Accessibility And Utilisation Of Primary Health Care Facilities In The Dangme West District Of The Greater Accra Region

ABSTRACT The thrust o f this study w as to identify the factors w hich influence accessibility and utilization o f health care facilities in the D angm e W est D istrict, and to find solutions to problem s w hich w ere identified. The study covered nine fully operational health centres and health posts in the district, as well as random ly sam pled service providers such as nurses, personnel o f N G O s. heads o f som e governm ent departm ents, opinion leaders and the district director of health services. The m ethod o f data collection was by structured questionnaires adm inistered to patients, and interview guides w ere used to collect inform ation from the service providers, opinion leaders, and the heads o f governm ent departm ents. T he data were analysed using the SPSS and A rcV iew GIS softw are packages to determ ine relationships and the spheres o f influence o f the health centres and posts. The study show ed that factors w hich played im portant roles in accessibility and utilisation o f the Prim ary H ealth Care (PH C) facilities in the D angm e W est D istrict, w ere socio-dem ographic ones like age and gender, distance and institutional factors such as the num ber and distribution o f health centres, inducem ents offered to patients, and quality o f care. For exam ple, the relatively high antenatal and postnatal coverage for the health centre at Pram pram is attributed to the free m eals offered to children who use the service. The m ajor com m unity w ide factor w as the poor road network. Some factors w hich did not play an im portant role included the educational level and occupation o f the respondents. Ways in w hich PHC can be strengthened in the district to m ake health care facilities accessible to all are recom m ended. These include the granting o f greater autonom y to D istrict H ealth M anagem ent Team s (D H M Ts) to hire com petent staff to ensure quality health delivery. It is also recom m ended that support for and supervision o f the health posts should be increased. The need for effective netw orking am ong the governm ent agencies and N G O s w orking in the health sector in the district was advocated.