Lawan M U, Abubakar I S, Zoakah A I
Department of Community Medicine, Bayero University Kano.
Niger J Med. 2009 Jul-Sep;18(3):299-302. doi: 10.4314/njm.v18i3.51194.
The health care system in Nigeria has been developed at three levels, the extension of health care to all people has been an objective of all National Health Systems for many years since the Alma - Ata conference on Primary Health Care (PHC) in 1978. Decades after the take off of PHC in all parts of this country, the goal of health for all and beyond is still far from being attained.
The management activities of Primary Health Care Facilities in Plateau State were investigated. A multistage sampling method was used to select 30 PHC facilities from 10 randomly selected LGAs out of the 17 Local Government Areas (LGAs) of Plateau State. All the heads, the secretaries and the chief matrons of the selected facilities were interviewed using self-administered structured questionnaires. Responses were scored using a dichotomous scale and categorized into poor, fair, good and excellent performances, and analyzed using Epi info 2.3.05 2003 statistical software.
Out of the 90 workers interviewed, 68.9% were females and 85.6% were married. Seventy four point four percent of the respondents were between 30-44 years of age, and 43.3% of the workers worked at the Basic Health Clinics (BHCs) while 20% of them worked in Comprehensive Health Centre (CHCs). Up to 40% of the LGAs had poor management performance, while the remaining 60% performed only fairly. Overall, PHC facilities in Langtang north did better in management of their facilities, while Shendam LGA scored least in management performance. In this study, no significant difference in scores of the various management activities between the LGAs was observed (F = 7.084, p > 0.05). However, a statistically significant difference in scores of management activities between the various types of PHC facilities was observed (F = 2.81, p < 0.05).
The management staff in most of the primary health care facilities lack resources at their disposal and this hinders the efficient and effective running of the facilities. Lack of transportation and poor maintenance of those available would seem to be the major constraint to the effective running of the health facilities.
尼日利亚的医疗保健系统分三个层次发展，自1978年关于初级卫生保健（PHC）的阿拉木图会议以来，多年来将医疗保健扩展至所有人一直是所有国家卫生系统的目标。在该国各地推行初级卫生保健数十年后，全民健康及更高目标仍远未实现。
对高原州初级卫生保健设施的管理活动进行了调查。采用多阶段抽样方法，从高原州17个地方政府区域（LGAs）中随机选取10个LGAs，从中选出30个初级卫生保健设施。使用自行管理的结构化问卷对所选设施的所有负责人、秘书和护士长进行了访谈。回答采用二分制评分，分为差、一般、良好和优秀表现，并使用Epi info 2.3.05 2003统计软件进行分析。
在接受访谈的90名工作人员中，68.9%为女性，85.6%已婚。74.4%的受访者年龄在30至44岁之间，43.3%的工作人员在基础卫生诊所（BHCs）工作，20%在综合健康中心（CHCs）工作。高达40%的LGAs管理绩效差，其余60%仅表现一般。总体而言，朗唐北部的初级卫生保健设施在设施管理方面表现较好，而申丹LGA在管理绩效方面得分最低。在本研究中，各LGAs之间各项管理活动的得分无显著差异（F = 7.084，p > 0.05）。然而，不同类型的初级卫生保健设施之间管理活动得分存在统计学显著差异（F = 2.81，p < 0.05）。
大多数初级卫生保健设施的管理人员缺乏可供支配的资源，这阻碍了设施的高效运行。缺乏交通以及现有交通工具维护不善似乎是卫生设施有效运行的主要制约因素。
