ABSTRACT
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 administration. 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, significance of study, delimitation and
scope of study, research questions and definition of terminology used. Chapter
two focuses on literature review. The researcher reviewed the work of experts
and renounce authors that are related to the research work. Chapter three deals
with the research methodology which includes research design, sampling
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 was discussed
in relation to the literature review and analysis from chapter four. It also
talks about the summary, conclusion and recommendations.
CHAPTER ONE
INTRODUCTION
The 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). Ebuehi
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 mailed. 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).
According 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. Felicia 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. Thus, 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 areas.
1.1 BACKGROUND TO THE STUDY
Access 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). There 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.
It 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). In 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.
Also, 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.
In Sagbanna local government, there has been
an increase in the participation by community members in the administration of
healthcare 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). According 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, healthcare equipment and qualified and well trained health
personnels to handle all healthcare 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. Based 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.
HISTORICAL BACKGROUND OF STUDY AREA
The 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. According 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.
Based 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. Meanwhile 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
It 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 healthcare service, Olubenga, (2010).