
Source: Field Survey.

Table 22 shows the responses of respondents if the healthcare facility has appropriate spaces for

patient consultations and treatment. 122 of the respondents representing 35.0 percent strongly

agree that the healthcare facility has appropriate spaces for patient consultations and treatment.

108 of the respondents representing 31.0 percent agree that the healthcare facility has appropriate

spaces for patient consultations and treatment. 64 of the respondents representing 19.0 percent

disagree that the healthcare facility has appropriate spaces for patient consultations and

treatment. 53 of the respondents representing 15.0 percent strongly disagree that the healthcare

facility has appropriate spaces for patient consultations and treatment.

58
Table 23: The facility has adequate supplies for hygiene and infection control

Frequency Percent Cumulative

Percent
Valid Strongly agree 90 26.0 26.0
Agree 142 41.0 67.0
Disagree 61 18.0 85.0
Strongly disagree 48 15.0 100.0
Total 347 100.0
Source: Field Survey.

Table 23 shows the responses of respondents if the facility has adequate supplies for hygiene and

infection control. 90 respondents representing 26.0 percent strongly agreed that the facility has

adequate supplies for hygiene and infection control. 142 respondents representing 41.0 percent

agreed that the facility has adequate supplies for hygiene and infection control. 61 respondents

representing 18.0 percent disagreed that the facility has adequate supplies for hygiene and

infection control. 48 respondents representing 15.0 percent strongly disagreed that the facility

has adequate supplies for hygiene and infection control.

4.4 Test of Hypothesis

Hypothesis I

H0: There is no significant difference in the utilization of healthcare facilities between students

who are aware of the available health care facilities and those who are not aware in University of

Delta, Agbor.

Hi: There is significant difference in the utilization of healthcare facilities between students who

are aware of the available health care facilities and those who are not aware in University of

Delta, Agbor.

Level of significance: 0.05

59
Decision rule: reject the null hypothesis H0 if the p value is less than the level of significance.

Accept the null hypothesis if otherwise.

Table 24 Test Statistics

There is significant difference in the utilization of healthcare
facilities between students who are aware of the available
health care facilities and those who are not aware in
University of Delta, Agbor
Chi-Square 105.520a
Df 3
Asymp. Sig. .000
a. 0 cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency is 25.0.

Conclusions based on decision rule:

Since the p-value= 0.000 is less than the level of significance (0.05), we reject the null

hypothesis and conclude that there is significant difference in the utilization of healthcare

facilities between students who are aware of the available health care facilities and those who are

not aware in University of Delta, Agbor.

Hypothesis II

H0: There is no significant relationship between the utilization of healthcare facilities and

students’ academic performance in university of Delta, Agbor.

Hi: There is significant relationship between the utilization of healthcare facilities and students’

academic performance in university of Delta, Agbor.

Level of significance: 0.05

60
Decision rule: reject the null hypothesis H0 if the p value is less than the level of significance.

Accept the null hypothesis if otherwise.

Table 25 Test Statistics

There is significant relationship between the utilization of
healthcare facilities and students’ academic performance in
university of Delta, Agbor
Chi-Square 700.347a
Df 2
Asymp. Sig. .000
a. 0 cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency
is 25.0.
Conclusions based on decision rule:

Since the p-value= 0.000 is less than the level of significance (0.05), we reject the null

hypothesis and conclude that there is significant relationship between the utilization of healthcare

facilities and students’ academic performance in university of Delta, Agbor.

Hypothesis III

H0: There is no significant correlation between the quality of healthcare services provided at the

University of Delta, Agbor, and the academic performance of its students.

Hi: There is significant correlation between the quality of healthcare services provided at the

University of Delta, Agbor, and the academic performance of its students.

Level of significance: 0.05

Decision rule: reject the null hypothesis H0 if the p value is less than the level of significance.

Accept the null hypothesis if otherwise.

61
Table 26 Test Statistics
There is significant correlation between the quality of
healthcare services provided at the University of Delta,
Agbor, and the academic performance of its students
Chi-Square 74.520a
Df 2
Asymp. Sig. .000
a. 0 cells (.0%) have expected frequencies less than 5. The minimum expected cell frequency is 25.0.

Conclusions based on decision rule:

Since the p-value= 0.000 is less than the level of significance (0.05), we reject the null

hypothesis and conclude that there is significant correlation between the quality of healthcare

services provided at the University of Delta, Agbor, and the academic performance of its

students.

62
 CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATIONS

5.1 Discussion of the Study

The research examines the efficient use of healthcare facilities and its effect on students'

academic achievement at Delta State University. Three hypotheses were established to ascertain

that there is no significant difference in the utilisation of healthcare facilities between students

who are cognisant of the available healthcare services and those who are not at the University of

Delta, Agbor. Furthermore, there is no significant relationship between the utilisation of

healthcare facilities and students' academic performance at the University of Delta, Agbor.

Lastly, there is no significant correlation between the quality of healthcare services provided at

the University of Delta, Agbor, and the academic performance of its students.

The objectives of the study were to;

a. To find out available health care services for students’ wellbeing at the university of

Delta, Agbor.

b. To find out the students’ perception concerning the university health care facility.

c. To find out the barriers that prevent students from effectively utilizing health care

facilities, including issues related to awareness, accessibility, and stigma.

d. To find out the relationship between students' health and their academic performance,

focusing on how health issues affect attendance, participation, and academic outcomes

e. To find out the adequacy of resources available in the university's health care facilities,

including medical staff, equipment, and supplies.

Findings from the study revealed that majority of the respondents were of the opinion that

63
 a. There is significant difference in the utilization of healthcare facilities between

students

who are aware of the available health care facilities and those who are not aware in

University of Delta, Agbor.

Decision Rule: The null hypothesis is rejected.

b. There is significant relationship between the utilization of healthcare facilities and

students’ academic performance in university of Delta, Agbor.

Decision Rule: The null hypothesis is rejected.

c. There is significant correlation between the quality of healthcare services provided at

the University of Delta, Agbor, and the academic performance of its students.

Decision Rule: The null hypothesis is rejected.

5.2 Summary of Findings

The study findings indicated a substantial correlation between students' awareness of accessible

healthcare services and their usage of these facilities. Students informed about accessible

healthcare options were more inclined to seek medical treatment, therefore enhancing their

academic engagement and performance. The findings demonstrated that consistent use of

healthcare services resulted in enhanced physical and mental health, which is essential for

academic achievement.

Furthermore, the study emphasised that the calibre of healthcare services offered at the university

was substantially associated with students' academic success. Students exhibiting greater

satisfaction with healthcare services also achieved superior academic results. The study revealed

64
obstacles to optimal healthcare use, including lack of awareness, accessibility challenges, and

stigma related to seeking assistance. These obstacles impeded certain students from accessing the

available programs, consequently impacting their health and academic performance.

The research highlighted the necessity of including healthcare services inside the educational

system, advocating that universities should prioritise health promotion initiatives to improve

students' overall well-being. By addressing health requirements, institutions may cultivate a

conducive educational atmosphere that promotes academic achievement. The findings highlight

the essential function of healthcare facilities in higher education institutions and their direct

influence on students' academic performance.

5.3 Conclusion

The efficient use of healthcare facilities is crucial for improving students' academic success at

Delta State University. The research indicated that access to high-quality healthcare services

positively affects students' health and academic performance. Overcoming obstacles to

healthcare access is essential for cultivating a conducive educational atmosphere that enhances

student welfare and achievement.

5.4 Recommendations

a. Increase awareness campaigns about available healthcare services to ensure all students are

informed.

b. Improve the accessibility of healthcare facilities by extending service hours and reducing

wait times.

c. Enhance the quality of healthcare services through regular training and development of

medical staff.

65
d. Integrate mental health services into the healthcare facilities to address the psychological

needs of students.

e. Establish a feedback mechanism for students to voice their concerns and suggestions

regarding healthcare services.

5.5 Limitations of the Study

The study had multiple constraints, notably a restricted sample size that may not adequately

represent the overall student population at Delta State University. Furthermore, dependence on

self-reported data may introduce bias, since students may underreport or over-report their

healthcare utilisation and academic achievement. The study also failed to investigate the long-

term impact of healthcare utilisation on academic achievement, which could yield more profound

insights into this relationship.

5.6 Suggestions for Further Studies

1. Conduct longitudinal studies to assess the long-term impact of healthcare utilization on

academic performance.

2. Explore the specific health issues faced by students and how these affect their academic

engagement.

3. Investigate the role of peer support and social networks in influencing healthcare utilization

among students.

4. Examine the effectiveness of different health promotion strategies in improving healthcare

utilization and academic outcomes.

66
5. Study the impact of telehealth services on students' access to healthcare and its subsequent

effect on academic performance.

67
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 QUESTIONNAIRE

This questionnaire is aimed at investigating the effective utilization of healthcare facilities at the

university of Delta, Agbor and its impact on students’ academic performance. It is an anonymous

questionnaire which does not require your name and all responses will be kept strictly

confidential.

INSTRUCTION: Please endeavor to complete the questionnaire by ticking the correct answer

(s) from the options or supply the information where necessary.

DEMOGRAPHIC DATA

1. Gender

Male

Female

2. Age range

15-20

21-25

26-30

Above 30

3. Level of Study

Year 1

Year 2

Year 3

Year 4

Others

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You are required to respond to the item under the following.

SA – Strongly Disagreed

A – Agreed

DA – Disagreed

SD – Strongly Disagreed

Section A: To check the available health care services for students’ wellbeing at the university of

Delta, Agbor.

S/N ITEMS SA A DA SD
1 The university healthcare facility provides a comprehensive
range of health services for students
2. Students are satisfied with the accessibility of university
healthcare facilities?
3. How do students rate the professionalism and attitude of the
healthcare staff?
4. Does the physical environment of the university healthcare
facilities influence student perceptions?

Section B: Students’ perception concerning the university health care facility.

S/N ITEMS SA A DA SD
5. The healthcare facility is a safe and welcoming environment for
students
6. The healthcare facility respects students' privacy and
confidentiality
7. The healthcare staff are well-trained and professional

8. The healthcare facility is conveniently located for easy access

by students

Section C: Barriers that may prevent students from effectively utilizing health care facilities,
including issues related to awareness, accessibility, and stigma.
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S/N ITEMS SA A DA SD
9. There is enough information on campus about the healthcare
services available
10. I am concerned about my privacy being maintained when using
the university healthcare facility
11. Lack of awareness about the healthcare services limits my
ability to use them
12. Worry about being judged or stigmatized for using the
university healthcare services

Section D: Relationship between students; health and their academic performance, focusing on
how health issues affect attendance, participation, and academic outcomes.
S/N QUESTIONS SA A DA SD
13. My health significantly impacts my attendance in class
14. My physical health affects my ability to participate actively in
class activities
15. My mental health affects my academic performance
16. I have had to miss academic obligations due to health problems

Section E: Evaluating the adequacy of resources available in the university;s health care
facilities, including medical staff, equipment, and supplies.
S/N QUESTIONS SA A DA SD
17. The university healthcare facility has sufficient medical staff to
attend to students
18. There is an adequate supply of medications available for
common illnesses at the healthcare facility
19. The healthcare facility has appropriate spaces for patient
consultations and treatment
20. The facility has adequate supplies for hygiene and infection
control

78