Evaluation Of Factors That Militate Against Effective Delivery Of Primary Health Care (PHC) System In Maigatari Primary Health Care, Maigatari Local Government Jigawa State

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Evaluation Of Factors That Militate Against Effective Delivery Of Primary Health Care (PHC) System In Maigatari Primary Health Care, Maigatari Local Government Jigawa State


Abstract


This study evaluated the factors that militate against effective delivery of primary health care (PHC) system in Maigatari Primary Health Care, Maigatari Local Government Jigawa State. A descriptive survey research was used for the study. The population consisted of all health care workers working in Maigatari Primary Health Care, Maigatari Local Government Jigawa State at the time of study. Through convenience sampling technique, the researcher sampled 70 respondents for data collection. Self-structured questionnaire made of two sections was used; Section A contained items on personal data while section B contained items that elicited responses from the respondents on the factors influencing quality of health care. Face-to-face interview was also used to collect pertinent data from the respondents. Data obtained were analyzed using frequency and percentage. Chi-square statistical tool was used to test the hypothesis. Data were presented in tables. The findings showed that the factors influencing the delivery of quality health care service includes health care staff shortage, continuous education and training of staff, working environment and teamwork; a significant relationship was found to exist between health care staff shortage and the quality of health care service delivered;. Based on the findings, the need for these factors to be positively harnessed and modified where necessary to improve the quality of health care is therefore suggested.


Table of Content


Chapter One:

Introduction

  • 1.1 Background of the study
  • 1.2 Statement of the problem
  • 1.3 Objective of the study
  • 1.4 Research questions
  • 1.5 Hypothesis of the study
  • 1.6 Significance of the study
  • 1.7 Scope of the study
  • 1.8 Limitation of the study
  • 1.9 Definition of terms
  • 1.10 Organizations of the study

Chapter Two:

Review of Literature

  • 2.1 Conceptual Framework
  • 2.2 Theoretical Framework
  • 2.3 Empirical Framework

Chapter Three:

Research Methodology

  • 3.1 Research Design
  • 3.2 Population of the study
  • 3.3 Sample size determination
  • 3.4 Sample size selection technique and procedure
  • 3.5 Research Instrument and Administration
  • 3.6 Method of data collection
  • 3.7 Method of data analysis
  • 3.8 Validity of the study
  • 3.9 Reliability of the study
  • 3.10 Ethical consideration

Chapter Four:

Data Presentation and Analysis

  • 4.1 Data Presentation
  • 4.2 Analysis of Data
  • 4.3 Answering Research Questions

Chapter Five:

Summary, Conclusion and Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • APPENDIX
  • QUESTIONNAIRE 

Chapter One


Introduction

1.1. Background of the Study

A wealth of knowledge and experience in enhancing the quality of health care has accumulated globally over many decades. In spite of this wealth of experience, the problem frequently faced by policy-makers at country level in both high- and low-middle-income countries is to know which quality strategies would have the greatest impact on the outcomes delivered by their health systems. Even where health systems are well developed and resources are available, there is clear evidence that quality remains a serious concern, with expected outcome not predictably achieved and with wide variations in standards of health-care delivery within and between health-care systems (WHO; 2006).

The Chambers Dictionary (2008) defines standard as a basic for measurement, an established or accepted model, a definite level of excellence or adequacy required, aimed at or possible.

In today’s society, the quality of Health care service delivered has become an index for classifying nation into the different world blocs and has made the provision of quality health care an issue for debate among the government of nations because citizens now glamour for health care as a right and no longer a privilege.

The general public has become increasingly interested and knowledgeable about health service delivery and health promotion through television, newspaper, internet, journals, magazines and other media outlets. Health care has become a topic of political debate as the delivery of quality health care is associated and influenced by various variables or factors. The public has also become more health conscious and subscribes to the belief that health and quality health care service constitutes a basic right rather than a privilege for a chosen few. (Suzanne, Brenda, Janice & Kerry, 2008).

The researcher while on clinical posting to the Maigatari Primary Health Care had observed reduction in the quality of health care services delivered to patients/clients. Some of the doctors, nurses and community health workers forget or negligently refuse to follow up simple standard precautionary procedures all of which could be detrimental to the health of the patient, that of the care giver and hamper quality health care delivery. It is on this premise that the researcher is interested and motivated to carry out a study on factors influencing the delivery of quality health care service in Maigatari Primary Health Care.

The current research study may compliment the findings of other literatures on the issue under study by further investigating current trends and Evaluation Of Factors That Militate Against Effective Delivery Of Primary Health Care (Phc) System In Maigatari Primary Health Care, Maigatari Local Government Jigawa State.


1.2 Statement of Problem

When quality health care delivery is not insured, the patient’s safety and recovery is endangered and hampered. This will further promote loss of confidence in health care services rendered, non adherence to medical advice and relapse.

The major point of concern is geared towards the factors influencing the improvement of patient’s experiences of quality health care and those that hampers quality health care service care delivery as well as its influence on patient’s health status. Primary health care workers need to know what factors within the primary health work environment are of influence. The challenges earlier mentioned leads to one form of breech or the other.

The disturbing image and the effect of these challenges, especially on the patient’s health and promotion of standards of practice in the Primary healthcare nursing profession has prompted this study on the Evaluation Of Factors That Militate Against Effective Delivery Of Primary Health Care (Phc) System In Maigatari Primary Health Care, Maigatari Local Government Jigawa State.


1.3 Purpose of the Study

The purpose of this study is an Evaluation Of Factors That Militate Against Effective Delivery Of Primary Health Care (Phc) System In Maigatari Primary Health Care, Maigatari Local Government Jigawa State. Specific Objectives of the Study are:

  1. To ascertain if staff shortage influences the delivery of quality health care service.
  2. To determine if team work influences the delivery of quality health care service.
  3. To determine if continuous education and training of staff influences the delivery of quality health care service.
  4. To evaluate if staff working environment influences the quality of health care service delivered.

1.4 Research Questions

The following research questions will be answered in the course of this research study

  1. Does staff shortage influence the delivery of quality health care service?
  2. Does team work influence the delivery of health care service?
  3. Does continuous education and training of staff influence the delivery of health care service?
  4. Does staff working environment influence the quality of health care service delivered?

1.5 Research Hypothesis

There is no significant relationship between staff shortage and the quality of health care service delivered.


1.6 Significance of the Study

The outcome of this study may assist the Primary health care service administration to assess and appraise the factors that may promote or reduce the delivery of quality health care service.

The result of this study when published may encourage the Primary health care service administration to ensure the effective implementation of programs that will improve the quality of care rendered by Primary health care workers in primary health centers and the community.

The result of the study may also bring to the awareness of the federal Government the need for better funding to improve facilities and services in Primary health care centers, as well as increase remunerations for Primary health care workers.


1.7 Delimitation of the Study

This study was an Evaluation Of Factors That Militate Against Effective Delivery Of Primary Health Care (Phc) System. The study was carried out in Maigatari Primary Health Care, Maigatari Local Government Jigawa State. It investigated if staff shortage, team work, continuous training and education of health workers as well as staff’ working environment are amongst factors influencing with the delivery of quality health care service.


1.8 Limitation of the Study

However, there were constraint imposed on the researcher this includes the following.

a. Time:

A study of this nature, needs a relatively long time during which information for accurate or at least near accurate inferences could be drawn. The period of the study was short, hence time posed as a constraint to the researcher.

b. Cost:

The researcher would have extent the survey to areas. But limitations here included cost of transportation to source for materials and cost of typesetting the already completed work.

c. Dearth (Scarcity) of Statistical Data:

Commercial banks adhere strictly to the rule of secret; in banking thus they refused to release information.


1.9 Operational Definition of Terms

The following working definition or concepts is used in this study and are defined within the context that they have been used;

Quality Care:

This refers to standards which are identifiable, recognizable and measurable in terms of the delivering of nursing care. Quality care implies nursing care that meets patients’ needs and expectation and also meets professional standards.

Standard Health Care Service:

This refers to health care service in relation to a basic for measurement, an established or accepted model, a definite level of excellence or adequacy required, aimed at or possible. Standard healthcare service is defined as health care services provided by health care workers that meet patients’ physical, psychological as well as spiritual needs.

Health Care Service Delivery;

The process or means by which Health care services are provided or given.

Community Health Workers;

They are voluntary health workers like traditional birth attendants (TBAs) and village health workers (VHWs) and includes health care workers deeply involved in community health care such as community health extension workers (CHEWs) and community health officers (CHOs)

Evidenced-Based Practice:

This is the use of current evidence from scientific research in order to make health care related decision.


1.10 Organizations of the Study

The chapter one consist of the introductory part of the study which includes the study background, the statement of the research problem, the study objective and scope of the study.

The second chapter is a critical review of other literatures relevant to the study and its objectives including the theoretical framework for the study. While the third chapter is methods of data collection, sampling and data analysis used in conducting the study.

The fourth chapter centres around the research findings including an analysis of how it relates to previous findings.

The fifth chapter consists of the summary of findings, conclusion and recommendations base on the study objectives.


Chapter Five


Summary, Conclusion and Recommendations

This chapter discusses the findings of the research study and goes on to make comparison with other studies related to the research area.


5.2 Summary

In summary, the purpose of this study was to evaluate the factors that militate against effective delivery of primary health care (PHC) system in Maigatari Primary Health Care, Maigatari Local Government Jigawa State. A descriptive study design was used and a sample size of seventy (70) respondents was drawn using the convenience sampling technique. Data was obtained from the respondents with the using a self structured questionnaire and face-to-face structured interview. Results revealed that the factors influencing the delivery of quality health care service includes health care staff shortage, continuous education and training of health care workers, working environment and teamwork; a significant relationship was found to exist between health care staff shortage and the quality of health care service delivered.


5.3 Conclusion

In today’s society, the quality of care delivered has become an index for classifying nation into the different world blocs and has made the provision of quality health care an issue for debate among the government of nations because citizens now clamor for health care as a right and no longer a privilege.

Primary health care workers form an important aspect of the workforce in the health care sector and the closest among all personnel to the patients in the community. They communicate with the patients to ascertain the state of wellbeing and provide care where necessary. Patients compare their expectation of care with the perceived service rendered and adjudge the quality of care. Where the perceived service is more than the patient’s expectation, they prefer to visit the health care center continuously but if it falls short of their expectation, often time, they look out for alternative places to derive satisfaction for their health needs. In recent past, the health care institutions have not lived up to the expectation of its clients as there are pockets of complaint about the quality of its health care.

This complaints ranges from issues relating to medication errors to caring attitudes, protocol in care delivery, poor communication, staffing, lack of attention, to mention but a few. The need for these factors to be positively harnessed and modified where necessary to improve the quality of health care is therefore suggested.


5.4 Recommendations

Based on the findings of the study, the following recommendations are proffered;

  1. Indices of quality healthcare service should be provided by the health care management board to the various health care centers.
  2. Healthcare facilities should be well staffed
  3. A patients care friendly health care environment where the health care workers can work efficiently and effectively should be provided
  4. Teamwork should be encouraged among health care providers.
  5. On employment, health care workers should be trained and oriented on parameters to ascertain clients’ satisfaction.
  6. Seminars and workshops on quality health care should be organized in the health centers frequently to discuss and orient on current issues on quality health care geared towards clients’ satisfaction.

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