Public Perception On The Effectiveness Of Indigenous Healthcare Delivery System In Enugu State
This study was carried out to examine public perception on the effectiveness of indigenous healthcare delivery system in Enugu State.The study was carried out to ascertain if primary healthcare is accessible in Enugu State, explore how indigens of Enugu state perceive primary healthcare system, determine if people’s perception health care delivery will impact their utilization indigenous healthcare system, and investigate if indigenous healthcare system has been effective in healthcare delivery. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprised of residents of Nsukka local Government, Enugu State. In determining the sample size, the researcher conveniently selected 147 respondents and 141 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables, and mean scores. While the hypotheses was tested Chi-square statistical tool. The result of the findings reveals that the indigens of Enugu state perceive primary healthcare system in the following ways: lack adequate facilities, lack poor of qualified health workers, not affordable, and not accessible. Furthermore, the study revealed that people’s perception of health care delivery impact their utilization healthcare services.Therefore, it is recommended that there is a need to ensure that patients have easy access to health care by ensuring that health personnel are available when needed. Long waiting times should be discouraged by identifying areas in the health care delivery system that is prone to causing long waiting times with a view to developing alternate health systems that will eliminate long hours of stay in public facilities. This can be achieved by involving consumers of health care in government facilities in decision making process to make the facility more customers oriented. To mention but a few.
Table of Content
- Title Page
- Table of Content
- List of Tables
- 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
Review of Literature
- 2.1 Conceptual Framework
- 2.2 Theoretical Framework
- 2.3 Empirical Review
- 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
Data Presentation and Analysis
- 4.1 Data Presentation
- 4.2 Analysis of Data
- 4.3 Answering Research Questions
- 4.4 Test of Hypotheses
Summary, Conclusion and Recommendation
- 5.1 Summary
- 5.2 Conclusion
- 5.3 Recommendation
1.1 Background of the Study
As part of commitment to the United Nations’ Sustainable Development Goals, countries around the world aspire to provide universal health care. In 2014, the global coverage of skilled providers during delivery was 71 percent, with 52 percent in Sub-Saharan Africa, where the public sector lacks resources (United Nations 2015). Child and maternal fatalities have decreased dramatically, indicating global success toward the health-related Millennium Development Goals (MDGs). Global under-five mortality fell from 12.7 million to 6.3 million between 1990 and 2013, while the maternal mortality ratio fell from 380 to 210 per 100,000 live births. In Sub-Saharan Africa, however, the proportion of infant and maternal deaths has climbed.
Between 2008 and 2013, the maternal mortality ratio in Nigeria climbed from 545 to 575 deaths per 100,000 live births, indicating a worsening condition. In Nigeria, interventions have been intended to minimize maternal mortality and help the country meet the MDG target of 250 deaths per 100,000 live births. Despite the government’s engagement with the private sector to encourage greater access to quality maternal health services, mother and child health continues to deteriorate.
Nigeria’s healthcare delivery system consists of primary, secondary, and tertiary healthcare facilities as a Sub-Saharan African country (Uzochukwu et al., 2009). Different local and regional elements that determine the quality and quantity existing in one location have shaped Nigerian health policy (Uzochukwu et al., 2009). The primary healthcare delivery system has been completely degraded and neglected as a result of this. The Enugu State government established the District Health System (DHS) in 1999 to support Nigeria’s national health policy on basic healthcare delivery. This is a type of health-sector decentralization that is implemented through a structured management system (District Health Management Team) that integrates primary and secondary healthcare services to meet the needs of the rural population.
However, contemporary realities show that massive global and national investments targeted at delivering effective health care have not given the anticipated results due to low utilization and, as a result, low access. Frost and Reich (2009) argue that the availability of interventions and services does not always imply access. The term “access” refers to the intended clientele’s ability to use interventions and services effectively and appropriately. Poor access to health facilities and services has been cited as a barrier to addressing significant health issues in Africa. Perception has emerged as a significant factor of health-care utilization.
People’s opinions and judgments are frequently influenced by factors that their traditions and cultures value, such as civility, responsiveness, attentiveness, and perceived competency of health care providers. People’s perceptions are shaped by their level of satisfaction with the health-care system, as well as their appraisal of health-care personnel’ attitudes, which often decides whether they would return in the future. To enable successful interventions and attain universal health for the people, it is critical that all stakeholders grasp the people’s perceptions of health services. This is critical to developing appropriate promotional messages and campaigns, aimed at creating demand for particular health interventions.
1.2 Statement of the Problem.
The demand for healthcare services has increased over the years in Enugu urban area due to the growing population of the city. Gaps have also been revealed between need and actual access to some critical health services .In Nigeria, 61% of mothers received antenatal care from a qualified provider. Only 51% of this group visited an antenatal care provider at least four times during their pregnancy. Between the first and fourth usages, there is a 49 percent drop in utilization. Only 19% of children (aged 12–23 months at the time of the survey) had received all of the recommended vaccinations, according to the vaccination cards. The third diphtheria, pertussis, and tetanus (DPT3) vaccine, which was used as a proxy for vaccine use, was only used 22.2 percent of the time, while DPT1 was used 26.7 percent of the time (Eze, C. 2008).
Healthcare facilities that were initially meant for two settlements are now being used by seventeen settlements of Enugu urban area. These has caused over utilization of public healthcare facilities and delays in accessing same. Another problem is congestions on routes in-and-out of these facilities due to traffic and economic activities associated with an urban area. In case of emergency, response to save life is very minimal because of no definite route to those healthcare facilities especially the specialist hospitals. The above mentioned problems lead to self medication, patronage of patent medicine dealers, infant and maternal mortality etc. In order to ameliorate the problems encountered in accessing good healthcare facilities, a GIS based technique was used to measure accessibility of the healthcare facilities in Enugu urban and to define shortest routes and closest facilities during emergencies. The current situation of healthcare delivery in Enugu urban leaves much to be desired. It is against this backdrop that the study which seeks to examine public perception on the effectiveness of indigenous healthcare delivery system in Enugu State was carried out.
1.3 Objective of the Study
The broad objective of this study is to examine public perception on the effectiveness of indigenous healthcare delivery system in Enugu State. Specifically the study seeks to:
- Ascertain if primary healthcare is accessible in Enugu State.
- Explore how indigens of Enugu state perceive primary healthcare system.
- Determine if people’s perception health care delivery will impact their utilization indigenous healthcare system.
- Investigate if indigenous healthcare system has been effective in healthcare delivery.
1.4 Research Questions
- Are primary healthcare accessible in Enugu State?
- How does indigens of Enugu state perceive primary healthcare system? They lack adequate facilities, lack poor of qualified health workers, Not affordable, Not accessible.
- Will people’s perception of health care delivery impact their utilization healthcare services?
- Has the indigenous healthcare system been effective in healthcare service delivery?
1.5 Research hypothesis
- Ho: Indigenous healthcare system has not been effective in healthcare delivery in Enugu State.
- Ha: Indigenous healthcare system has been effective in healthcare delivery in Enugu State.
1.6 Significance of the Study
Findings from the study will be helpful to health care providers working at primary healthcare centres those in the medical line, policy maker and academia. The study will reveal the need for government to make provision for more equipped healthcare centre in rural and urban areas. The study will enlighten professional care givers on the need to show empathy to patients while rendering health services. Empirically the study will contribute to body of existing literature and serve a s reference material to both scholars and student who wishes to conduct further studies in related field.
1.7 Scope of the Study
The scope of this study borders on public perception of the effectiveness of indigenous healthcare delivery system. The study will ascertain if primary healthcare is accessible. It will determine if people’s perception health care delivery will impact their utilization indigenous healthcare system. The study will also investigate if indigenous healthcare system has been effective in healthcare delivery. The study is however delimited to selected local government in Enugu State.
1.8 Limitation of the Study
Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint was the scanty literature on the subject owing that it is a new discourse thus the researcher incurred more financial expenses and much time was required in sourcing for the relevant materials, literature, or information and in the process of data collection, which is why the researcher resorted to a limited choice of sample size. Additionally, the researcher will simultaneously engage in this study with other academic work. Despite the constraint encountered during the research, all factors were downplayed in other to give the best and make the research successful.
1.9 Definition of Term
The health care system refers to the institutions, people and resources involved in delivering health care to individuals. A health system consists of all organizations, people, and actions whose primary intent is to promote, restore, or maintain health such as hospital systems, patient care, insurance.
1.10 Organization of the Study
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.
Summary, Conclusions and Recommendations:
This chapter summarizes the findings on public perception on the effectiveness of indigenous healthcare delivery system in Enugu State.The chapter consists of summary of the study, conclusions, and recommendations.
5.2 Summary of the Study
In this study, our focus was to examine public perception on the effectiveness of indigenous healthcare delivery system in Enugu State. The study specifically was aimed to ascertain if primary healthcare is accessible in Enugu State, explore how indigens of Enugu state perceive primary healthcare system, determine if people’s perception health care delivery will impact their utilization indigenous healthcare system, and investigate if indigenous healthcare system has been effective in healthcare delivery.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 141 responses were validated from the enrolled participants where all respondents areresidents of Nsukka local Government, Enugu State.
Based on the findings of this study, the researcher made the following conclusion.
- Primary healthcare are not accessible in Enugu State.
- The indigens of Enugu state perceive primary healthcare system in the following ways: lack adequate facilities, lack poor of qualified health workers, not affordable, and not accessible.
- People’s perception of health care delivery impact their utilization healthcare services.
- The indigenous healthcare system has not been effective in healthcare service delivery.
Based on the findings of the study, the following recommendations are proffered.
- Political actors, policy makers and all stakeholders in the health sector should establish a government funded social and financial risk protection scheme through a general tax financing system for the poor and vulnerable, and invest in basic infrastructure for health care in rural areas for quality health care service delivery. UHC schemes are important in addressing the problem of poor coverage, limited access to health care, and poor quality of health care services.
- There is a need to ensure that patients have easy access to health care by ensuring that health personnel are available when needed. Long waiting times should be discouraged by identifying areas in the health care delivery system that is prone to causing long waiting times with a view to developing alternate health systems that will eliminate long hours of stay in public facilities. This can be achieved by involving consumers of health care in government facilities in decision making process to make the facility more customers oriented.
- Policy makers and political actors need to devise health care reforms to address the lack of social and financial protection for the poor and vulnerable populations. Part of this reform is the expansion of the NHIS. States should be mandated to provide health insurance coverage to all residents. Making health insurance optional for states over the years has affected the ability of the NHIS to increase the level of coverage for the people.
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