The Status of Primary Healthcare Services Capacity in a State in South-South, Nigeria
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Abstract
BACKGROUND: Supportive supervision involves the practice of regularly visiting health facilities to monitor staff performance, record observations, build relationships and provide constructive feedback with the aim of improving performance and treatment outcomes. This study aims to provide baseline records on the status of primary healthcare delivery in Rivers State before the commencement of the Saving One Million Lives Program for Results (SOMLPforR) Integrated Supportive Supervision in Rivers State.
METHODS: This baseline assessment conducted in 2018 adopted a descriptive design and involved 223 primary and 3 secondary healthcare facilities located within 22 Local Government Areas in Rivers State, Nigeria. A standardised Integrated Supportive Supervision (ISS) checklist comprising 187 indicators under various thematic areas (including immunisation, essential drugs supply, among others) was used to assess the services provided at the healthcare facilities. Data on the specific indicators were analysed using the Statistical Package for Social Sciences (SPSS) version 24 software.
RESULTS: The overall performance of primary healthcare service delivery in the state across all the thematic areas was 40.9%. Performance in the various thematic areas included immunisation service delivery (94.7%), human resources for health/health information management systems (79.4%), availability of basic equipment and supplies (58.6%), tuberculosis services (57.1%), infrastructure (57%), provision of malaria services (35.8%), HIV care (35.7%), essential drugs (35.4%), utilisation of prenatal services (14.1%), outpatient facilities (10.1%), delivery under the care of a skilled birth attendant (3.6%), and prevalence of contraceptive utilisation (2.3%).
CONCLUSION: The delivery of primary healthcare services in Rivers State is below average. While immunisation services were optimally delivered, other services, including the uptake of modern contraceptives/provision of family planning services, need to be improved. There is the need for the Rivers State Government to improve its capacity in meeting up with the requirements of the poorly delivered thematic areas as well as sustaining efforts in thematic areas with high performance.
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References
Ephraim-Emmanuel BC, Adigwe A, Oyeghe R, Ogaji DS. Quality of health care in Nigeria: a myth or a reality. Int J Res Med Sci. 2018 Sep 6;6(9):2875-81.
Ugwu GO, Enebe NO, Onah CK, Ochie CN, Asogwa TC, Ezema GU. Primary health care under one roof: knowledge and predictors among primary health care workers in Enugu state, South East, Nigeria. Nigerian Journal of Medicine. 2020;29(4):649-54
Opuowei B, Atibinye D, Chukwunweike B. Evaluation of Client/Patient satisfaction in Primary Healthcare Practice in Ogoloma Health Centre of Okrika LGA of Rivers State of Nigeria. Cont J Med Res 2014; 8: 1–8.
Ogu RN, Ephraim-Emmanuel BC. Prevention of Maternal Mortality in Nigeria : Public Health to the Rescue Prevention of Maternal Mortality in Nigeria : Public Health to the Rescue. J Gynecol Women’s Heal 2019; 10: 001–005.
Abdulraheem BI, Olapipo AR, Amodu MO. Primary health care services in Nigeria: Critical issues and strategies for enhancing the use by the rural communities. Journal of public health and epidemiology. 2012 Jan 31;4(1):5-13.
Odikeme ED, Ephraim-Emmanuel BC, Ebiowei J, et al. Timeliness and Completeness Rates of Immunization of Children (12-23 Months) in Rural and Urban Communities in Bayelsa State. Asian J Res Nurs Heal 2022; 5: 54–62.
Abdulraheem BI, Olapipo AR, Amodu MO. Primary health care services in Nigeria: Critical issues and strategies for enhancing the use by the rural communities. Journal of public health and epidemiology. 2012 Jan 31;4(1):5-13.
Family Planning 2030 F 2030. Nigeria FP2030 Indicator Summary Sheet: 2023 Measurement Report Modern. 2023.
Anoke CI, Onuoha HE, Njoku EO. Effects of Supportive Supervision on Improved Quality Healthcare Service Delivery. Int J Innov Creat Chang 2021; 15: 422–434.
Nass SS, Isah MB, Sani A. Effect of Integrated Supportive Supervision on the Quality of Health-Care Service Delivery in Katsina State , Northwest Nigeria. Heal Serv Res Manag Epidemiol 2019; 6: 1–7.
Moyimane MB, Matlala SF, Kekana MP. Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: a qualitative study. Pan African Medical Journal. 2017;28(1):157.
Nyamhanga TM, Frumence G, Hurtig A. Facilitators and barriers to effective supervision of maternal and newborn care : a qualitative study from Shinyanga region , Tanzania. Glob Health Action 2021; 14: 1–12.
World Health Organization W. Training for mid-level managers (MLM). Module 4: supportive supervision. Geneva: World Health Organization: World Health Organization; 2008, republished 2020 under the licence: CC BY-NC-SA 3.0 IGO, 2020.
Ohadi E, Ekbladh L, Okwuosah A, et al. Nigeria TB Supportive Supervision Pilot Evaluation. Bethesda, MD: Health Systems 20/20 project, Abt Associates Inc. Abt, 2012.
Djibuti M, Gotsadze G, Zoidze A, Mataradze G, Esmail LC, Kohler JC. The role of supportive supervision on immunization program outcome-a randomized field trial from Georgia. BMC international health and human rights. 2009 Oct;9:1-2.
Som M, Panda B, Pati S, Nallala S, Anasuya A, Chauhan AS, Sen AK, Zodpey S. Effect of supportive supervision on routine immunization service delivery-a randomized post-test study in Odisha. Global journal of health science. 2014 Jun 30;6(6):61.
Gopalakrishnan L, Diamond-Smith N, Avula R, Menon P, Fernald L, Walker D, Patil S. Association between supportive supervision and performance of community health workers in India: a longitudinal multi-level analysis. Human resources for health. 2021 Dec;19:1-0.
Umar AS, Bello IM, Okeibunor JC, Mkanda P, Akpan GU, Manyanya D, Eshetu SM, Brine M, Belem M, Penelope M, Fussum D. The effect of real time integrated supportive supervision visits on the performance of health workers in Zambia. Journal of immunological sciences. 2021 Apr 15(2):1109.
United Nations Children Fund (UNICEF). Supportive Supervision: A Manual for Supervisors of Frontline Workers in Immunization, ipc.unicef.org (2019).
Bobo FT, Asante A, Woldie M, Dawson A, Hayen A. Child vaccination in sub-Saharan Africa: Increasing coverage addresses inequalities. Vaccine. 2022 Jan 3;40(1):141-50.
Hermsdorf MO, da Silva TM, Lachtim SA, Matozinhos FP, Beinner MA, Vieira EW. Availability of the Yellow Fever Vaccine in Primary Health Care Services in Brazil. Frontiers in Tropical Diseases. 2022 Jun 6;3:866554.
Barcelos RS, Santos IS, Munhoz TN, Blumenberg C, Bortolotto CC, Matijasevich A, Salum C, Santos Júnior HG, Santos LM, Correia L, Souza MR. Vaccination coverage in children up to 2 years old, receiving financial support from the Family Income Transfer Program, Brazil. Epidemiologia E Servicos de Saude. 2021 Jul 9;30:e2020983.
Akamike IC, Okedo-Alex IN, Eze II, Ezeanosike OB, Uneke CJ. Why does uptake of family planning services remain sub-optimal among Nigerian women? A systematic review of challenges and implications for policy. Contraception and reproductive medicine. 2020 Dec;5:1-1.
Ogu RN, Ephraim-Emmanuel BC. Nigerian Government Expenditure, Economic Productivity and the Prevention of Maternal Mortality: A Call to Action. J Econ Manag Trade 2018; 21: 1–9.
Lerberg PM, Sundby J, Jammeh A, Fretheim A. Barriers to skilled birth attendance: a survey among mothers in rural Gambia. African journal of reproductive health. 2014 Apr 11;18(1):35-43.
Ntoimo LF, Okonofua FE, Ekwo C, Solanke TO, Igboin B, Imongan W, Yaya S. Why women utilize traditional rather than skilled birth attendants for maternity care in rural Nigeria: Implications for policies and programs. Midwifery. 2022 Jan 1;104:103158.
Chimezie RO. Failure of primary healthcare delivery in Africa. 2015; 2: 208–215.
Gyuse AN, Ayuk AE, Okeke MC. Facilitators and barriers to effective primary healthcare in Nigeria. African J Prim Heal care Fam Med 2018; 10: e1–e3.
Adam VY, Nwaogwugwu JC. Availability of personnel, facilities and services in Primary Healthcare Centres in a Local Government Area in Benin City, Nigeria. Ann Clin Biomed Res; 1. Epub ahead of print 9 November 2020. DOI: 10.4081/acbr.2020.111.
O’BRIEN-CARELLI C, Steuben K, Stafford KA, Aliogo R, Alagi M, Johanns CK, Ibrahim J, Shiraishi R, Ehoche A, Greby S, Dirlikov E. Mapping HIV prevalence in Nigeria using small area estimates to develop a targeted HIV intervention strategy. PloS one. 2022 Jun 8;17(6):e0268892.
Okoroiwu HU, Umoh EA, Asanga EE, Edet UO, Atim-Ebim MR, Tangban EA, Mbim EN, Odoemena CA, Uno VK, Asuquo JO, Effiom-Ekaha OO. Thirty-five years (1986–2021) of HIV/AIDS in Nigeria: bibliometric and scoping analysis. AIDS research and therapy. 2022 Dec 21;19(1):64.
World Health Organization (WHO). World malaria report 2022, Regional data and trends briefing kit World malaria. 2022.
Egbom SE, Nduka FO, Nzeako SO. Point prevalence mapping of malaria infection in Rivers State , Nigeria. Tanzan J Health Res 2022; 23: 1–11.
National Population Commission (NPC) & ICF Macro. Nigeria Demographic Health Survey
Abuja, Nigeria, 2013.
Bekele D, Surur F, Nigatu B, Teklu A, Getinet T, Kassa M, Gebremedhin M, Gebremichael B, Abesha Y. Contraceptive prevalence rate and associated factors among reproductive age women in four emerging regions of Ethiopia: a mixed method study. Contraception and Reproductive Medicine. 2021 Jun 1;6(1):18.
Adetiloye O. The use of integrated supportive supervision (ISS) visits to strengthen family planning service delivery in two selected states of Nigeria. Texila Intl J Public Health. 2017;5(4).
Iheanachor N, Ozegbe AE. An assessment of foreign direct investment and sustainable development nexus : The Nigerian and Ghanaian perspectives An Assessment of Foreign Direct Investment and Sustainable Development Nexus : The Nigerian and Ghanaian Perspectives. Int J Manag Econ Soc Sci 2021; 10: 49–67.
Agwu P, Onwujekwe O. Addressing security threats affecting primary healthcare service delivery and uptake in Nigeria. Australian Journal of Primary Health. 2023 Jan 18;29(4):327-31.
Morhason-Bello IO, Kareem YO, Adewole IF. Modeling for predictors of knowledge score on etiology and prevention strategies for cervical cancer among women of reproductive age in ibadan. JCO Global Oncology. 2020 Jun;6:892-903.
Mounier-Jack S, Griffiths UK, Closser S, Burchett H, Marchal B. Measuring the health systems impact of disease control programmes: a critical reflection on the WHO building blocks framework. BMC public health. 2014 Dec;14:1-8.
World Health Organisation W. Monitoring the building blocks of health systems: a handbook of indicators and their measurement strategies. 2010.
Lutwama GW, Sartison LJ, Yugi JO, Nehemiah TN, Gwang ZM, Kibos BA, Jacobs E. Health services supervision in a protracted crisis: a qualitative study into supportive supervision practices in South Sudan. BMC health services research. 2022 Oct 14;22(1):1249.