Community response to primary health care: Obadan project in Bendel State of Nigeria.

Abstract

This paper describes a pilot study in which a rural community in Bendel State was involved in the provision of basic health care for themselves. The communitys contribution to planning and support for the project the services provided and their utilization are described. In view of the problem of lack of medical care a maternal-child health center was established by community members. The responsibilities of the village health committee were: the planning and supervision of the operation of the project; liason between the health team the elders and the people; collaboration with the health team; and periodical reports on the progress of the project to the Committee of Elders. After 1 year the response of the community was assessed in terms of their participation support utilization and services rendered. The Health Committee was very active in the planning and implementation of the programs of the project. Weekly antenatal clinics were run served by traditional birth attendants (TABs). A fee equivalent to US$1.5 is charged at the time of 1st antenatal attendance. All personnel for the clinic are TBAs and village health workers (VHWs) who receive no enumeration for their services. TBAs were instructed on how to estimate gestational age to identify a few risk factors in pregnancy and when to refer patients for more skilled care. VHWs weigh and chart children under 5 and treat some minor ailments. The male members of the health committee dress wounds and dispense drugs. Issues not agreed on by the committee members are ultimately decided by the Council of Elders. Support for the project was provided by the community itself. Additional services rendered are: screening children for malnutrition home visiting by VHWs and TBAs for health education and surveillance of at-risk families. Given motivation guidance and supervisory support the community can provide adequate health services.