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  • Title: The use of selected interventions in monitoring primary health care implementation in rural Nigeria.
    Author: Egwu IN.
    Journal: Scand J Prim Health Care; 1992 Mar; 10(1):30-5. PubMed ID: 1589661.
    Abstract:
    Nigeria's Primary Health Care (PHC)-based health system development aims to strengthen PHC in the local government areas (LGA) through technical planning and implementation that emphasize maternal and child health services. Convenient variables, including expanded programme on immunization (EPI), antenatal care (ANC) utilization and attended births, were selected as interventions to monitor the progress of implementation of PHC activities during 1985-90 in Odukpani LGA. Analysis of available data at the LGA showed that immunization coverage for most EPI antigens increased; ANC services showed increased utilization; health worker-attended births increased as traditional birth deliveries declined during the period. Some of the increases were modest but are considered important. The study offers a pilot approach to monitoring implementation of PHC activities in Odukpani LGA. The implications of the findings for similar studies are discussed. A community health professor analyzed 1986-1989 data on selected primary health care (PHC) services (immunizations, prenatal care, and delivery) to examine the progress of PHC interventions in the rural Odukpani local government area (LGA) in Cross River State, Nigeria. Coverage for the diphtheria-pertussis-tetanus (DPT) and oral poliovirus (OPV) vaccines increased steadily over time (DPT-1 and DPT-2 18-32%; DPT-3 3-28%; OPV-1 18-35%; OPV-2 8-32%; and OPV-3 3-28%). On the other hand, measles and bacille Calmette-Guerin (BCG) vaccine coverage fell (42-28% and 49-31%, respectively). Tetanus toxoid coverage was 13% in 1986 and fell to 12% in 1987 and increased above original levels in 1988 (17%). Odukpani LGA vaccine coverage figures were below national coverage figures. The proportion of all 15-49 year old women using antenatal services fluctuated around 20% during this period, but the percent increase in utilization of antenatal services increased from 0-14%. Overall, the proportion of health worker (HW) attended deliveries increased (e.g., 56-69% during 1988-1989) while the proportion of traditional birth attended (TBA) deliveries decreased (e.g., 45-31% during 1988-1989). On the other hand, in 1986-1987, TBA deliveries rose (39-47%) while HW attended deliveries fell (62-53%). Traditional birth attendants did receive training to reduce maternal and child mortality. There was a real possibility of underreporting in this LGA. These results do indicate, however, that the PHC system has effected at least modest increases in specific interventions. This pilot approach can serve as a practical means to monitor implementation of PHC efforts.
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