Management audit for primary health care faciities in Plateau State

Abstract

The health care system in Nigeria has been developed at three levels, the extension of health care to all people has been an objective of all National Health Systems for many years since the Alma - Ata conference on Primary Health Care (PHC) in 1978. Decades after the take off of PHC in all parts of this country, the goal of health for all and beyond is still far from being attained. The management activities of Primary Health Care Facilities in Plateau State were investigated. A multistage sampling method was used to select 30 PHC facilities from 10 randomly selected LGAs out of the 17 Local Government Areas (LGAs) of Plateau State. All the heads, the secretaries and the chief matrons of the selected facilities were interviewed using self-administered structured questionnaires. Responses were scored using a dichotomous scale and categorized into poor, fair, good and excellent performances, and analyzed using Epi info 2.3.05 2003 statistical software. Out of the 90 workers interviewed, 68.9% were females and 85.6% were married. Seventy four point four percent of the respondents were between 30-44 years of age, and 43.3% of the workers worked at the Basic Health Clinics (BHCs) while 20% of them worked in Comprehensive Health Centre (CHCs). Up to 40% of the LGAs had poor management performance, while the remaining 60% performed only fairly. Overall, PHC facilities in Langtang north did better in management of their facilities, while Shendam LGA scored least in management performance. In this study, no significant difference in scores of the various management activities between the LGAs was observed (F = 7.084, p > 0.05). However, a statistically significant difference in scores of management activities between the various types of PHC facilities was observed (F = 2.81, p < 0.05). The management staff in most of the primary health care facilities lack resources at their disposal and this hinders the efficient and effective running of the facilities. Lack of transportation and poor maintenance of those available would seem to be the major constraint to the effective running of the health facilities.