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

Abstract

Background: Sudan’s health system is based on the district health system approach, which emphasizes the principles of Primary HealthCare (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 primary Healthcare facilities coverage for rural population in Sharg Elnil locality from 2018 to 2020. The study was conducted in the rural areas of Sharg Elnil locality.
 Materials and methods: Analytical, prospective Facility based study. A number of (37) Health facility was selected for the study. The study was conducted by using questionnaires. Data was computed and analyzed using SPSS program version 25.0. Descriptive and inferential statistic was used.
 Results: The majority of health facilities were compliance with classification of ministry of health standards (94.6%). The number of villages that health facility covered in rural hospital was (10.3±1.4), (4.9±.5) health centers and (3.9±.6) in dispensaries. The vast majority of health facilities 83.8% have a mean of transportation to access health facility. Nearly half of the health facilities were distance less than 2 km of health area 48.6%. The vast majority of health facilities 83.8% have a mean of transportation to access health facility. The majority of health services available in health facilities were vaccination service (100%), nutrition services (94.6%), reproductive health services (70.3%), health education services (64.9% ), disease surveillance system (64.9%), Essential, Community mobilization service (51.4%) while the health services available by less than 50% were drugs list in the health facility (45.9%), Health insurance coverage (27%) Free drugs for children less than 5 yrs (16.2%), the lab services (21.6%), referred system 24.3%, ambulance services 24.3%, blood bank services (13.5%), dentist services 5.4%, x-rays services 8.1% and other services 2.7%. Only 10.8% of the existence equipment in health facilities was adequate. The most basic problems and challenges found in health facilities were unsuitability of work environment 51.4%, deficit in medical devices 35.1%, deployment of contractors and health promoters 32.4%, no ambulance during summer days where scorpion and snake bites is more 32.4%, no treatment available during rainy season days 29.7%, un-continuity of electricity and water 21.6%, no health insurance 16.2% and building maintenance 5.4%.
 Conclusion: The results show that, although the average PHC performance is almost appropriate and some of the surveyed health facilities have very high performances, some low-income and deprived areas experience substantial challenges. It is recommended that PHC plans should be formulated across the country and then implemented according to the local health needs and priorities.