Assessment of Community Services Coverage at Primary Healthcare Facilities in Rural Population of Sharg-Elnil Locality - Khartoum State from 2018 to 2020.

Abstract

Background: Sudan health system is based on the district health system approach, which emphasizes the principles of primary health care (PHC). Nevertheless, the decentralization of the public sector resulted in more deterioration of the PHC system particularly in rural and peripheral areas due to lack of financial resources and managerial capacities.
 Objectives: The study aimed to assess the community services coverage at primary Healthcare Facilities in Rural Population of Sharg-Elnil Locality - Khartoum State from 2018 to 2020.
 Materials and methods: A number of (37) Health facilities was selected in addition to (333) households. All selected mothers/care takers of children aged 12–23 months; all working Primary Healthcare sites and all health worker who are the first responsible of Health sites in the study area were included in the study. The study was conducted by using questionnaires, checklists, observation and Interview with structure close ended questionnaire. Data was computed and analyzed using SPSS program version 25.0. Descriptive and inferential statistic was used.
 Results: The study showed that 55.6% of the participants stated that their areas distance less than 2 km. The majority of the participants 72.4% were obtained their health services by going to the hospital or rural health center. More than two thirds of the participants 66.7% stated that there was transportation mean for health center. The majority of participants 69.7% stated that their families or household having ability to pay the cost of transportation. Only 46.2% of the participants stated that there was health insurance for families. Approximately 96% of the participants had vaccination card explained the vaccination that taken the children less than 2 years. Also 98.5% their child completes the routine vaccination until the date of visit. The majority 93.4% of the participants their child under five obtained any vaccines including that taken in vaccination campaigns or national days for vaccination or during child health days. The majority of the participants 69.1% indicate that their children under 5 previously taken BCG vaccines. More than half of the participants 50.8% stated that their children under 5 infected with diarrhea disease the last 2 weeks. Also 58.3% had children under 5 infected with fever during the last 2 weeks. Less than 50% (45.6%) of the participants their family having bed nets for mosquito control. Only 26.1% of the participants had one sleep under nets last night. The majority of the participants 88% had periodic follow-up during the pregnancy. The most reasons for not follow-up during pregnancy were because the health center is faraway 23.7%, economic barriers 6.3% and family barriers 3%. The participants stated that the tetanus doses coverage was 94%. The most doses of tetanus taken by the participants were five doses 36.3%. Also 56.5% of the participants sated that they were gave any medical care during the first last 6 weeks after last delivery (postnatal). More than 63% of the participants were used contraceptive. The most reasons of not used contraceptive were fear from side effects 24.3%, due to refuse of husband 2.7%, due to culture believes 3.3%, not able to by 2.4% and because of not aware 2.4%. There was association education level of father and periodic follow-up during the pregnancy, p=.000. There was association education level of mother and use of contraceptive, p=.000. There was association between occupation of mother and use of contraceptive, p=.000. there was highly association between children under 5 infected with fever during the last 2 weeks and having any bed nets for mosquito control, p=.002.
 Conclusion: The results show that coverage of the services provided were moderate which need to be strengthening and provision of resources for rural communities.