Indicators of accessibility to primary health care coverage in rural Odukpani, Nigeria.

ABSTRACT

PIP: In the Akpabuyo zone in the Odukpani local government area, Cross River State, Nigeria, data collected from a survey of 90 households, from health facilities, the State Ministry of Health, and the Ministries of Local Government and of Lands and Surveys were analyzed to examine accessibility to primary health care (PHC) coverage. Children under 5 years old and reproductive age women comprised 58% of the population. 5 km from home to PHC coverage was considered accessible and all the children lived within this distance. Most respondents (67.8%) considered an immunization site to be not far. The majority (88.9%) used PHC health facilities, suggesting a relatively high rate of acceptability. Health personnel made home visits to 55.5% of respondents. Many adults' work schedules limited their ability to take their children to health sites (52.2% were farmers and 18.9% were traders). Thus, inappropriate scheduling of immunizations and maternal and child health services likely explained low immunization coverage (5.3-12.7%). This coverage was low despite the relatively high literacy rate in Akpabuyo (57.8%). Trained health personnel attended 98.9% of all deliveries, but traditional birth attendants (TBAs) conducted 61.3% of all deliveries, suggesting inaccessibility to health services. Further, 3.7% of deliveries at health facilities resulted in newborn death compared to 9.8% of TBA deliveries. This indicated a need for appropriate supervision and health education of TBAs. Only 39 cases of diarrhea existed. Most (87.2%) received oral rehydration therapy (ORT), reflecting the relatively high literacy rate and awareness levels. Yet, just 2.9% received a home-based sugar/salt solution, suggesting a need to increase ORT education for mothers. Almost all respondents (97%) noted that no village health or development committee existed, indicating a low level of community participation.