Factors militating against effective implementation of primary health care (PHC) system in Nigeria

Abstract

Objectives: This study aimed to evaluate the factors that militate against effective implementation of a primary health care (PHC) system in Nigeria. Materials and Methods: The study was conducted at four selected PHC centers in Enugu State from November 2014 to January 2015. The primary health center was chosen by systemic sampling from about eight primary health centers in Enugu metropolis. The sixteen-item questionnaire was elaborated with the Likert scale. Data retrieved were collected with the aid of a structured study pro forma and analyzed using SPSS Version 18. Results: A total of 169 health workers were recruited from four primary health centers. The mean age of all participants was 38.42 years standard deviation (SD) = 9.8, while the male: Female ratio was 2:1. Among the subjects, 59% were aged 30-39 years. Existing equipment and manpower on one hand and job security and salary on the other hand are negative factors in the implementation of PHC; the respondents believed that adequate supply of gloves, needles, bandages, good access to drugs and medications, a good cold chain system, and full implementation of immunization programs all exist in PHC centers. Adequate community participation, culture and religion, access to safe and clean water, and steady electricity, on the other hand, are nonexistent in the PHC centers in the study. Conclusions: The PHC centers studied showed that much remains to be desired, especially in terms of manpower, communication, and the remuneration of health workers.