Patronage Of Rural Dwellers Towards Primary Health Care Delivery System

Project and Seminar Material for Public Health

Patronage Of Rural Dwellers Towards Primary Health Care Delivery System


Abstract


This study focus on patronage of rural dwellers towards primary healthcare delivery system with special reference to residents in Ikole local government area, Ekiti State. Specifically, the study ascertain the extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti, examine the factors influencing the patronage of rural dwellers towards primary healthcare delivery system in Ikole-Ekiti and propose strategies aimed at enhancing primary healthcare delivery system in Ikole-Ekiti. The study employed the survey descriptive research design. A total of 259 responses were validated from the survey. From the responses obtained and analyzed, the findings revealed that the extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti is high. The study hereby recommend that there must be increase awareness among the people of the need to be healthy; this can also be achieved through enhancing the educational status of especially women in rural communities. Also, efforts should be made to improve the road conditions especially the ones in a terrible condition as this is the major access route for communities. Although some efforts have been made in this direction, some pot holes exist and community efforts will be required to completely resolve such a problem.


Table of Content


  • Title Page
  • Certification
  • Dedication
  • Acknowledgement
  • Table of Content
  • List of Tables
  • Abstract

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 Research Hypothesis
  • 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 Organisations of the Study

Chapter Two:

Review of Literature

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

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
  • 4.4 Test of Hypotheses

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

According to the United Nations in 2009, almost half of the world’s population lived in rural regions, with 3.41 billion people residing in rural areas and 3.42 billion people living in urban areas. In Nigeria, 48.04 percent of the population resides in rural regions, according to the Nigeria Rural Population Service (2020). The latest United Nations study highlighted the need to focus efforts on nations and areas with the greatest child mortality rates in order to achieve MDG4: Target 4.a, which aims to reduce the under-five mortality rate by two thirds between 1990 and 2015. These locations were classified as emerging regions and remote areas (United Nations, 2013). In addition, the availability and quality of healthcare services in underserved and rural regions are insufficient. As a result, those who are economically disadvantaged experience the burdensome financial consequences of poor health in two ways: via the expenses associated with obtaining healthcare services and the loss of productive days (Ministry of Health, 2007). In order to achieve a satisfactory level of health among the population and accomplish the Millennium Development Goals (MDGs), it is necessary to substantially enhance access to high-quality healthcare in rural areas. Nevertheless, this has had a devastating impact on several governments, especially those in the developing world.

Accessing health care services is essential for maintaining good health and promoting socio-economic and infrastructural progress (Bathia & Rifkin, 2010). The use of health care services is affected by certain factors, such as the presence of healthcare facilities (Cueto, 2004). Availability encompasses several aspects such as proximity, ease of access, knowledge, transportation, language, cultural differences, and personal choice. Other factors include the expense of healthcare services and the level of service delivered by healthcare professionals. The utilisation of health care varies significantly between urban and rural communities due to disparities in the availability of essential medical equipment and the presence of trained medical personnel. Urban areas tend to have a higher supply of such resources, while rural communities, where over 60% of the population resides, face a relatively limited supply. Health indices in Nigeria have seen a significant slowdown in overall growth, particularly in terms of maternal mortality ratio, where the country ranks among the highest. Based on the 2018 NDHS, the estimated maternal mortality ratio for the 7-year period prior to the survey is 512 maternal deaths per 100,000 live births (Gillam, 2008). In rural areas, where access to modern health facilities is restricted, the situation is even more concerning. The majority of residents rely on local traditional birth attendants for their healthcare needs. The utilisation of health facilities in rural and urban populations is significantly influenced by the distribution of health facilities and the presence of healthcare workers at these facilities.

These recurring gaps have been attributed to factors such as the state of service, inadequate working equipment, insufficient infrastructure, and poor communication service and access road (Gillam, 2008). Rural residents have challenges in accessing healthcare due to the need to drive larger distances and spend more time reaching health centres, which hinders their ability to make repeat visits. The lack of sufficient access to healthcare services has resulted in a decrease in life expectancy among rural residents and urban slum dwellers, as well as an increase in newborn mortality rates (Gillam, 2008). Therefore, the researcher sought to examine Patronage of rural dwellers towards primary healthcare delivery system.


1.2 Statement of the Problem

Access to high-quality healthcare is a basic entitlement for all individuals worldwide, and Nigeria is no exception. The objective of primary health care was to provide universal and readily available healthcare services for all individuals, both in the year 2000 and in the future. Undoubtedly, this is yet to be accomplished in Nigeria. Primary health care facilities were built in both urban and rural regions in Nigeria to promote equity and provide convenient accessibility. The majority of individuals living in underdeveloped nations, particularly in Africa, possess little knowledge of their national health systems and programmes, resulting in a propensity to underutilize healthcare services. Furthermore, several studies conducted in Nigeria since the establishment of PHC in 1992 have consistently revealed low rates of utilisation, which in turn contribute to the poor health condition of the population (Jaro and Ibrahim, 2012; Galadanchi, 2007; Cueto, 2004). Considering that a primary goal of primary health care (PHC) in developing nations is to enhance the health of individuals and communities by promoting health and increasing the use of preventive, curative, and rehabilitative health services, it is important to comprehend the factors that lead to the utilisation of health care facilities, particularly at the primary level. Rural populations continue to have ongoing difficulties in accessing sufficient healthcare services, leading to discrepancies in health outcomes when compared to metropolitan regions. Although attempts have been made to enhance primary healthcare delivery systems, there is still a lack of comprehension of the elements that influence the behaviour of rural residents in seeking and using these services. Hence, the study examine Patronage of rural dwellers towards primary healthcare delivery system.


1.3 Objective of the Study

The broad objective of the study is to examine Patronage of rural dwellers towards primary healthcare delivery system

  1. To ascertain the extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti.
  2. To examine the factors influencing the patronage of rural dwellers towards primary healthcare delivery system in Ikole-Ekiti
  3. Propose strategies aimed at enhancing primary healthcare delivery system in Ikole-Ekiti.

1.4 Research questions

The following questions have been prepared to guide the study

  1. What is the extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti?
  2. What are the factors influencing the patronage of rural dwellers towards primary healthcare delivery system in Ikole-Ekiti?
  3. What are the proposed strategies aimed at improving primary healthcare delivery system in Ikole-Ekiti.

1.5 Research Hypotheses

The hypotheses have been formulated to further guide the study

  • H0: The extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti is low.
  • Ha: The extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti is low.

1.6 Significance of the Study

The findings of this study will aid the local governments in charge of service delivery at these facilities in focusing their education and community communications on the core aspects that operate as obstacles to health-care utilization. It will also assist service providers at the facility level in developing strategies and action plans to encourage increased use of the services available. These efforts will help to start the process of enhancing access to health care services, which will eventually improve the overall health of everyone in the state.
The findings of the study will further be of benefit to the academic community as it will contribute to the existing literature.


1.7 Scope of the Study

The study focuses on Patronage of rural dwellers towards primary healthcare delivery system. Empirically, the study will ascertain the extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti, examine the factors influencing the patronage of rural dwellers towards primary healthcare delivery system in Ikole-Ekiti and propose strategies aimed at enhancing primary healthcare delivery system in Ikole-Ekiti. Geographically, residents in Ikole local government area, Ekiti State.


1.8 Limitation of the Study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection (internet, questionnaire, and interview), which is why the researcher resorted to a moderate choice of sample size. More so, the researcher will simultaneously engage in this study with other academic work. As a result, the amount of time spent on research will be reduced.


1.9 Definition of Terms

Patronage Behavior:

The actions and decisions made by individuals or communities regarding their utilization of goods or services, particularly in the context of healthcare, encompassing factors such as choice of healthcare provider, frequency of visits, and adherence to treatment plans.

Rural Dwellers:

Individuals residing in sparsely populated areas characterized by agricultural or natural landscapes, typically located outside urban centers and cities.

Primary Healthcare Delivery System:

The network of healthcare facilities, professionals, and services focused on providing essential and preventive care to individuals and communities, typically serving as the first point of contact within the healthcare system.


1.10 Organization of the Studies

The study is categorized into five chapters. The first chapter presents the background of the study, statement of the problem, objective of the study, research questions and hypothesis, the significance of the study, scope/limitations of the study, and definition of terms. The chapter two covers the review of literature with emphasis on conceptual framework, theoretical framework, and empirical review. Likewise, the chapter three which is the research methodology, specifically covers the research design, population of the study, sample size determination, sample size, and selection technique and procedure, research instrument and administration, method of data collection, method of data analysis, validity and reliability of the study, and ethical consideration. The second to last chapter being the chapter four presents the data presentation and analysis, while the last chapter(chapter five) contains the summary, conclusion and recommendation.


Chapter Five


Summary, Conclusion and Recommendation

5.1 Introduction

This chapter summarizes the findings into the patronage of rural dwellers towards primary healthcare delivery system using residents in Ikole local government area, Ekiti State, as a case study. The chapter consists of summary of the study, conclusions, and recommendations.


5.1 Summary

In this study, our focus was to examine patronage of rural dwellers towards primary healthcare delivery system using residents in Ikole local government area, Ekiti State, as a case study. The study specifically was aimed at highlighting the extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti, examine the factors influencing the patronage of rural dwellers towards primary healthcare delivery system in Ikole-Ekiti and propose strategies aimed at enhancing primary healthcare delivery system in Ikole-Ekiti.. A total of 259 responses were validated from the enrolled participants where all respondent are drawn from residents in Ikole local government area, Ekiti State.


5.2 Conclusion

Access to health facilities and services is prudent to ensuring high living standards among the population hence, irrespective of one’s geographical and socio-economic circumstances, access to health must be a basic service. Therefore, based on the finding of this study, the following conclusions were made:

  1. The extent to which rural dwellers patronize primary healthcare delivery system in Ikole-Ekiti is high.
  2. The factors influencing the patronage of rural dwellers towards primary healthcare delivery system in Ikole-Ekiti includes: proximity of the primary healthcare, poor attitude of health care workers, poor medical services, and long waiting time in assessing biomedical health care
  3. The proposed strategies aimed at improving primary healthcare delivery system in Ikole-Ekiti includes: There is a need to expand private networks and funding for health, Conduct periodic trainings for health workers, Align the primary healthcare with government priorities, and There is need to fund PHC-focused research

5.3 Recommendation

Based on the responses obtained, the researcher proffers the following recommendations:

  1. There must be increase awareness among the people of the need to be healthy; this can also be achieved through enhancing the educational status of especially women in rural communities.
  2. Efforts should be made to improve the road conditions especially the ones in a terrible condition as this is the major access route for communities. Although some efforts have been made in this direction, some pot holes exist and community efforts will be required to completely resolve such a problem.
  3. Training and retraining of health personnel on friendliness and putting up good attitude to encourage hospital visits among clients.
  4. The government at the state and local governments should reduce drug costs through subsidies and making essential drugs available. The availability of drugs in this study has been shown to improve hospital visits.

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