Abstract
IntroductionThis study aimed to analyze the spatial distribution and capacities of public health facilities and assess utilization of the facilities in Biu area of Borno State, Nigeria.MethodsA descriptive survey of health facilities and households were conducted by stratifying the area into 11 electoral wards. Data collection instruments include a hand-held GPS (Garmin 76CSx) and 2 sets of structured questionnaires (facility and household). The hand-held GPS was used in taking the coordinates of each health facility in the area. Twenty-five facility-based and 400 household-based questionnaires were administered.ResultsIt was identified that 138 public health personnel serve the area’s population of 240,838. Medical professionals (doctors/nurses/midwives) to patient ratio is 1:2973, about 7 times less than the minimum WHO recommendation of 2.5 medical personal per 1000 population. Uneven distribution of facilities exists, which impact on utilisation. For instance, a ward (Mandaragrau) with a population of 18,732 have 5 facilities (4 dispensaries and 1 primary health care) in comparison to a ward (Miringa) with a population of 21,343 with only one Dispensary. Income level and distance were significant socio-economic factors affecting service utilisation (p < 0.001). Area’s households Gini index was 26.7, most of which (49.7%) survive on less than USD2/day and majority (33.6%) spend an average cost of treatment of ₦2,750 (approx. $8) per clinic visit.ConclusionIt was concluded that insufficiency and inequity in distribution of healthcare services exist in Borno State. It is thus recommended that future policies be directed toward improving healthcare in under-served areas.
Highlights
Healthcare is central to community well-being as well as a fundamental aspect of life
The estimated Gini index of the population was 26.7, about two-times less than that of the country (48.8), based on the CIA (Central Intelligence Agency) world factbook estimate of 2013. This indicates more equality in wealth distribution in Biu Local Government Area (LGA) compared to Nigeria as a country
Based on the findings of this study, it was concluded that health facilities in the study area were unevenly distributed and the number of primary care facilities and capacities were far below the recommendation of the National Primary Health Care Development Authority (NPHCDA) and WHO
Summary
Healthcare is central to community well-being as well as a fundamental aspect of life. Lack of basic health facilities and services in any community is significantly associated with poor productivity, reduced life expectancy and increased mortality rates [1,2,3,4,5]. This necessitate the need for equity in distribution of health facilities. Both accessibility and utilization are important aspects of equitable distribution of health resources, which is based on needs of the population rather than equal distribution. Awoyemi et al [4] opined that, improvement in healthcare leads to improvement in life expectancy, which serves as a robust indicator of human development
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