The study attempts to explore the impact and challenges of PHC delivery system with the intension of generating data for policy and planning.
The goal of primary health care (PHC) was to provide accessible health for all by the year 2020 and beyond. Unfortunately, this is yet to be achieved in Nigeria and seems to be unrealistic in the next decade. The PHC aims at providing people of the world with the basic health services. Though PHC centers were established in both rural and urban areas in Nigeria with the intention of equity and easy access, regrettably, the rural populations in Nigeria are seriously underserved when compared with their urban counterparts.
About two-thirds of Nigerians reside in rural areas therefore they deserve to be served with all the components of PHC. Primary health care, which is supposed to be the bedrock of the country's health care policy, is currently catering for less than 20% of the potential patients. While most PHC facilities are in various state of disrepair, with equipment and infrastructure being either absent or obsolete, the referral system is almost non-existent.
The goal of the National Health Policy (1987) is to bring about a comprehensive health care system, based on primary health care that is promotive, protective, preventive, restorative and rehabilitative to all citizens within the available resources so that individuals and communities are assured of productivity, social well- being and enjoyment of living.
The health services, based on PHC, include among other things: education concerning prevailing health problems and the methods of preventing and controlling them, promotion of food supply and proper nutrition, material and child care, including family planning immunization against the major infectious diseases, prevention and control of locally endemic and epidemic diseases and provision of essential drugs and supplies. The provision of health care at PHC level is largely the responsibility of local governments with the support of state ministries of health and within the overall national health policy. Private medical practitioners also provide health care at this level.
Table of Contents
SECTION ONE: INTRODUCTION
1.1 Background to the study
SECTION TWO: REVIEW OF RELATED LITERATURE
2.1 Conceptual Review
2.1.1 The Concept of Health
2.1.2 Primary health care
2.2 Contextual Review
2.2.1 Critical issues in Primary Health Care Services in Nigeria
2.2.2 Health needs and problems of rural populations
2.3 Strategies for Enhancing the use of PHC Services by Rural Communities
2.4 Advocacy and political support/ commitment for health equity
2.5 Empirical Review
2.6 Theoretical framework
SECTION THREE: ISSUES/GAPS AND OUTCOMES
3.1 Emerging issues
3.2 Gaps in PHC Services in Rural Communities
3.3 Outcomes
SECTION FOUR: CONCLUSION AND RECOMMMENDATIONS
Research Objectives and Themes
The primary objective of this work is to examine the current state of primary health care (PHC) delivery in Benue State, Nigeria, by identifying critical challenges, gaps in service provision, and systemic failures, while proposing strategic interventions to improve accessibility and utilization for rural populations.
- The impact of socioeconomic factors and poverty on rural health service utilization.
- Challenges in resource allocation, infrastructure maintenance, and personnel distribution.
- The role of community participation and institutional support in PHC effectiveness.
- The efficacy of supervisory frameworks and current health policies in local government areas.
- Strategies for capacity building and sustainable funding models for rural healthcare.
Excerpt from the Book
2.2.2 Health needs and problems of rural populations
There are three health care delivery systems in Nigeria (primary, secondary and tertiary).There are innumerable problems within primary health care delivery system which affect the whole population. An assessment of these problems and needs is important to assure easy accessibility to health care services by rural people. Apparently, people living in remote areas show an adaptability that allows them to adjust to the adverse conditions. Critical observation of some groups of nomads, for example the Fulanis and fishermen from the core northern states, the migrant Tiv farmers from Benue State, reveals satisfactory physical health and increasing resistance to disease or illness, but they are not without health problems.
The health and health-related problems of nomads, migrant farmers and rural people include the following: i. Poverty associated with poor housing, unsatisfactory environmental sanitation, polluted water and food which predispose to malnutrition and infectious diseases. ii. Uneven distribution of health services, and shortage of physicians, nurses and trained health personnel in rural areas.
iii. High mortality and low average life expectancy, due to lack of access to health services. It is unfortunate that systematically collected data are lacking about levels of morbidity and mortality in rural communities. Despite the availability of PHC services, some rural dwellers in Nigeria tend to underuse the services due to perceptions of poor quality and inadequacy of available services (Sule et al., 2008). Various reasons can be adduced for the underuse of the services provided: a) difficulties associated with transportation and communications; b) high rates of illiteracy among rural peoples ; c) traditional conservatism and resistance to ideas from outside; deep rooted traditions and customs, including health beliefs and practices, which increase the patronage of the services of traditional healers; and d) lack of understanding of PHC among health professionals and decision-makers resulting in poor quality services; and e) heath worker attitude to work (frequent abstinence from the work place) (Adeyemo, 2005).
Summary of Chapters
SECTION ONE: INTRODUCTION: Outlines the global importance of PHC and provides context for the specific health challenges and demographic pressures faced by rural communities in Benue State.
SECTION TWO: REVIEW OF RELATED LITERATURE: Examines the theoretical foundations of health, the evolution of PHC policies in Nigeria, and reviews empirical evidence regarding service utilization and elite theory.
SECTION THREE: ISSUES/GAPS AND OUTCOMES: Analyzes the current infrastructure, human resource limitations, and service gaps, while proposing a 'hub and spoke' model for improved delivery.
SECTION FOUR: CONCLUSION AND RECOMMMENDATIONS: Summarizes the findings and provides policy recommendations focused on financial autonomy, community education, and administrative reform for local governments.
Keywords
Primary Health Care, PHC, Benue State, Nigeria, Rural Health, Healthcare Delivery, Community Participation, Health Equity, Service Utilization, Infrastructure, Human Resources, Public Policy, Preventive Medicine, Socioeconomic Factors, Health Education
Frequently Asked Questions
What is the primary focus of this research paper?
The paper examines the delivery of primary health care (PHC) services in Benue State, Nigeria, focusing on identifying the barriers and challenges that prevent rural populations from effectively utilizing these essential health services.
What are the core thematic areas addressed in the work?
The research covers infrastructure deficits, human resource shortages, the impact of community perception and tradition on health-seeking behavior, and the role of administrative policy in healthcare efficacy.
What is the central research question?
The research asks how the PHC system in Benue State can overcome funding constraints, ineffective management, and uneven resource distribution to better serve the health needs of the under-privileged rural populace.
Which research methodology is employed?
The paper utilizes a systematic review of existing literature, policy frameworks, and empirical studies to assess the status of PHC delivery, combined with a theoretical analysis based on Elite Theory.
What does the main body of the work cover?
The main sections transition from the historical and theoretical background of PHC to a diagnostic analysis of infrastructure and operational failures, concluding with strategic recommendations for systemic reform.
Which keywords best describe this study?
The study is characterized by terms such as Primary Health Care, Rural Health, Health Equity, Community Participation, and Public Policy implementation in Nigeria.
How does "Elite Theory" explain the current state of PHC in Nigeria?
The theory suggests that resources are concentrated in the hands of the elite, often neglecting the rural poor who lack political and economic power, thereby reinforcing their marginalization from modern health services.
What is the "hub and spoke" model proposed in the research?
It is a proposed infrastructure strategy where specific facilities are designated for basic out-patient services while others serve as centers for 24-hour maternal and child health (MCH) care, ensuring better network efficiency.
Why is traditional supervision considered a failure in this context?
The author argues that traditional supervision focuses excessively on fault-finding and inspection rather than mentorship, resulting in poor staff morale and a lack of real-world problem solving for health workers in remote areas.
- Arbeit zitieren
- Makar Linus Iornenge (Autor:in), 2020, Primary health care services delivery. Issues and challenges, München, GRIN Verlag, https://www.grin.com/document/939337
