AVAILABILITY, ADEQUACY AND UTILIZATION OF CHILD HEALTH SERVICES IN PRIMARY HEALTH CARE CENTERS IN NSUKKA HEALTH DISTRICT, ENUGU STATE

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Abstract

The purpose of the study was to find out the availability, adequacy and utilization of child health services in Primary Health Care Centers in Nsukka Health District, Enugu State. To achieve the purpose of the study, eight specific objectives with corresponding research questions were posed and five hypotheses postulated to guide the study. The Descriptive survey research design was used for the study. The population for the study consisted of 3882 mothers (3666) and health service provider (216). The multi-stage sampling procedure was used to draw a sample of 474 mothers (366) and health providers (108) for the study. The instrument for data collection was the availability, adequacy and utilization of child health services questionnaire (AAUCHSQ) designed by the researcher. Cronbach’s Alpha statistic and Kuder Richardson 20 (KR-20) were used to establish the reliability of the instrument. Means and percentage were used to analyze descriptive data, while null hypotheses were tested using t-Test, Chi-Square and ANOVA statistics. The criterion mean for adequacy and utilization was 2.50. The major findings of the study were as follows: All the child health services were available in primary health centres, All the child health services were adequate ( X = 2.98, SD = .92). Mothers of different level of education utilized child health services effectively (no formal education ( X = 2.93) primary education ( X = 2.80), secondary school education ( X = 2.85) tertiary education ( X = 2.81)). Mothers of different occupation utilized child health services effectively farming ( X = 2.67), trading ( X = 2.81), public/civil servant ( X = 2.89), cloth weaving/hair dressing ( X = 2.82), house wives ( X = 2.81) and student ( X = 2.67). Mothers in both urban ( X = 2.96) and rural ( X = 2.65) utilized child health services effectively. All the components of child health services were available in both urban and rural primary health centres. All the child health services were adequate in both urban ( X = 3.14) and rural ( X = 2.96). There was no significant difference in the level of utilization of child health services according to level of education at .05. There was significant difference in the level of utilization of growth monitoring services and immunization services according to level of education. There was no significant difference in the level of utilization of; growth monitoring, curative services, ORT and immunization services while there was significant difference in the level of utilization of nutritional services according to mothers’ occupation. There was no significant difference in the level of utilization of growth monitoring, nutritional services, curative services and immunization service according to residential location of mothers. There were significant differences in the level of availability of growth monitoring, nutritional services, curative services, ORT and immunization services. There was also no significant difference in the level of adequacy of growth monitoring, nutritional services and immunization services according to mother’s residential location while there were significant difference in the level of utilization of curative services and ORT according to residential occupation of mothers. The researcher recommended that government should see that primary health centers are located equally in both urban and rural areas, and that health workers should strengthen their teaching on the utilization of all the components of CHs especially growth monitoring and curative services. 

CHAPTER ONE

Introduction

Background to the Study

People seek to improve quality of life in both developed and developing countries. Unfortunately, most people in developing countries live in overcrowded houses with inadequate sanitation and unsafe water supply. Infectious disease and malnutrition are common especially among children. Death rate is high and life expectancy is low. World Health Organization – WHO (2002) estimated that ten million children under the age of five years die each year from complications arising from childhood diseases and 80 per cent of these deaths occur in SubSaharan Africa. The ratio of infant mortality in the region is one of the highest in the world reaching a proportion of 113 per 1000 live births (World Bank, 2004). In Nigeria, the Federal Ministry of Health-FMOH (2007) reported that about 5.3 million children are born annually that is 11.000 per day. One million of these children die before the age of 5 years. The ministry further submitted that Nigeria’s infant mortality rate (528 per day) is one of the highest in the world. Infant mortality and under five mortality are 100 and 201 per 1000 live births respectively, and these deaths are from preventable causes such as malaria, pneumonia, diarrhoea, measles and HIV & AIDS. One explanation for poor health outcome among children is the non-use of available child health services by sizable proportion of mothers. Haddad (2005) Stated that the cost and utilization of health services in developing countries clearly showed that the utilization of available child health services is very low in developing countries. This according to Haddad is influenced by culture, economics, access, perceptions and lack of knowledge of mothers on existing child health services.

 Stanfield (2004) noted that child health services is an integral part of Primary Health Care, which is concerned with the provision of accessibly integrated biopsychological health care services by the health care personnel. The author maintained that the health care personnel are accountable for addressing a large majority of personal health needs, developing a sustained partnership with patients and participating in the context of family and community. Onuzulike (2005) asserted that child health services are the total care and services rendered to children 0-5 years in order to maintain healthy living. Turmen (2006) described child health services as the provision made to improve optimal growth and development in infancy and childhood through disease prevention, good nutrition and health supervision.