THE EFFECT OF A DONOR SUPPORT ON DISTRICT HEALTH SERVICE UTILIZATION IN ENUGU STATE.

  • : Ms Word, Ms Word Format
  • : 70 Pages
  • : ₦5,000
  • : 1-5 Chapters
  •  
  • Click to DOWNLOAD Materials
THE EFFECT OF A DONOR SUPPORT ON DISTRICT HEALTH SERVICE UTILIZATION IN ENUGU STATE.

Abstract

INTRODUCTION: The World Health Organization recommends the District Health System (DHS), (which is a self contained segment of the national health system) as a good means of achieving the aims for which the primary health care approach to health service delivery was set up. Health outcomes are unacceptably poor in most of the developing countries, including Nigeria; hence the need to reform. In 1988 when the National Health Policy was launched, Nigeria adopted the district health system as a means of ensuring self reliant health care delivery to the entire population.
In Enugu state, the need to reform arose as a result of the negative health indicators in the state and Nigeria generally. Partnership for Transforming Health Systems (PATHS), which was a United Kingdom Department for International Development (DFID) funded programme, supported the DHS from planning stage in 2004, until the PATHS programme wound up in June, 2008. This research project is aimed at investigating the effect of the PATHS support in respect of the health facilities utilization. The general objective is to evaluate the effect of the DFID support through the PATHS programme, on district health service utilization in Enugu state.
LITERATURE REVIEW: The general principle for developing DHS include; equity, accessibility, emphasis on promotion and prevention, intersectoral action, community involvement, decentralization, integration of health programmes, and co-ordination of separate health activities. Donor support has been shown to improve health facility utilization, while lack of drugs decreases health facility utilization.
MATERIALS AND METHODS: The 77 primary health care facilities that were supported by PATHS through drug and equipment supply, constituted the study population. An equal number of the primary health facilities that were not supplied with drugs and equipment were selected as control facilities. Retrospective Cohort study was used to extract secondary data from the ministry of health, while structured questionnaire was used to carry out a cross-sectional study designed to assess the knowledge, attitude and practice of the Officers-in-
9
Charge (OICs) of the primary health care facilities in the state, and their Assistants, on the district health system in Enugu state. Data analysis was done using SPSS.
RESULTS: The results revealed that the supported facilities were already doing better than the control facilities, prior to the support. The support however resulted in improved health facility utilization, especially in terms of outpatient attendance. The Central Medical Store records revealed that most of the primary health care facilities in Enugu state were not buying drugs from the store. The OICs of the primary health facilities and their Assistants had good knowledge and attitude towards DHS, but their reported practices were inconsistent with observed practices.
DISCUSSION: This research project successfully looked at the general and specific objectives for which it was embarked upon. The findings were essentially in keeping with similar findings In Nigeria and elsewhere. There were however some other findings that require further research work.
CONCLUSION: District Health System in this study provided the best chance of implementing the primary health care system, and donor support significantly contributed to improved health facility utilization in the supported facilities.
RECOMMENDATIONS: These include choosing poorly performing facilities for support in future, strengthening the Central Medical Store by establishing district bulk stores, focusing on personnel issues, and research on the impediments to effective implementation of District Health System in Enugu state.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

THE EFFECT OF A DONOR SUPPORT ON DISTRICT HEALTH SERVICE UTILIZATION IN ENUGU STATE.

 

Sharing is caring!

Leave a Reply