Okoronkwo Ijeoma L, Onwujekwe Obinna E, Ani Francis O
Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria.
BMC Health Serv Res. 2014 Mar 21;14:132. doi: 10.1186/1472-6963-14-132.
Knowledge and understanding of health service usage are necessary for health resource allocation, planning and monitoring the achievement of universal coverage (UHC). There is limited information on patterns of utilization among adult users of primary health care (PHC) services. Lack of understanding of current and past utilization patterns of health services often hinders the improvement of future Primary Health Care (PHC) delivery in the remote areas of developing countries. This paper presents new knowledge on the patterns of utilization of PHC services among adults in Enugu metropolis southeast Nigeria.
A cross-sectional study was conducted in 15 PHC facilities of Enugu North Local Government Area (LGA) from June to July 2012. A total of 360 consenting adult users aged 18 years and above were consecutively recruited as they attended the health facilities. An interviewer-administered questionnaire was used to collect data from the respondents. A modified Likert scale questionnaire was used to analyze data on patterns of utilization. Utilization of PHC services was compared by gender, socio-economic status (SES) and level of education.
Out of the 360 respondents, (46.9%) utilized PHC services regularly. The components of PHC mostly utilized by respondents were immunization with a mean score of 3.05, treatment of common ailments (2.99) and maternal and child health (2.64). The least poor SES group utilized PHC services the most while the very poor and poor SES groups used PHC services least. There were statistically significant relationships between utilization of PHC services and gender (p = 0.0084), level of education (p=0.0366) and income (p =0.0001).
Most adult users in this study did not utilize the health facilities regularly and there were gender, educational and SES inequities in the use of PHC services. These inequities will negate the achievement of universal health coverage with PHC services and should be remedied using appropriate interventions.
了解和掌握卫生服务利用情况对于卫生资源分配、规划以及监测全民健康覆盖（UHC）的实现至关重要。关于初级卫生保健（PHC）服务成年使用者的利用模式信息有限。对卫生服务当前和过去利用模式缺乏了解，往往阻碍发展中国家偏远地区未来初级卫生保健（PHC）服务的改善。本文介绍了尼日利亚东南部埃努古市城区成年人初级卫生保健（PHC）服务利用模式的新知识。
2012年6月至7月，在埃努古北地方政府辖区（LGA）的15个初级卫生保健机构开展了一项横断面研究。共有360名年龄在18岁及以上且同意参与的成年使用者在前往卫生机构就诊时被连续招募。通过访谈员填写的问卷收集受访者数据。使用经过修改的李克特量表问卷分析利用模式数据。按性别、社会经济地位（SES）和教育水平比较初级卫生保健（PHC）服务的利用情况。
在360名受访者中，（46.9%）定期利用初级卫生保健（PHC）服务。受访者最常利用的初级卫生保健组成部分是免疫接种，平均得分为3.05，常见疾病治疗（2.99）以及母婴健康（2.64）。社会经济地位最低差组利用初级卫生保健（PHC）服务最多，而社会经济地位极差和差组利用初级卫生保健（PHC）服务最少。初级卫生保健（PHC）服务利用与性别（p = 0.0084）、教育水平（p = 0.0366）和收入（p = 0.0001）之间存在统计学显著关系。
本研究中的大多数成年使用者未定期利用卫生机构服务，并且在初级卫生保健（PHC）服务使用方面存在性别、教育和社会经济地位不平等。这些不平等将不利于通过初级卫生保健（PHC）服务实现全民健康覆盖，应采用适当干预措施加以纠正。
