This project work on the importance of
community health administration and rural development was carried out to find
out the importance community health administration in rural development and
what are the adverse health implications when the community involvement is very
minimal. It also try to find out what factors are responsible for its
ineffectiveness during its implementation. While it also took a look at the
method best suited for the checkmating and control of all factors and
conditions that adversely affects the amdinistraiton.
However, this project is divided into five(5)
chapters, the chapter one gives a general overview of the topic, which includes
background overview of the topic, which includes background of study historical
background of study area, statement of problem, purpose and objectives of the
study, signifcnace of study, delimitation and scope of study, research
questions and definition of terminology used. Chapter two focuses on literature
rreview. The researcher reviewed the work of experts and renounce authors that
are related to the rsearch work. Chater three deals with the research
methodology which includes research design, smapling techniques, sample size,
determination, and instruments for data collection.
In the chapter four, the data were vividly
presented and carefully analyzed, using the simple percentage table. While in
chapter five the findings were discussed in relation to the literature review
and analysis from chpter four. It also talks about the summary, conclusion and
TABLE OF CONTENTS
1.1 BACKGROUND OF THE STUDY
HISTORICAL BACKGROUND OF STUDY AREA
STATEMENT OF THE PROBLEM
PURPOSE OF THE STUDY
DELIMITATIONS OF STUDY
OBJECTIVES OF THE STUDY
SIGNIFICANCE OF THE STUDY
1.9 DEFINITION OF TERMS
2.1 OVERVIEW OF COMMUNITY HEALTH
COMMUNITY HEALTH STRATEGIES
2.3 HEALTH PROMOTION
2.4 HEALTH PROTECTION
HEALTH SERVICES AND OTHER RESOURCES
2.6 FOUNDATIONS OF COMMUNITY HEALTH
2.7 HISTORY OF COMMUNITY HEALTH PRACTICE
2.8 THREE TOOLS OF COMMUNITY HEALTH PRACTICE
OVERVIEW OF COMMUNITY HEALTH WORKERS
OF COMMUNITY HEALTH WORKERS
CONDITIONS OF CHWS
MOTIVATING HEALTH WORKERS TO RURAL VILLAGES
OF HEALTH WORKERS TO REJECT RURAL POSTING
OF COMMUNITY HEALTH ADMINISTRATION IN RURAL DEVELOPMENT
TO SUCH OBSTACLES
3.0 RESEARCH METHODOLOGY
POPULATION OF THE STUDY
3.4 SAMPLE SIZE DETERMINATION
3.5 SAMPLE TECHNIQUE
INSTRUMENT FOR DATA COLLECTION
3.7 VALIDITY OF INSTRUMENT
3.8 RELIABILITY OF INSTRUMENT
3.9 TECHNIQUE FOR DATA ANALYSIS
4.2 DATA PRESENTATION AND ANALYSIS
5.1 DISCUSSION OF FINDINGS
APPENDIX II: QUESTIONNAIRE
basic human needs of psychological needs, love needs, Esteem needs and
self-actualization hinge on the availability of good health care delivery
services. Although quality health is seen as one of the active ingredients for
the development of any nation. Woyd, (2009).
is pertinent to note that in Nigeria,
inequality and poor accessibility to health care has been a persistent problem.
This is so, because majority of the population lives in the rural areas. The
sustainability and viability of country’s economy and social growth depends
largely on a well vibrant health care sector. While health care needs is
increasing, government expenditure on health services are declining. This
expenditure has been described as being inadequate, insufficient, inequitable
and unsustainable. Thus, the burden of paying for health care services,
especially by the ever increasing rural populace, has been very difficult due
to the fact that majority of the country’s citizens could not afford a good and
quality health care service, Olubenga, (2010).
et al (2008), states that quality health is one of the active ingredients for
the development of any nation. That a nation suffers economically,
educationally, physically and socially if a greater percentage of its population,
especially the work force is ill or mained. For example, persons suffering from
AIDS, Tuberculosis, and terminal stage of cancers, may not be as productive as
if is expected of them. Consequently, they may become liabilities to the rest
members of the community. Wadinga A, (2007).
to Amadi, (2004) he stated that the vulnerable ones in any society or
community, includes the infants, childbearing/ pregnant women and the aged who
are very susceptible to infections. He further attributes this to the inability
of the three tiers of government to provide basic health care infrastructures
and services, and also the scarcity of health care providers in the country
especially in the rural areas.
Monye, states that shortage of health workers is a major problem in Nigeria,
especially in the rural areas where more than 70% of the entire population
lives. Also, she states that of the primary care level, trained community
health officers provides services normally reserved for doctors or medical specialists.
That in order to improve such services, especially in the rural areas, the
community health officers must therefore be supported and motivated in order to
provide effective and efficient health care services.
this study is carried out on how community health administration can be
improved for efficient and effective health care delivery services in the rural
communities. Also to find out what factors either motivates or demotivates the
health workers in accepting/rejecting rural posting. Through this study, we
will know the role the local government NGO’s, the community and the health
care providers in enhancing the community health administration in the rural
OF THE STUDY
to health care in Nigeria
today is generally limited. The problem of poor funding has resulted in low
quality of health services and facility. It is pertinent to note that health
services and facilities of all levels, is either dilapidated, poorly equipped,
or dysfunctional. The poor management of the available health personnels
translate to inefficient and ineffective health care delivery services in the
rural areas, Osuorji, (2009).
is considerable interest by local governments in the country in exploring the
potential of social health insurance in order to increase accessibility and
affordability of health care delivery service, Ojo, (2008). Also Airede (2006)
identified with the above statement and also went further to suggest that if
the local governments are ready to support and motivates health care providers,
the morbidity and mortality rate of most rural communities will greatly
reduced. Thus, the reverse is the case, because most local government
administrators do not take the health sector seriously . they handle it as they
handle all political issues.
is pertinent to note that every community accepts some forms of treatment as
appropriate and others as unacceptable. Though all forms of treatment is seen
to have multiple effects and this varies from person to person, and are greatly
influenced by age, level of susceptibility, finance, culture and ignorance,
which is attributed mostly to the rural dwellers, sturgeon and Meer, (2006).
Sagbam local government area which happens to comprise of rural communities,
there ahs been an unprecedented rise in mortality and morbidity rate of infants
due to either maladministration in the health sector or inadequate well trained
health personnels. According to Dr. Kpokiri (2008), we states that three (s) of
one thousand (3/1000) death occurs yearly while two hundred (100) in one
thousand (1000) infants falls sick monthly. Still births is recorded as three
(3) in three hundred (300) births.
the health facilities are very few and it cannot carter for the ever increasing
rural populace. Though at times it is due to the low patronage, poverty and
ignorance of the rural dwellers.
Sagbanna local government, there has been an increase in the participation by
community members in the administration of health care delivery services. It
has been highly accepted by most groups in individual communities that made up
the local government. This is due to the prevalence of infections agents that
abound in the communities which is responsible for ever increasing morbidity
rate of infants and women of childbearing age, Wilfred, (2009).
to Kpokiri (2009), he states that for any community health administration to
function in any rural setting, two things are basically involved. Firstly, the
need of local government administration to adequately fund thee health sector,
by providing adequate health facilities, helth care equipment and qualified and
well trained health personnels to handle all health care delivery services in
the communities. Secondly, the community members needs to be well mobilized,
involved, sensitized and allowed to effectively participate in all health
related causes, should be ensured.
on the aforementioned, there is need for everyone in the community to become
aware of the importance of community health administration in the development
of the rural dwellers. Thus, this project work will attempt to discuss and determine the success, failures and factors
that are responsible for the successful implementation of community health
administration in our rural communities.
1.2 HISTORICAL BACKGROUND OF STUDY AREA
surviving historical account of the settlement of the people of gagbama local
government area, has it that Sagbama probology settled in its present location
on the 16th century, having broken off from their kins from the Benin kingdom.
to Mr. Emmanuel Ogosi, the descendant of OPOROZAOWE, was from the Benin kingdom.
He left the kingdom of the time when it
was under severe political pressure from within and outside the period of the
historical rupture which some how corresponded with the reign of king Ovour,
amwem Nogbaisi, who suffered Torment and physical defeat from the British
government. Oporozawei settle somewhere in the deep Nigeria Delta with his sons
namely Kabowel, kumbowei and gbanwei. At the death of their father, kabowei
exhibited his hostile behaviour towards his brothers.
on this gbaranwei left for another area and found Gbaran kingdom now in the
present day yenagoa local government area of Boyelsa state named gbaran
Ekpeteiama. Kabowei left too, to find another settlement andd established his
kingdom known as kabowei
Kingdom with its
headquaters in patani, presently in delta state.
Kumbowei with his hine sons left and lived in a palce known as udophori, one of
his sons, named Sagbamaowei left his dad and brothers and found Sagbama
community which later spread to different other settlements that made up the
present day Sagbama local government area in the present Bayelsa state
PEOPLE AND POPULATION
present day Sagbama local government area comprises various tribes of the
country but originally it consist mainly of Ijaw aand Urobo speaking tribes.
The local government has an estimated population of about nine hundred and six
thousand eight hundred people (906,800), according to the 1991, national
major occupation of the people of Sagbama L.G.A are basically that of
Agriculture and fishing according to Mr. Emmanuel Ogesi. Though, due to
civilization, most people are now civil servants, self employed and
people of Sagbama L.G.A today are more of Christians, this is because, the
majority of people have disengaged themselves from idol worshipping. Yet there
are few who still practice idolatry.
first thing here to mention is the language. The language mostly spoken in
Sagbama L.G.A, is the Izon Language while Uhrobo and igoko languages are spoken
by very few communities. Also the English language is often spoken in all the
communities that make up sagbama l.G.A.
aspect of the culture of the people of Salga is their festival which often
differ from community to community. Also their traditional marriage ceremonies
differs from one community to another.
OF THE PROBLEM
is no denying the fact that our health care index is very poor and that
majority of our people are suffering. Today, Sagbama L.G.A, has been rated as
one of the highest maternal morbidity and infant mortality rate in Bayelsa
state. This is because public hospitals and health centres are grossly
under-equipped while private hospitals provides cash and carry health services
and take-away medical services, to the deteriment of the poor. Also, self
medications is on the increase just as the market for quackery has blossomed in
the community, Aganaba (2008).
(2004), identified with the above statement and also went further. He said that
factors that contributes to the dwindling effect of community health
administration in any rural areas, includes, inadequate funding of health care
delivery services by the local government chairmen, rising cost of treatment,
poor integration of private health sector, low public enlightenment and lack of
community involvement and participation.
there is need for urgent intervention of the governments, parastatals to seek
for solutions to tackle the problem of low patronage by members of the
is against this background that the researcher undertook the study as a means
of bringing a lasting solution to the challenges faced in the implementation of
the community health administration in the development of the rural areas.
OF THE STUDY
purpose of carrying out this study is to establish the relationship between
community health administration and the effects it has in the development of
our rural areas. Also the suggest strategies that would make the program more
effective and accepted by all community members. It is also intended to
identify the challenges affecting the implementation of community health
administration programme in Sagbama L.G.A and to suggest appropriate
recommendations and best solutions.
project work is meant to study the role of community health administration
plays in the development of the people of Sagbama local government area, while
it is limited to the literate and non-literate adult of the local government
researcher is greatly constrained with time factor in terms of meeting up
lectures, coupled with other financial problems as opposing factors to each
other. Also the searching of materials did not prove easy, since materials on
the subject matter are not easily gotten or accessed within the school
the above constraints did not in any way invalidate this project work in any
OF THE STUDY
project work is designed to meet the following objectives
establish the relationship between community health administration and rural
identify ways by which the programme will be successful
identify ways by which the community will effectively participate in the
identify problems of poor access to healthcare in the rural areas.
suggest ways to integrate the private sector to participate in community health
identify challenges in the implementation of community health in the rural
identify public health problems associated with non-compliance by community
members in the community health programme
identify factors that motivates or demotivates health workers to rural settings
identify problems of community administration
to identify ways by which stakeholders, NGO’s
and L.G can assist in community health administration.
there ways that the private sectors/NGO’s could be integrated into the
community health administration?
are the challenges that hinders the successful implementation of the programme
are the strategies needed for the successful implementation of the programme?
can the community be motivated to effectively participate in the programme?
the leverage of community health administration adequate?
are the motivating factors that attracts health workers to rural areas?
OF THE STUDY
project work will help to inform three tiers of governments on ways by which
healthcare services will be made readily available, affordable and easily
accessible to the ever increasing rural populace.
suggest ways the government could easily integrate the private sector in order
to ensure a wider coverage of the programme.
study will intend to identify the challenges that hinders the successful
implementation of the programme. And the
management of such challenges being faced by the health workers.
results and recommendations of this study might serve as a guide to the local
authorities in promulgating laws relating to community health administration.
1. Primary Health Care
is an essential health care based on practical, scientifically sound and
socially acceptable, methods and technology, made universally accessible to
individuals and families in the community through their full participation and
at a cost which the country can afford to maintain at ever stage of their
development in the spirit of self-reliance and self determination, WHO (1980)
2. Community Mobilization
is a process of encouraging and arousing the interest of members of t\a given
community to b actively involved in identifying their problems and planning for
solutions to them, to ensure self-reliance and initiative.
3. Community diagnosis
is the process of finding out the needs (problems) of a particular community
with the assistance of members of the community.
in primary health care simply means the process of creating awareness on
certain w\health programmes
is defined as a state of complete physical, social and mental wellbeing of an
individual and not mainly the absence of disease or infirmities, WHO (1999)
defined as a specific group of people living in a defined geographical area,
who share a common culture, values and norms and arranged in a social structure
according to relationships over a period of time WHO, (1988).
is the organization and co-ordination of the activities of an enterprise in
accordance with certain policies and in with certain policies and in
achievement of defined objectives.