AN APPRAISAL OF PRIMARY HEALTH CARE STAFFING SITUATION IN THE FEDERAL CAPITAL TERRITORY, ABUJA, NIGERIA

ABSTRACT

Health personnel are central to the effective implementation of Primary Health Care (PHC). The Federal Capital Territory (FCT), Nigeria by virtue of its political status is expected to be a model regarding the effective implementation of PHC. One of the indicators of quality PHC implementation is adequate health manpower. This information with regard to the FCT is needed to ascertain the fulfillment of this expectation as a model. Hence, this study was conducted to assess Health Manpower availability in PHC facilities.

A cross-sectional study was carried out among all the 809 health personnel in 180 PHC facilities in FCT. Population figure was obtained from national census, 2006. Data were collected with a pre-tested, structured, self-administered questionnaire which focused on respondents‟ socio-demographic characteristics and their perception of personnel availability. In-Depth Interviews (IDI) were conducted with all heads of the six PHC departments. Four randomly selected PHC centres were visited for five consecutive days to record absentees using a register review checklist. Staff Population Ratio (SPR) was compared with the minimum standard set by the National Primary Health Care Development Agency (NPHCDA). Data analysis was done using descriptive statistics, Chi-square and thematic approach.

Respondents‟ mean age and years of work experience were 33±7.4 and 8.1±6.7 years respectively while 98.6% had post secondary education. The respondents included senior Community Health Extension Workers (CHEWs) (40%), junior CHEWs (23.3%), Nurse/Midwives (18.8%), Community Health Officers (CHOs) (5.0%), Laboratory Technicians (2.5%), Medical Record Officers (MROs) (1.7%) and, Medical Officers (1.4%). Others (7.1%) included Pharmacy Technicians, Environmental Health Officers, and Laboratory Scientists. The SPR per 100,000 population for various cadres were 1.0 Medical Officers), 3.2 (CHOs), 32.0 (senior CHEWs), 18.0 (junior CHEWs), 5.8 (Nurse/Midwives), 0.9 (MROs), 1.0 (Pharmacy Technicians) and 2.2 (Laboratory Technicians) compared with the NPHCDA minimum SPR of 2.3, 2.3, 24.6, 50.2, 9.1, 2.3, 2.2, and 2.0 respectively. Majority (69.5%) of the respondents perceived that health personnel were adequate in their health facilities. The IDIs revealed that services rendered met most of the patients‟ requirements and lapses occasionally observed were due to lack of functioning equipments and frequent drug stock-outs. The respondents stated that opportunity for continuing education (60.3%), availability of working materials (53.3%), and matching skill to task (51.5%), substantially encouraged staff retention. Major reasons given by respondents for inadequate health personnel were lack of recruitment by the government (75.3%), nonprovision of equipment (16.9%) and basic infrastructure (9.0%). Both IDI and observation revealed staff absenteeism was mostly due to ill health and lack of accommodation for staff. Absenteeism rate in the observed facilities was 10.7%. All PHC services except oral and mental health care were provided in observed health facilities. Availability of primary health care personnel in the Federal Capital Territory fell short of the minimum standard for most primary health care cadres. There is a need to plan for adequate primary health care personnel in the Federal Capital Territory to achieve comprehensive health care delivery.