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A Case Study of Primary Healthcare Services in Isu, Nigeria Raymond Ogu

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A Case Study of Primary Healthcare Services in Isu, Nigeria Raymond Ogu Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 1-1-2011 A Case Study of Primary Healthcare Services in Isu, Nigeria Raymond Ogu. Chimezie Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the African Languages and Societies Commons, African Studies Commons, Health and Medical Administration Commons, and the Public Health Education and Promotion Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Health Sciences This is to certify that the doctoral dissertation by Raymond Chimezie has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Michael Schwab, Committee Chairperson, Public Health Faculty Dr. Richard Jimenez, Committee Member, Public Health Faculty Dr. Monica Gordon, University Reviewer, Public Health Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2013 Abstract A Case Study of Primary Healthcare Services in Isu, Nigeria by Raymond Ogu Chimezie MA, Argosy University, San Francisco, 2006 HND, Federal Polytechnic, Nekede, 1985 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health: Community Health Education and Promotion Walden University April 2013 Abstract Access to primary medical care and prevention services in Nigeria is limited, especially in rural areas, despite national and international efforts to improve health service delivery. Using a conceptual framework developed by Penchansky and Thomas, this case study explored the perceptions of community residents and healthcare providers regarding residents’ access to primary healthcare services in the rural area of Isu. Using a community-based research approach, semistructured interviews and focus groups were conducted with 27 participants, including government healthcare administrators, nurses and midwives, traditional healers, and residents. Data were analyzed using Colaizzi’s 7- step method for qualitative data analysis. Key findings included that (a) healthcare is focused on children and pregnant women; (b) healthcare is largely ineffective because of insufficient funding, misguided leadership, poor system infrastructure, and facility neglect; (c) residents lack knowledge of and confidence in available primary healthcare services; (d) residents regularly use traditional healers even though these healers are not recognized by local government administrators; and (e) residents can be valuable participants in community-based research. The potential for positive social change includes improved communication between local government, residents, and traditional healers, and improved access to healthcare for residents. A Case Study of Primary Healthcare Services in Isu, Nigeria by Raymond Ogu Chimezie MA, Argosy University, San Francisco, 2006 HND, Federal Polytechnic, Nekede, 1985 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health: Community Health Education and Promotion Walden University April 2013 UMI Number: 3558764 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMI 3558764 Published by ProQuest LLC (2013). Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106 - 1346 Dedication I dedicate this work to my family for the warm support, prayers, and financial help they gave to me during these long years of adult learning; to my wife Eunice for her great understanding and care; to my sons, Chidozie, for his feedback on my initial efforts of this project, and Chimdike, for his unrelenting prayers to God that I may have the strength to accomplish this task; to my parents, the late Simon Chimezie and Anthonia Chimezie, who began this journey for me earlier in my life; to my uncle, the late Chief Hilary Obiechefu, who always has supported my quests in life and wished that I get a doctoral degree; to my late father-in-law, Chief Bernard Ogbuji Nwadike, whose encouraging words will remain with me as long as I live; and to my late uncle, Elder Alex Asuzuo, who inspired me in the face of great suffering and difficulties. Finally, I dedicate this work to the people of the Isu Local Government Area and particularly to my own community, Nnerim Umundugba, for all they have suffered and endured in the face of neglected healthcare. To those whose lives were cut short by lack of access to healthcare—I wish that they rest in perfect peace that Christ Jesus gives. Acknowledgments I thank Almighty God for the strength and sustenance both to begin and complete this study. Without His guidance and assistance, I would not have overcome the great challenges I faced. My gratitude goes to my dissertation chair, Dr. Michael Schwab, and my methods advisor, Dr. Richard Jimenez, for their candid advice and proper guidance to see that I successfully completed this project. I thank them for their patience and understanding throughout this process. I also am grateful to the staff of the Isu Local Government Area and residents of the communities in Isu for their willingness to participate in my study. I also am grateful to all my fellow doctoral student classmates, in particular Mrs. Mary Uzochukwu, for all their support and encouragement. I thank all of my friends who encouraged me to carry on during trying times, especially when I was fell short of my expectations. My appreciation also goes to my brother-in-law and friend, Mr. Meltus Nwadike, for his words of encouragement during the trying time in this project. Finally, I am grateful to Walden University for the opportunity to realize my dream and for instilling in me the philosophy of social change. I am greatly empowered by it. Table of Contents List of Tables .................................................................................................................... vii Chapter 1: Introduction to the Study ....................................................................................1 Problem Statement .........................................................................................................3 Purpose of the Study ......................................................................................................4 Conceptual Framework ..................................................................................................4 Nature of the Study ........................................................................................................6 Research Questions ........................................................................................................6 Definition of Terms........................................................................................................8 Assumptions and Limitations ......................................................................................10 Scope and Delimitations ..............................................................................................11 Significance of the Study .............................................................................................12 Summary and Content of the Remaining Chapters......................................................13 Chapter 2: Literature Review .............................................................................................16 Conceptual Framework: A Model of Healthcare Access ............................................17 Traditional Healthcare System in Nigeria....................................................................20 Modern Healthcare Systems ........................................................................................22 International Origins and Scope of Primary Health Care ......................................22 Postcolonial Development in Nigeria ....................................................................29 Healthcare Conditions in Nigeria...........................................................................33 The Importance of Primary Healthcare ........................................................................36 Barriers to Healthcare Access ......................................................................................38 i Availability ............................................................................................................39 Accessibility ...........................................................................................................39 Accommodation .....................................................................................................40 Affordability ..........................................................................................................41 Acceptability
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