Sule S S, Ijadunola K T, Onayade A A, Fatusi A O, Soetan R O, Connell F A
Department of Community Health, ObafemiAwolowo University, Ile-Ife, Nigeria.
Niger J Med. 2008 Jan-Mar;17(1):98-106. doi: 10.4314/njm.v17i1.37366.
This study assessed service/organisational factors and clients' perceptions that influenced utilisation of Primary Health Care (PHC) facilities in a rural community in Nigeria.
A cross-sectional household survey in the community as well as key-informant interviews of opinion leaders and health care providers and participant observations of health facilities and utilisation pattern was used to collect data.
Forty-four percent of respondents to the survey who were ill in the preceding six months visited a PHC facility for treatment, while others relied on self-medication/self-treatment. Education was positively associated with utilisation of PHC services (P<0.05). Maternal and child health (45.4%), prompt attention (23.0%), and appropriate outpatient (20.5%) services attracted respondents to use PHC services. Poor education about when to seek care, poverty, perceived high cost of PHC services, lack of drugs and basic laboratory services, and a regular physician on site at the facility were identified as barriers to utilisation.
We conclude that community perceptions of poor quality and inadequacy of available services was responsible for low use of PHC services.
本研究评估了影响尼日利亚农村社区初级卫生保健（PHC）设施利用情况的服务/组织因素及客户认知。
采用社区横断面家庭调查、对意见领袖和医疗服务提供者的关键 informant 访谈以及对卫生设施和利用模式的参与观察来收集数据。
在调查中，前六个月生病的受访者中有 44%前往初级卫生保健设施就诊，而其他人则依靠自我用药/自我治疗。教育与初级卫生保健服务的利用呈正相关（P<0.05）。孕产妇和儿童保健（45.4%）、及时关注（23.0%）和适当的门诊服务（20.5%）吸引受访者使用初级卫生保健服务。对何时寻求医疗护理的教育不足、贫困、认为初级卫生保健服务成本高、缺乏药品和基本实验室服务以及设施内缺乏常驻医生被确定为利用的障碍。
我们得出结论，社区对现有服务质量差和不足的认知是初级卫生保健服务利用率低的原因。
