Roles and Responsibilities of Primary Health Care Programme in Emerging Diseases Prevention and Control in Delta State

CHAPTER ONE

Objectives of the Study

Content Summary

General Objective

The general objective of the study was to assess factors that have been contributing to those impact of primary health care programme on the prevention and control of emerging diseases in Warri Local Government Area of Delta state.

Specific Objectives

To assess types of services provided to the local community during the implementation of primary health care programme in Warri LGA.;
To examine the extent to which Primary health care programme has prevented disease in Warri LGA.;
To identify factors that have contributed to achievements and challenges in the effective implementation of the primary health care programme in Warri LGA.; and
To identify the strengths and constraints of the primary health care programme implemented in Warri LGA.

CHAPTER TWO

REVIEW LITRATURE

Introduction

Health systems in Sub-Saharan African countries often suffer from weak infrastructure, lack of human resources, and poor supply chain management systems. Access to health services is particularly low in rural areas, where the majority of the population still lives. The few private outlets that are available usually favor urban or wealthy areas. Together with an uneven distribution of health workers, this pattern often results in little availability and poor quality of health services in rural areas (Bilal, 2012, p. 433).

The Nigerian Government has been exerting too much effort to the health sector performance. To upgrade its citizens’ health status, it has developed and is implementing a series of health sector development programmes (HSDPs). And it introduced primary health care programme as a part of HSDP to ensure accelerated expansion of health care services which has focused on health promotion, preventive and curative health care services.

General Policy

High rates of disease and premature mortality in Sub Saharan Africa are costing the continent dearly. Poor health causes pain and suffering, reduces human energies, and makes millions of Africans less able to cope with life. The economic consequences are immense. Poor health shackles human capital, reduce returns to learning, impedes entrepreneurial activities, and holds back growth of gross national product (World Bank, 1995, p. 40).

The policy includes the following broad areas: democratization and decentralization of health service system, development of the preventive and promotive components of health care, development of an equitable and acceptable standard of health service system that will reach all segments of the population within the limits of resources, promoting and strengthening of intersectoral activities, assurance of accessibility of health care for all segments of the population, development of appropriate capacity building based on assessed needs, provision of health care for the population on a scheme of payment according to ability with special assistance mechanisms for those who cannot afford to pay, promotion of the participation of the private sector and nongovernmental organizations in health care (TGE, 1993). To combat the serious health problems the nation has been facing, the Nigerian Government has given priorities for Information, Education and Communication (I.E.C.) to enhance health awareness and to propagate the important concepts and practices of self-responsibility in health, the control of communicable diseases, epidemics and diseases related to malnutrition and poor living conditions, provision of essential medicines, medical supplies and equipment shall be strengthened, and so forth ( FMoH, 1993, 26-27).

CHAPTER THREE

RESEARCH METHODOLOGY

Research Design and Methods

The research shall focus at assessing achievements and challenges of the primary health care programme encountered during the time of implementation in Warri Local Government Area. Accordingly, the researcher will employ mainly non-experimental study design and uses quantitative and qualitative approaches and descriptive sample survey methods.

Sampling Methods and Sample Size

Sampling methods shall be developed based on the population size of the study. The method used for drawing a sample is significant to arrive at dependable results or conclusions. For the purpose of this study, purposive sampling method of the non-probability sampling methods was used based on the judgment of the researcher. The guiding factors in non-probability sampling methods include: the availability of the units, the personal experience of the researcher and /her convenience in carrying out a survey. The technique used was thus purposive sampling technique, because it would be more appropriate to select household cases that were judged to be typical of the population.

In order to assess the achievements and challenges of primary health care programme implementation in Warri LGA., the total number of respondents was purposively determined. From the selected local administration site, a total of 75 residents from the local community were selected because of their important role in the implementation of primary health care programme. In addition, the HEWs assigned in the site, as well as the primary health care programme Supervisor at Local Government Area level was interviewed.

CHAPTER FOUR

DATA ANALYSIS AND INTERPRETATION

Socio-demographic Characteristic of Respondents

Based on the data obtained from 75 respondents who are living in the study area, it is possible to summarize and describe the different characteristic features of them as illustrated in Table 4.1. Three-fifth of the total respondents was found to be females. Table 4.1 shows that 61.3% of the beneficiaries were females, while 38.7% of them were males. In relation to their age distribution, about two-third (64.0%) of them were categorized in the age bracket of 25-64 years. Thus, the majority of the beneficiaries of the primary health care programme are young and older adults. They were also found to achieve the second cycle of the primary education as thirty-two percent of the respondents attended Grade 1 – 8 levels.

Concerning their marital status, among 75 respondents, sixty percent of them were in wedlock. Thus, significant majority of the beneficiaries are married ones. These respondents then gave birth to either 2 or 3 children as their perpetuators. About fifty-six percent of them had 2 to 3 children in their respective households. Therefore, they have acceptable numbers of children in the households. The respondents lived for 4 and more years in the area. Specifically, 44.0% of them lived 4-7 years. Generally, about thirty-five percent of their occupation was found to be trade, but there were farmers, government employees, house wives and students as beneficiaries of the Programme.

CHATER FIVE

CONCLUSIONS AND RECOMMENDATIONS

5.1 Conclusion

Different data collection methods were employed to gather data from the local community members, Local Government Area health office supervisors and HEWs involved in the implementation of primary health care programme. Appropriate analysis instruments were put in place to look into the patterns of data collected which have been summarized.

To begin with the awareness activities the community is well informed and understood the importance of the primary health care programme; satisfied with the services provided and even participated in the program implementation activities. The data shows there is a good acceptance of the program among the local community and indicates that HEWs have been providing primary health services at village level to improve the health standards of the local communities. Among the achievements registered, increased utilization of family planning services, construction and usage of sanitary latrines, increased number of immunized children, increased maternal and child health services and provision of health education by HEWs at each family level have been identified as major achievements of the execution of primary health care programme.

On the other hand, the findings of the study showed many poor performance areas in the execution of the health extension packages; like in the adolescent reproductive health package, first aid package, nutrition package, food hygiene and safety measures package and personal hygiene packages.

It also highlighted that there have been challenges in high rate of turnover ad difficulty to recruit soon, lack of transportation facilities, and shortage of provisions of stationary materials. Moreover, the result of the study has proven that HEWs has complained for lower salary payments and lack of appropriate and frequent supervisory activities.

Nonetheless, the findings showed up that there is a significant shortage of basic necessary stationary materials, medical equipments and drugs for HEWs to serve communities as intended.

Supervision is an important management tool to ensure effective and efficient management of primary health care programme. In the study areas, the findings reflected that generally there have been weak and lack frequent supervision. In addition, there was no transportation facility for supervisors to smoothly coordinate and supervise the performance of HEWs.

5.2 Recommendations

Based on the findings of the study, recommendations having options for further practical interventions and corrective measures in order to improve health service delivery performance and to achieve the goal of the primary health care programme; the following recommendations have been forwarded.

Materials and essential drugs needed for the provision of quality health services should be delivered soon before the stock balance becomes nil. It is important to fulfill health service delivery kits, gloves, and supply of family planning drugs should be improved to ensure sustainable provision of health services.
As presented in this thesis, adequate positive changes in the knowledge /understanding/ about the program is encouraging, Thus, health education and communication should be reinforced and continued to inculcate receptive spirit among the local community so that their full participation would be realized that could be a potential assurance for the success of the program.
The support and supervision activities should be immediately improved. The present support and supervision system is very weak that it induces changes in terms of improving the managerial and technical skills of supervisors. In addition immediate feedback should be given to the HEWs. In addition further study should be conducted to solicit feasible and sustainable transportation facilities for supervisors and HEWs such as motor cycle should be used to smooth support and supervision activity.
As of any other sector staff, arrangements have to be made to address the increasing needs of HEWs like salary increment. There should be a system to handle them to decrease turnover, and if not immediate recruitment and training should be given.
HEWs are expected to provide primary health services and referral arrangements for patients with chronic illness those cannot be treated at health posts to higher health institutions i.e. health centre or hospital. But evidences have shown that there have been problems in performing the service as needed, in doing timely referrals, so HEWs should be capacitated and supported for this basic service.
Heath education and communication should be given priority in primary health care by government. Despite this fact, the result of the study showed that it has not been considered as it is very important method of community mobilization so as to address the local community.

The study indicates that health education was not given due attention as a result, it was noticed that HEWs could not impart the basic information and knowledge to the local community to bring positive behavioral changes among them to be self reliant in keeping their health.

Finally, further study should be conducted to improve the implementation of the primary health care programme in order to achieve the intended goals.

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