Primary Health Care In Nigeria Research Articles

Improvised source of water coolant for ultrasonic scaler: an appropriate technology in underserved communities

Traditionally dental plaque, calculus and stains have been removed by scaling and polishing manually with hand instruments such as curettes, chisels, hoes and scalers. However, ultrasonic scaling is becoming the preferred method of initial periodontal treatment and maintenance, due to improved patient and operator comfort. Ultrasonic scaling can be performed effectively using pipe-borne water as coolant. However, such a water supply is unavailable in many rural dental clinics, especially in underserved communities in Nigeria. This article reports on an improvised source of water coolant, designed and fabricated to make modern, easy and effective plaque control available to people in communities where there is no pipe-borne water. The device will improve operator efficiency in tooth cleaning and patient compliance with treatment. Due to its simple design but effective function, the device is ideal for use in Nigeria's primary healthcare delivery program, offering enhanced preventive and curative services to remote, rural and semi-urban populations. In doing so oral health can be improved with a reduction in the incidence of oral diseases.

Managing Primary Health Care in the South - South Geo Political Zone of Nigeria

Management of Primary Health Care (PHC) is one of the main pillars of a health system through Human Resources. Furthermore, the quality of health services depends to a large extent on the people who manage the services. The paper reviews the role of stakeholders in the management of primary health service provisioning in general and in Primary Health Care in particular, it examines brief historical review of the gradual introduction of new cadres of health managers into the health system in response to perceived health needs, training and deployment of health during the colonial era, establishment of the advance schools for health workers, events at third national development plan and the unfortunate decline of community nursing and community midwifery, etc. It further analyzes factors and challenges of leadership which affect the performance of health managers. It also discussed case studies of proven innovative approaches and best practices in the management of human resources in sub – Saharan Africa and Nigeria. Data used in this paper is derived from secondary sources. An urgent need for a comprehensive database on the Human Resource for Health (HRH) situation in Primary Health Care should be developed. The current Human Resource situation indicates that the availability and distribution of HRH and PHC is far from being adequate. The need to mobilize communities to get them to take ownership of primary health care delivery and its maintenance is important. The morale and motivation of personnel have major implications for their performance. In the case of Human Resource for PHC in Nigeria, data is not easilyavailable and when available tends to be incomplete and/or contradictory. The distribution and availability of HR and PHC is also a major concern in most parts of Nigeria. The poor distribution and inadequate number of the various health personnel required for an effective PHC in Nigeria is compounded by the brain drain, poor motivation among health personnel and inappropriate policies among others.

Profile Of Institutional Infrastructure For Implementing Universal Precautions In Primary Health Care Facilities In Sokoto State, Nigeria: Implication For Occupational Safety

Background: The adoption of primary health care in Nigeria has led to the expansion of health care delivery frontiers especially at the rural level. At this level is the most critical health services delivery point, with an attendant increase in contact between primary health care providers and patients. There is however also a simultaneous increased exposure to occupational and related health risks and hazards.Methods: The objectives of this study were to assess the universal precaution profile of primary health care facilities and determine those factors that inform their prevailing safety status. Using a structured checklist, 23 representative primary health care facilities from the 23 local government areas in Sokoto State were randomly selected for the study, one from each of the local government areas. Results: The facilities were found to have poor universal precaution profile that could guarantee effective control of infection transmission and safety of their personnel. The facilities’ mean score on measures and frameworks for ensuring the implementation of Universal Precautions was 53.12% ± 21.68% with only 56.52% scoring above 50%. Conclusion: Safety protocol and facilities for ensuring safe environment were inadequate and poorly developed. None of the facilities had full complement of facilities or resources for ensuring safety of working environment and for personnel’s implementation of Universal Precautions. Policy for safety practice was poor, and post exposure intervention programmes for staff in event of accidental exposure grossly underdeveloped. Interventions to improve safety environment and creation of safe climate are essential to protect primary health care workers against occupational hazards.

Nigeria still searching for right formula

In 1990, Michael Asuzu held high hopes for the development in of a primary health care (PHC) system based on community participation, using well-trained, well-equipped and motivated community health professionals. Writing in the March 1990 issue of World health magazine, Asuzu, at the time a lecturer and consultant in the Department of Preventive and Social Medicine at the University College Hospital in Ibadan, enthused about a bottom-up grassroots PHC project in the hamlet of Elesu, 32 kilometres north of lbadan. Members of Asuzu's university department had helped villagers develop a programme to control outbreaks of waterborne guinea-worm disease and adopt other PHC measures. We expect to be able to replicate this programme in any local community ready to take charge of its needs for PHC as the Elesu community has, he said. case history shows that, when community health development workers are available and willing to go out and assist communities, it is possible for them to come forward to request and be helped to provide community-owned and self-reliant PHC programmes for themselves. Fast forward 18 years and Asuzu, now professor of Public Health and Community Medicine at the University of Ibadan, is less ebullient when discussing PHC in his country. Addressing the Nigerian Academy of Science Seminar in Abuja in May this year, Asuzu said: Nigeria has never succeeded in establishing community medical and health services for very many reasons ... some limited levels [have] been practised in Nigeria, even during the colonial days, but never fully. In June, Asuzu told the Nigerian Medical Students Association that had in the mid-1980s joined the international push for PHC after the 1978 Alma-Ata Declaration of 'health for all'. Some progress seemed to have been made with the health services between then and the mid-1990s, he said. However, the health indices have been deteriorating since then [judging] by every health system evaluation [carried out] in the country. Unfortunately, has never learnt or developed any system of authentic and full-scale community health care before Alma-Ata or after it. This explains why we have not made any success of the The world health report 2000 ranked 187 out of 191 countries for health service performance, a situation that has not changed much since then, according to Asuzu, who cites several statistics to highlight the inadequacies in Nigeria's PHC system. Annual budget allocations to health have been persistently below 5% except for the years 1998-1999 and 2002-2003 when they were at or just above this level. Infant mortality rates have been deteriorating from 85 per 1000 live births in 1982, 87 in 1990, 93 in 1991 to 100 in 2003, according to the Demographic and Health Survey, 2003. And in 2007, the Federal Ministry of Health reported 110 deaths per 1000 live births. Maternal mortality ratios are estimated at 1100 per 100 000 live births in WHO's Worm health statistics 2008. Asuzu identifies five attempts at reform over the past 70 years: * 1940s. The Nigerian Colonial Development Plan had a limited framework for a unitary health service. * 1950s. Regional governments ran independent and sometimes parallel health systems to the federal government. * 1960s. The Second National Development Plan in the post-independence era did not articulate a system with clear responsibilities for each level of government. * 1970s. The ambitious Third National Development Plan had the Basic Health Services Scheme as its focus, but again failed to share responsibilities between the governments for resource generation, manpower development, health professional deployment and service delivery. * 1980s. Following the Declaration of Alma-Ata, there were serious attempts at health system reform, based on the principles of PHC resulting in the National Health Policy in 1988. …

Reforming Primary Health Care in Akwa Ibom State

INTRODUCTION:Society and all social systems are dynamic which means that changes occur continuously. Some changes occur spontaneously while others are planned and executed. Planned changes, or reforms, occur in all sectors of life, the aim usually being to improve efficiency and performance in the system so that society could be better served. Since health is now regarded as a central focus in the overall developmental efforts of human societies, planned changes in the health sector occur very rapidly[1]. These changes have engendered profound impacts on the health of nations, leading to visible improvements in the quality of life. Primary health care is one such planned change. Since its definition and adoption in 1978[1], primary health care, where properly implemented has led to tremendous improvement in the health status of various communities as shown by drops in maternal mortality, infants mortality and other indices used in assessment of the health status of communities. It has not been a smooth sail for primary health care in Nigeria, and by extension, Akwa Ibom State. In the hay days of the programme, for example, immunization coverage country wide, as at 1990 was 65%[2]. Recently, coverage is said to have dropped to just 13%[3]. At a stage, things took such a dramatic turn that an assessment by some workers indicated that primary health care has completely collapsed at the local government level[4]. For the drift not to continue, primary health care at the local government level, which itself is a reform, has to be reformed. In this article, we discuss reforms in general, in the health sector in particular and suggest measures to reform primary health care in Akwa Ibom State.

Local Government and Health Care Delivery in Nigeria: A Case Study

This paper seeks to highlight the recent activities of local government in health care delivery. The literature review reveals the interconnectedness between local government and the sustenance of primary health care in Nigeria. The study traced the historical antecedent of health service delivery from the colonial era to the present day. It identifies the major contradictions in the management of primary health care implementation, using a local government as case study. They include shortage of qualified personnel and finance, inadequate transportation, inaccessibility to communities, lack of maintenance culture, political instability, high degree of leadership turn-over. For the sustainability of health care service delivery at the grassroots, the study recommends increase financial allocation, community mobilization, improved health education, policy consistency and provision of qualified health workers.

Utilization of maternal health services by rural Hausa women in Zaria environs, northern Nigeria: has primary health care made a difference?

Background: Expanding coverage, strengthening of, and increasing access and utilization of maternal health services is one of the key components of Nigeria's Primary Health Care (PHC) efforts , which was started in 1986. A descriptive study was undertaken to document the level and pattern of utilization of selected maternal health services among rural Hausa women in order to assess progress in PHC implementation. Methods: A cross-sectional descriptive, quantitative study using structured interviewer-administered questionnaire was used to collect data on family planning, antenatal, post natal and delivery services utilization pattern from a total population of 655 currently married women in the reproductive age group in two predominantly Hausa villages in north-western Nigeria. The findings were compared with the baseline data obtained in the local government area at the start of PHC in 1986. Results: About two-thirds of the women had heard of family planning. There were statistically significant associations between age (P Conclusion: Utilization of orthodox maternal health services among the rural Hausa women is abysmally low and PHC implementation has not made any appreciable impact on their maternal health services uptake. KEY WORDS: Primary health care; Progress assessment; Maternal health services; Utilization; Rural Hausa women; Nigeria Journal of Community Medicine & Primary Health Care Vol.16(2) 2004: 47-54

Childbirth and primary health care in Nigeria

Like many developing countries, Nigeria is unable to provide adequate maternal and child health care to its people because of inadequate and inequitable distribution of health resources. This paper explores the issues of traditional birth attendants in primary health care in Nigeria. This work is part of a larger study which investigated the role of traditional birth attendants in primary health care in the Rivers State, Nigeria: (Adikibi, 1988). The author has continued to follow up these traditional birth attendants in this area to monitor their progress within their community.

An appraisal of Nigeria's primary health care system

AbstractExpressing his disgust in a keynote address at a workshop on the role of nurses in reducing child morbidity and mortality in Nigeria, Omene (1986) asserts that an appraisal of the performance of the primary health care sector in Nigeria is saddled with difficulties. Some of these, he claims, are not only due to financial constraints but also to the poor management of the meagre available resources.

Women's and Health-Care Providers' Views of Maternal Practices and Services in Rural Nigeria

Maternal mortality and morbidity estimates in Nigeria continue to be dramatically high largely because maternal services, especially in rural areas, are often deficient and inappropriate to women's situations. The Safe Motherhood Project in Zone A examined the pregnancy-related knowledge, attitudes, and practices of community members, and women's use of community maternal health services. Focus-group discussions and interviews confirmed a number of recent findings by other studies; they also documented extensive hostility between the two most commonly used health-care providers: traditional birth attendants and midwives. The hostility resulted in rumors, deliberate attempts to discourage women from seeking higher levels of care, and refusals to accept referrals or treat patients, which were found to be serious constraints to good maternal care in the targeted rural area.

Quality assurance management methods applied to a local-level primary health care system in rural Nigeria.

Introduction. Management of primary health care (PHC) systems in less developed countries is often impeded by factors such as poorly trained personnel, limited financial resources, and poor worker morale. This study explored the ability of local-level PHC supervisors in rural Nigeria to use quality assurance (QA) management methods to improve the quality of the PHC system. Methods. PHC supervisors from Bama Local Government Area were trained for 3 days in the use of QA methods and tools. The supervisors targeted the supervisory system and the health information system (HIS) for improvement. Health worker performance in diarrhoea case management was assessed, using a simulated case, to measure the impact of supervision. A HIS audit assessed data collection forms used by 17 PHC facilities. Gaps in quality were monitored over a 2-month study period and flaws in work processes were modified. Results. PHC supervisors introduced a checklist during monthly visits to facilities to monitor how workers managed cases of diarrhoea. Performance in history-taking, physical examination, disease classification, treatment and counselling improved over the evaluation period. The HIS audit found that a variety of reporting forms were used at PHC facilities. After HIS reporting was standardized, the number of health facilities using a daily disease registry significantly improved during the study period. Conclusions. QA management methods were used by PHC supervisors in Nigeria to improve supervision and the HIS. QA management methods are appropriate for improving the quality of the PHC in Nigeria and in other less developed countries where at least a minimal PHC infrastructure exists.

The use of selected interventions in monitoring primary health care implementation in rural Nigeria.

Nigeria's Primary Health Care (PHC)-based health system development aims to strengthen PHC in the local government areas (LGA) through technical planning and implementation that emphasize maternal and child health services. Convenient variables, including expanded programme on immunization (EPI), antenatal care (ANC) utilization and attended births, were selected as interventions to monitor the progress of implementation of PHC activities during 1985-90 in Odukpani LGA. Analysis of available data at the LGA showed that immunization coverage for most EPI antigens increased; ANC services showed increased utilization; health worker-attended births increased as traditional birth deliveries declined during the period. Some of the increases were modest but are considered important. The study offers a pilot approach to monitoring implementation of PHC activities in Odukpani LGA. The implications of the findings for similar studies are discussed.

Reducing attrition among village health workers in rural Nigeria

Nigeria's primary health care program relies on village health workers (VHWs) to provide simple curative and preventive services to largely rural underserved communities. Despite the reported need for these services, there is increasing evidence that VHWs often take leave of their jobs as a result of low patient demand, competing time interests, and less than adequate supervision. This paper describes the use of a simple operations research (OR) approach [1] to assist rural health program managers design strategies for reducing VHW attrition. It illustrates the feasibility and potential utility of employing the Nominal Group Technique (NGT) to draw on the experience and judgment of a variety of health professionals in arriving at local program decisions. This OR approach to problem solving resulted in a feasible and acceptable strategy which is now being implemented in southern Gongola State, Nigeria.

Mobilizing indigenous resource for primary health care in Nigeria: A note on the place of traditional medicine

Noting the challenges posed by the goal of Health For All by the Year 2000, this paper re-echoes the need to mobilize traditional medicine for Primary Health Care in Nigeria. The paper points to the inadequacy of modern health facilities and the obstacles that stand in the way of providing enough modern health facilities to meet the demand of Nigeria's population by the year 2000. It is observed that traditional medicine offers an alternative model not only because it is relatively inexpensive both to the practitioners and patients who often settle their bills in kind or cash but also because of its acceptability among Nigerians. Finally, it is suggested that government and traditional medical practitioners should cooperate for it is in this way that the practice of traditional medicine can be improved and the practitioners encouraged to add Primary Health Care activities to the repertoire.