Primary Health Care Services in Nigeria: Critical Issues and Strategies for Enhancing the Use by the Rural Communities
CHAPTER ONE
Objectives of the study
The main aim of this study is assess the primary health care services in Nigeria based on critical issues and strategies for enhancing the use in rural Nigeria. The specific objectives are to;
- Find out the critical issues in primary health care services in Nigeria.
- Find the current status and gaps in PHC services in rural communities.
- Determine the strategies for enhancing the use of PHC services by rural communities.
CHAPTER TWO
REVIEW OF RELATED LITERATURE
INTRODUCTION
This chapter reviews the literature on the primary health care in Nigeria critical issues and strategies for enhancing the use by rural communities. It discusses issues arising from the topic of interest as viewed from different perspectives.
CONCEPT OF HEALTH CARE SYSTEM
Good health is one of the fundamental human rights everybody is entitled to enjoy. And the onus rests on the healthcare system to provide health services at the three tiers of the government (federal, state and local government). A health system can then be said to be an organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations. Health system planning then should be distributed among market participants, governments, trade unions, charities, religious, or other coordinated bodies to deliver planned health care services targeted to the populations (Frenk, 2010). World Health Organization [WHO] (2000) identified three basic goals of a healthcare system which include:
- Good health (improvement and protection of the health of the populace)
- Fair financial contribution (receiving the services paid for)
- Responsiveness of the healthcare providers (living up to the people‘s expectation) Achievement of these goals is dependent on how the healthcare systems carryout the following functions:
- Rendering of efficient health services
- Resources generation such as healthcare financing (raising, pooling and allocating)
- Health investment such as material resources
- Stewardship such as human resources.
Other dimensions for the evaluation of health systems include quality, efficiency, acceptability, and equity. They have also been described in the United States as “the five C’s”: Cost, Coverage, Consistency, Complexity, and Chronic Illness (Brody, 2007).
CHAPTER THREE
RESEARCH METHODOLOGY
research design
The methodologies used in this research work are, in the main, doctrinal or library research in nature. The doctrinal method of the research, which is mainly theory-based, would enable this writer to consult, refer to, review, study and fill the gaps in the works of authors, contained in textbooks, journals, and the internet. The data collected through library research in which the researcher reads, writes and gathers pertinent information related to the topic of this project. After having information from relate d documents such as international legal instrument, books, scientific journals, and others regarding the main problem as the object of this research, then the researcher tries to make conclusion.
Population of study
The target population for this study comprised of multinational companies in Nigeria. There is no current document specifying the figure for the total number of MNC in Nigeria, however it suffice to say that there are over 100 mnc in Nigeria.
CHAPTER FOUR
DATA ANALYSIS AND INTEPRETATION
INTRODUCTION
Efforts will be made at this stage to present, analyze and interpret the data collected from all secondary sources. It will also show answers to questions relating to the research questions for this research study. The researcher employed qualitative methods in the analysis.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATION
Introduction
It is important to ascertain that the objective of this study was to examine the impact of accounting ethics on accounting practice in Nigeria.
In the preceding chapter, the relevant data collected for this study were presented, critically analyzed and appropriate interpretation given. In this chapter, certain recommendations are made, which in the opinion of the researcher will be of benefit in addressing the challenges of accounting ethics on accounting practice in Nigeria.
- Summary
This study aimed at having a critical analysis of impact of accounting ethics on accounting practice in Nigeria. The study opened with chapter one where the statement of the problem was clearly defined. The study objectives and research hypotheses were defined and formulated respectively. The study reviewed related and relevant literatures. The chapter two gave the conceptual framework, empirical and theoretical studies. The third chapter described the methodology employed by the researcher in collecting both the primary and the secondary data. The research method employed here is the descriptive survey method. The study analyzed and presented the data collected in tables and the hypotheses were tested using the Chi square while the fifth chapter gives the study summary and conclusion.
- Conclusion and recommendations
While the PHC centers are relatively uniformly distributed throughout Nigeria, rural people tend to under-use the basic health services. Although there is no single solution to this problem in Nigeria, some strategies have been outlined which could result in enhancing the use of health services by the rural communities. Capacity building and empowerment of communities through orientation, mobilization and community organization as regards training, information sharing and continuous dialogue, could further enhance the utilization of PHC services by rural populations. Quality of care and service delivery must be assured by those in management positions. In situations of scarce resources, it is particularly important to maintain standards of practice when huge demands are placed on staff, often resulting in less-than-ideal behaviour. It is precisely in such situations that staffs need to know there is support from their superiors, and managers need to know that the scarce health budget is being used to best advantage. Primary health care in Nigeria and especially in rural areas have come a long way and certainly still require more effort so as to achieve the goal of health for all now and beyond Having identified the litany of problems against effective and efficient implementation and achievement of the goals and objectives of primary health care services delivery at the local government, the following recommendations are suggested as a way forward:
- There is the dearth need for the Local government as well as all the other tiers of government to increase their allocation to the health sector. Local governments on the other hand should be more inward-looking and aggressive in the area of internally-generated revenue. This is to reduce the dependence on the federation account in financing health programmes.
- Priority should be given to improved living condition of the people beyond the present poverty level, so as to enhance better healthy living. To this end, intensive and effective health education of the public must of necessity be reinforced in other to eliminate such diseases as malaria, typhoid and other infectious diseases.
- There is the need for maintenance of minimum health standard, improved housing condition, adequate potable water supply, environment sanitation and food supply for the sustenance of good health condition.
- Poor leadership and political instability have been the basis for unsuccessful implementation of most govern-ment policies and programmes on health care delivery. Therefore, good leadership and political stability is desirable to provide enabling environment for the implementation of the PHC programmes. This will invariably reduce the problem of abandoned projects in the health sector.
- There is the need to put a stop to unnecessary responsibilities being given to LGA’s by the state governments. It is a common occurrence for federal and state governments to shift part of their responsibilities to LGA, such as purchase of nonfunctioning generator, fridges, iceliners and solar fridges and imposition of sponsored programmes. All these are drains on the lean purse of the local governments with its attendant effects on health services delivery.
- Adequate supervision, monitoring and evaluation of programmes should be pursued with vigor and required manpower provided. The Nigerian health policy makers should give priority to the training of more rural health workers. This is to prevent the drift of rural health workers from the rural communities to the urban centers.
- More financial and other incentives should be provided to prevent the high staff turn-over of health workers.
REFERENCES
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