This document is a thesis submitted by Azanui Clifford Aluofuh to the University of Bamenda exploring community perception of primary healthcare services in Nkwen Health District, Cameroon. It includes an introduction outlining the study background, objectives to identify available services, utilization frequency, and factors influencing accessibility, quality and affordability. The methods section describes the descriptive cross-sectional study of 360 respondents using questionnaires. Key results found most services were available but underutilized, with top factors influencing accessibility being resource availability and cost. Factors for quality included increased professionals, proper planning and effective resource management. The study aims to improve healthcare in the region.
Factors associated with Non Enrollment into Community Based Health Insurance ...Premier Publishers
The world has a growing attention on moving towards universal health coverage, and health insurance is instrumental in that endeavor. As a prepaid financing system, health insurance ensures collective pooling of risks and the redistribution of financial resources in a way that guarantees financial protection against the cost of illnesses. The main aim of the study was to determine the factors associated with Non enrollment into Community based health insurance schemes in the BHD. A community based cross-sectional study was carried-out among Parents in BHD. Multistage sampling technique was used to select participants and data collected using a structured interviewer administered questionnaire. Data collected was analysed using SPSS version 21. A total of 384 participants took part in the study. The rate of enrolment into CBHIS in BHD was 2.4% (95% CI: 0.9-3.9%). Salary employed individuals were 2.7 times more likely to be enrolled into CBHIS compared to those who were self-employed. (O.R: 2.70, 95%CI; 1.15-6.37: P = 0.023). Low level of education was also found to be significantly associated with non-enrollment into CBHIS (O.R: 0.455, CI: 0.212-0.976, P: 0.043). Unawareness of CBHIS (O.R: 0.025, CI: 0.006-0.113, P: <0.001), low income level (O.R: 0.305, CI: 0.134-0.697, P: 0.005) and age less than 40yrs (O.R: 0.255, CI: 0.103-0.631, P: 0.003) were found to be significantly associated with non-enrolment. There was low enrollment into CBHIS in the BHD (2.4%). Factors significantly associated with non-enrolment into CBHIS in BHD were; low level of education, low age group of less than 40yrs, non-salary employment, low income level and unawareness of existence of schemes.
Are you looking to integrate the CHNA into your strategy?
Then you don’t want to miss this webinar.
All hospitals are required to conduct these assessments, so learn how best to connect and streamline your strategic planning and marketing activities to maximize your brand’s impact.
In this webinar, originally presented December 6, 2016, Lee Ann Lambdin, Stratasan’s SVP of Healthcare Strategy, and Jon Headlee, President of Ten Adams, discuss how to extend your Community Health Needs Assessment to create effective wellness initiatives from the inside out.
Household survey as a tool for training medical students in measuring public ...Alim A-H Yacoub Lovers
Habib OS, Ajeel NAH, Yacoub AAH. Household surveys as a tool for training medical students in measuring population health. The Iraqi Journal of Community Medicine 2002; 15: 5-8.
Over the past decade, Kenya has made tremendous efforts to enhance maternal and child health. Secure maternity policies such as free maternity care are one of the initiatives that have enhanced maternal and child health in all public health facilities. Despite these attempts, public health facilities for maternal and child health are still underused. This study employed a cross-sectional descriptive study design to identify determinants of free maternal health services by evaluating factors determining perceptions and health-seeking behavior of 384 pregnant mothers in Malava Sub-County, Kakamega County. The study used a mixed-method (quantitative and qualitative approaches). Questionnaires were administered to pregnant mothers selected for the study. The study employed a purposive sampling of research participants. Quantitative data were collected using the questionnaire administered by the research assistants whereas qualitative data were collected by the researcher through interview schedules. Quantitative data analysis was carried out using SPSS 23. However, qualitative data were analyzed through content analysis. Quantitative data representation was done in terms of frequency and percentages. Analysis of chi-square testing was used to assess the association between the variables of socio-economic and health facilities and the provision of free maternity facilities (p<0.05). The study established that the uptake of free maternal service by pregnant mothers was influenced by their level of primitivism and religious beliefs. In addition, this study found out that 53.8% and 77.7% of the pregnant mothers could not attend antenatal and post-natal care because government facilities were located far away from their residences and they also had less access to some information about free maternal health care. The results of this research would be disseminated to the hospital management team, Sub-Country health management team, County health management team, and other stakeholders, thereby demonstrating reasons for low uptake of free maternity services and helping to strategize for better service delivery. Based on the finding, the study recommends that to improve access to free maternal health care, the county government ought to place health services as close as possible to the community where people live. Secondly, there is a need to embrace the usage of the existing media network to sensitize pregnant mothers to the danger signs and the need to have decision-making powers over their safety. Lastly, hospital management ought to increase the awareness of free maternal health care and to include it among the community priorities during dialog days, action days, and other group discussions.
Factors associated with Non Enrollment into Community Based Health Insurance ...Premier Publishers
The world has a growing attention on moving towards universal health coverage, and health insurance is instrumental in that endeavor. As a prepaid financing system, health insurance ensures collective pooling of risks and the redistribution of financial resources in a way that guarantees financial protection against the cost of illnesses. The main aim of the study was to determine the factors associated with Non enrollment into Community based health insurance schemes in the BHD. A community based cross-sectional study was carried-out among Parents in BHD. Multistage sampling technique was used to select participants and data collected using a structured interviewer administered questionnaire. Data collected was analysed using SPSS version 21. A total of 384 participants took part in the study. The rate of enrolment into CBHIS in BHD was 2.4% (95% CI: 0.9-3.9%). Salary employed individuals were 2.7 times more likely to be enrolled into CBHIS compared to those who were self-employed. (O.R: 2.70, 95%CI; 1.15-6.37: P = 0.023). Low level of education was also found to be significantly associated with non-enrollment into CBHIS (O.R: 0.455, CI: 0.212-0.976, P: 0.043). Unawareness of CBHIS (O.R: 0.025, CI: 0.006-0.113, P: <0.001), low income level (O.R: 0.305, CI: 0.134-0.697, P: 0.005) and age less than 40yrs (O.R: 0.255, CI: 0.103-0.631, P: 0.003) were found to be significantly associated with non-enrolment. There was low enrollment into CBHIS in the BHD (2.4%). Factors significantly associated with non-enrolment into CBHIS in BHD were; low level of education, low age group of less than 40yrs, non-salary employment, low income level and unawareness of existence of schemes.
Are you looking to integrate the CHNA into your strategy?
Then you don’t want to miss this webinar.
All hospitals are required to conduct these assessments, so learn how best to connect and streamline your strategic planning and marketing activities to maximize your brand’s impact.
In this webinar, originally presented December 6, 2016, Lee Ann Lambdin, Stratasan’s SVP of Healthcare Strategy, and Jon Headlee, President of Ten Adams, discuss how to extend your Community Health Needs Assessment to create effective wellness initiatives from the inside out.
Household survey as a tool for training medical students in measuring public ...Alim A-H Yacoub Lovers
Habib OS, Ajeel NAH, Yacoub AAH. Household surveys as a tool for training medical students in measuring population health. The Iraqi Journal of Community Medicine 2002; 15: 5-8.
Over the past decade, Kenya has made tremendous efforts to enhance maternal and child health. Secure maternity policies such as free maternity care are one of the initiatives that have enhanced maternal and child health in all public health facilities. Despite these attempts, public health facilities for maternal and child health are still underused. This study employed a cross-sectional descriptive study design to identify determinants of free maternal health services by evaluating factors determining perceptions and health-seeking behavior of 384 pregnant mothers in Malava Sub-County, Kakamega County. The study used a mixed-method (quantitative and qualitative approaches). Questionnaires were administered to pregnant mothers selected for the study. The study employed a purposive sampling of research participants. Quantitative data were collected using the questionnaire administered by the research assistants whereas qualitative data were collected by the researcher through interview schedules. Quantitative data analysis was carried out using SPSS 23. However, qualitative data were analyzed through content analysis. Quantitative data representation was done in terms of frequency and percentages. Analysis of chi-square testing was used to assess the association between the variables of socio-economic and health facilities and the provision of free maternity facilities (p<0.05). The study established that the uptake of free maternal service by pregnant mothers was influenced by their level of primitivism and religious beliefs. In addition, this study found out that 53.8% and 77.7% of the pregnant mothers could not attend antenatal and post-natal care because government facilities were located far away from their residences and they also had less access to some information about free maternal health care. The results of this research would be disseminated to the hospital management team, Sub-Country health management team, County health management team, and other stakeholders, thereby demonstrating reasons for low uptake of free maternity services and helping to strategize for better service delivery. Based on the finding, the study recommends that to improve access to free maternal health care, the county government ought to place health services as close as possible to the community where people live. Secondly, there is a need to embrace the usage of the existing media network to sensitize pregnant mothers to the danger signs and the need to have decision-making powers over their safety. Lastly, hospital management ought to increase the awareness of free maternal health care and to include it among the community priorities during dialog days, action days, and other group discussions.
NRHM Policies and Lacking in its ImplementationSupriya_1995
Survey was conducted to examine the impact of NRHM Policies in Rural and Urban Areas and its related implementation. To analyze the opinion and reaction towards the same, the general public from Rural and Urban areas of Bulandshahr were selected
Background: Maternal health remains today, one of the major public health concerns in developing countries. Maternal deaths and newborn deaths usually occur within 48 hours of delivery. In Cameroon, despite all the initiatives set up by the Ministry of Public Health to reduce the mortality rate, the situation remains alarming in terms of postnatal consultation; this is much more felt in the West region of Cameroon, which is one of the most affected regions because 43.1% of women who give birth in hospitals do not return to postnatal consultation and this rate is higher than the national average with a value of 21.5%. Objective:This work aims to determine the factors influencing postnatal follow-up in the Bafang Health District. Methodology: This is a cross-sectional descriptive study for analytical purposes, carried out in the Bafang Health District between January 1 to November 30, 2017. Our study population consisted of all women of childbearing age living in the Bafang Health District during the study period. The variables studied were sociodemographic characteristics, socio-cultural characteristics and the provision of care. Results: Analysis carried out during this study, it appears that, the person who informs the women on the dates of rendez-vous during the CPoN (OR = 2.92; [95%CI = 1.16-7,]; p-value = 0.02), women who think the appropriate period of postnatal follow-up is 6 weeks postpartum (OR = 4.27, [95%CI = 1.47-12.39], p-value = 0.00 ) and those who massage the abdomen after childbirth (OR = 2.62, [95%CI = 1.34 - 5.12], p-value = 0.00) are more likely to have knowledge about follow-up postnatal. While women who have no knowledge of postnatal follow-up (OR = 0.18, 95%CI = 0.07-0.45, p-value = 0.00) are less likely to have more knowledge. Conclusion: Lack of knowledge of the existence and importance of postnatal consultation (CPoN), traditional practices are the factors that influence postnatal follow-up in the Bafang Health District. A good and effective care for women after childbirth requires increased awareness campaigns at the hospital level as well as in community settings.
Running head UNION COUNTY, GEORGIA .docxtoltonkendal
Running head: UNION COUNTY, GEORGIA 1
UNION COUNTY, GEORGIA 2
Union County, Georgia
Kimberly Crawford
January 30, 2017
Kaplan University
The following paper will answer the asked questions.
Name of County and State
Union County, Georgia.
County population with racial and gender breakdowns
As of July 1, 2015 estimates, the County population was 22, 267 individuals. Of this, 51.7% were Females, while as the males were 48.3%. The white people were 96.5%, the African Americans were 1.0%, the American Indian and Alaska Natives were 0.5%, Asians were 0.7%, Hispanics were 3.2%, and people with two or more races present accounted for 1.3%.
Number of Senior Citizens
The number of senior citizens was 32.5%.
Number of Disabled Individuals
The number of disabled individuals under the age of 65 was 13.9%.
Number of Children
The number of children was 16.1%.
Of the populations above, I choose the senior citizens. The first health concern for this population is elder abuse. At this age, this people are not able to actively take care of themselves like they would a while back. For this reason, they constantly required to be taken care of, in almost all the aspects of their lives. However, elder abuse is a common occurrence in which, the caregivers neglect this population so much, to the extent of some of them even dying. It is such a shame that such a thing might happen to such a delicate population. A second health concern for this population, is the risk of heath disease and other chronic diseases. According to the Centre for Disease Control (CDC), heart disease is one of the leading killers for the senior citizens because at this age, they are delicate and their hearts are very weak (Motooka et al., 2006).
The senior citizens require a number of community health interventions and public policies, which are aimed at ensuring they lead a comfortable life. For instance, they should have access to caregivers when they cannot adequately take care of themselves (Takano, 2002). In addition, they should have access to proper diets, and they should be provided with as much assistance as possible when they are at home and in public places. They should also have regular medical check-ups, to ascertain their health conditions, as well as have access to a hospital and a personal doctor in case they need consultation before their regular sessions (Anderson, 2003). Regular exercises is also good for ensuring their lives are going on smoothly.
Health Risk Assessment
In the health risk assessment tests, I took the eating behaviour test. The questions asked basically were about the kind of foods and drinks that I take on a daily basis, how often I take the meals per day, the rate and posture at which I take the meals, my favourite comfort food, and the circumstances under which I take th ...
Ijsrp p8825 Caregiver factors influencing seeking of Early Infant Diagnosis (...Elizabeth kiilu
Caregiver factors influencing seeking of Early Infant Diagnosis (EID) of HIV services in selected hospitals in Nairobi County, Kenya:A qualitative Study
We report on the results of a survey carried out on 30 Traditional Birth Attendants (TBA) in the littoral region of the Republic of Cameroon. The main objective of this survey was to evaluate knowledge, attitudes and practices of traditional birth attendants with regard to their ability to recognize danger signs during pregnancies and the prevention of infections. The survey did not include trained birth attendants who perform deliveries in homes. The mean age of traditional birth attendants was 49.6 years; the lowest age being 33 and the highest 69.
Brief overview of group 2 final PowerPoint presentation pertaining to the affects of macro-trends on the U.S.Healthcare Systems and potential job growth/opportunities that will come from them.
"What Happens When Women's Preventive Care is Undervalued? Lessons from Romania"
Adriana Baban, PhD
Professor, Babes-Bolyai University, Cluj-Napoca, Romania
May 10, 2006
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
NRHM Policies and Lacking in its ImplementationSupriya_1995
Survey was conducted to examine the impact of NRHM Policies in Rural and Urban Areas and its related implementation. To analyze the opinion and reaction towards the same, the general public from Rural and Urban areas of Bulandshahr were selected
Background: Maternal health remains today, one of the major public health concerns in developing countries. Maternal deaths and newborn deaths usually occur within 48 hours of delivery. In Cameroon, despite all the initiatives set up by the Ministry of Public Health to reduce the mortality rate, the situation remains alarming in terms of postnatal consultation; this is much more felt in the West region of Cameroon, which is one of the most affected regions because 43.1% of women who give birth in hospitals do not return to postnatal consultation and this rate is higher than the national average with a value of 21.5%. Objective:This work aims to determine the factors influencing postnatal follow-up in the Bafang Health District. Methodology: This is a cross-sectional descriptive study for analytical purposes, carried out in the Bafang Health District between January 1 to November 30, 2017. Our study population consisted of all women of childbearing age living in the Bafang Health District during the study period. The variables studied were sociodemographic characteristics, socio-cultural characteristics and the provision of care. Results: Analysis carried out during this study, it appears that, the person who informs the women on the dates of rendez-vous during the CPoN (OR = 2.92; [95%CI = 1.16-7,]; p-value = 0.02), women who think the appropriate period of postnatal follow-up is 6 weeks postpartum (OR = 4.27, [95%CI = 1.47-12.39], p-value = 0.00 ) and those who massage the abdomen after childbirth (OR = 2.62, [95%CI = 1.34 - 5.12], p-value = 0.00) are more likely to have knowledge about follow-up postnatal. While women who have no knowledge of postnatal follow-up (OR = 0.18, 95%CI = 0.07-0.45, p-value = 0.00) are less likely to have more knowledge. Conclusion: Lack of knowledge of the existence and importance of postnatal consultation (CPoN), traditional practices are the factors that influence postnatal follow-up in the Bafang Health District. A good and effective care for women after childbirth requires increased awareness campaigns at the hospital level as well as in community settings.
Running head UNION COUNTY, GEORGIA .docxtoltonkendal
Running head: UNION COUNTY, GEORGIA 1
UNION COUNTY, GEORGIA 2
Union County, Georgia
Kimberly Crawford
January 30, 2017
Kaplan University
The following paper will answer the asked questions.
Name of County and State
Union County, Georgia.
County population with racial and gender breakdowns
As of July 1, 2015 estimates, the County population was 22, 267 individuals. Of this, 51.7% were Females, while as the males were 48.3%. The white people were 96.5%, the African Americans were 1.0%, the American Indian and Alaska Natives were 0.5%, Asians were 0.7%, Hispanics were 3.2%, and people with two or more races present accounted for 1.3%.
Number of Senior Citizens
The number of senior citizens was 32.5%.
Number of Disabled Individuals
The number of disabled individuals under the age of 65 was 13.9%.
Number of Children
The number of children was 16.1%.
Of the populations above, I choose the senior citizens. The first health concern for this population is elder abuse. At this age, this people are not able to actively take care of themselves like they would a while back. For this reason, they constantly required to be taken care of, in almost all the aspects of their lives. However, elder abuse is a common occurrence in which, the caregivers neglect this population so much, to the extent of some of them even dying. It is such a shame that such a thing might happen to such a delicate population. A second health concern for this population, is the risk of heath disease and other chronic diseases. According to the Centre for Disease Control (CDC), heart disease is one of the leading killers for the senior citizens because at this age, they are delicate and their hearts are very weak (Motooka et al., 2006).
The senior citizens require a number of community health interventions and public policies, which are aimed at ensuring they lead a comfortable life. For instance, they should have access to caregivers when they cannot adequately take care of themselves (Takano, 2002). In addition, they should have access to proper diets, and they should be provided with as much assistance as possible when they are at home and in public places. They should also have regular medical check-ups, to ascertain their health conditions, as well as have access to a hospital and a personal doctor in case they need consultation before their regular sessions (Anderson, 2003). Regular exercises is also good for ensuring their lives are going on smoothly.
Health Risk Assessment
In the health risk assessment tests, I took the eating behaviour test. The questions asked basically were about the kind of foods and drinks that I take on a daily basis, how often I take the meals per day, the rate and posture at which I take the meals, my favourite comfort food, and the circumstances under which I take th ...
Ijsrp p8825 Caregiver factors influencing seeking of Early Infant Diagnosis (...Elizabeth kiilu
Caregiver factors influencing seeking of Early Infant Diagnosis (EID) of HIV services in selected hospitals in Nairobi County, Kenya:A qualitative Study
We report on the results of a survey carried out on 30 Traditional Birth Attendants (TBA) in the littoral region of the Republic of Cameroon. The main objective of this survey was to evaluate knowledge, attitudes and practices of traditional birth attendants with regard to their ability to recognize danger signs during pregnancies and the prevention of infections. The survey did not include trained birth attendants who perform deliveries in homes. The mean age of traditional birth attendants was 49.6 years; the lowest age being 33 and the highest 69.
Brief overview of group 2 final PowerPoint presentation pertaining to the affects of macro-trends on the U.S.Healthcare Systems and potential job growth/opportunities that will come from them.
"What Happens When Women's Preventive Care is Undervalued? Lessons from Romania"
Adriana Baban, PhD
Professor, Babes-Bolyai University, Cluj-Napoca, Romania
May 10, 2006
The Indian economy is classified into different sectors to simplify the analysis and understanding of economic activities. For Class 10, it's essential to grasp the sectors of the Indian economy, understand their characteristics, and recognize their importance. This guide will provide detailed notes on the Sectors of the Indian Economy Class 10, using specific long-tail keywords to enhance comprehension.
For more information, visit-www.vavaclasses.com
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
The Art Pastor's Guide to Sabbath | Steve ThomasonSteve Thomason
What is the purpose of the Sabbath Law in the Torah. It is interesting to compare how the context of the law shifts from Exodus to Deuteronomy. Who gets to rest, and why?
1. REPUBLIQUE DU CAMEROUN
……………………………………………
Paix- Travail- Patrie
……………………………………
UNIVERSITE DU BAMENDA
…………………………………..
FACULTE DES SCIENCES DE LA SANTE
……………………………………...
BAMBILI, BAMENDA
REPUBLIC OF CAMEROON
……………………………………………
Peace- Work- Fatherland
……………………………………
THE UNIVERSITY OF BAMENDA
…………………………………..
FACULTY OF HEALTH SCIENCES
……………………………………...
BAMBILI, BAMENDA
DEPARTMENT OF PUBLIC HEALTH
OPTION: COMMUNITY HEALTH
COMMUNITY PERCEPTION ON ACCESSIBILITY,
QUALITY AND AFFORDABILITY OF PRIMARY HEALTH
CARE SERVICES IN NKWEN HEALTH DISTRICT
PRESENTED BY
AZANUI CLIFORD ALUOFUH (B.Sc. in Nursing)
Registration number UBa20HP022
SUPERVISOR
PROF. GERALD NGO TEKE
Associate Professor of Pharmacology, UBa
OCTOBER 2022
1
2. 2
PRESENTATION OUTLINE
INTRODUCTION
STATEMENT OF THE PROBLEM
RESEARCH QUESTIONS
RESEARCH OBJECTIVES
MATERIALS AND METHODS
RESULTS AND DISCUSSION
CONCLUSIONS
RECOMMENDATIONS
LIMITATIONS OF THE STUDY
ACKNOWLEDGMENT
REFERENCES
SIGNIFICANCE OF THE STUDY
3. 3 INTRODUCTION
The WHO defines primary health care as essential health care based
on practically, scientifically, and socially accepted method and
technologically made universally accessible to the individual and
families in the community through their full participation and at a
cost that the community and the country can afford to maintain at
every stage of their development in the spirit of self-reliance and self-
determination. Globally, more than half the world’s population
already lacked access to essential health services before the COVID-
19 pandemic[1].
4. 4 INTRODUCTION CONT.
Research indicates that patients’ perception of quality is influenced by
a variety of factors, such as features of the national health system,
practice type and the providers’ personal and clinical skills. It seems
that patients value immediate comfort while physicians addressing
quality of care are concerned more about resources. A large body of
research addressing different aspects of quality of care from the
perspective of patients and providers exists. However, these studies
mostly cover a single country and/or one health problem. There is a
lack of data about the perception of quality of care by patients and
health providers in an international context.
5. 5 STATEMENT OF THE PROBLEM
A key message of the World Health Report 2010 is that “...millions
of people cannot use health services because they have to pay for
them at the time they receive them. And many of those who do not
use these services suffer financial hardship, or are even
impoverished, because they have to pay.[1] To date, much of the
focus has been on the implications of out-of-pocket payments
(OOPs), including user fees for individuals and households in
relation to socio-economic status.
6. STATEMENT OF THE PROBLEM CONT.
In Cameroon, little is known about the perception rates of PHC
services and factors influencing community perception especially
with the advent of the COVID-19 pandemic. The socio-political
unrest in the North West region of the country has caused an
increase in internally Displaced population (IDP population), an
increase in the rate of poverty and decrease in levels of education
among the community. With all these changes, there is little or no
knowledge on the perception rates of PHC services in this region.
6
7. RESEARCH QUESTIONS
• What are the available primary health care services in Nkwen Health
District?
• How frequent is the utilization of these primary health care services
in Nkwen Health District?
• What are the factors that influence accessibility, quality and
affordability of primary health care services by inhabitants in Nkwen
Health District?
• What are the ways of improving accessibility, quality and
affordability of these primary health services in Nkwen Health
Districts?
7
8. RESEARCH OBJECTIVES
Main Research Objective
The general objective of this study is to explore community perception on accessibility,
quality and affordability of primary health care services in Nkwen Health District.
Specific Research Objectives
• To identify the available primary health care services in Nkwen Health District.
• To determine the frequency of utilization of these primary health services in Nkwen
Health District.
• To identify the factors that influence accessibility, quality and affordability of
primary health care services by inhabitants in Nkwen Health District.
• To determine the ways of improving accessibility, quality and affordability of
primary health care services in Nkwen Health District.
9. 9
Access to primary healthcare services expressively improves productivity,
increase life expectancy and reduces both morbidity and mortality rates
among citizens. Hence, investigating the factors that affect access to
healthcare, and also child mortality, will help to guide the policy makers to
improve on their interventions, with respect to issues concerning
improvement in access to primary healthcare services.
Significance of the Study
10. 10
MATERIALS AND METHODS
STUDY DESIGN
The study was a community
based descriptive cross-sectional
study
STUDY PERIOD
This study covered a period of 3 months from
March to July 2022
STUDY AREAAND SETTING
This research is limited to households within the Nkwen Health Area of the
Nkwen Health District in the North-West Region of Cameroon.
11. 11 MATERIALS AND METHOD CONT
TARGET POPULATION
This study will be a community-based study, to be carried out in randomly selected
households within the Nkwen Health Area of the in North-West Region
INCLUSION CRITERIA
All households randomly selected
and consent to the study will be
included in the survey.
EXCLUSION CRITERIA
All unoccupied households
All household that refused/opted out from
the survey.
All Red (highly insecure) zones vis a vis the
sociopolitical crisis
12. 12
MATERIALS AND METHODS CONT.
Sampling Method
A simple random sampling
will be use to select the
households of the study
The sample size was calculated using Taro
Yamane `s formula
A total of 360 respondents were
enrolled in the study.
Sample Size Determination
Ethical Considerations
• Ethical clearance was obtained from the Institutional Review Board (IRB) of the University of
Bamenda.
• Administrative authorization was gotten from the regional delegate of public health.
• Informed consent form from the school was signed by the participants.
13. 13
MATERIALS AND METHODS CONT.
• Data for this study was analyzed using SPSS for version 26.
• The results were presented in the form of tables and charts, in
representation of frequencies and percentages according to the various
objectives of the study.
• Association between categorical variables was done using Bivariate
logistic regression analysis technique. A P-value of <0.05 was
considered as statistically significant.
14. 14
RESULTS AND DISCUSSION
Demographic Data
Gender of Respondents
Frequency
Percen
t
Variables Male 97 26.9
Female 263 73.1
Total 360 100.0
Employment status
Frequency
Percen
t
Variables Unemployed 260 72.2
Private sector 56 15.6
Public sector 30 8.3
Retired 13 3.6
Informal sector 1 .3
Total 360 100.0
73.1% females and 26.9% males during the study majority of our respondents were unemployed, that is 72.2%
(260), 15.6% (56) worked in the private sector while 8.3% (30)
were civil servants
15. 15
RESULTS AND DISCUSSION CONT.
Demographic Data cont.
0.83% had no education, 75.56% had attended
university studies. 18.06% had attended
secondary school closely followed by 5.56% for
primary scholars.
most of our respondents, 63.3% (228) were 21 – 40 years,
followed by those of the age of 41 – 60 years, 21.1% (76). The
minority were those of both <= 20 years and 60+ years with a
percentage of 7.8% and frequency being 28.
16. 16
RESULTS AND DISCUSSION CONT.
Demographic Data cont.
Marital status
Frequency Valid Percent
Variables single 152 42.2
Married 136 37.8
Divorced 2 .6
Widow/Widower 70 19.4
Total 360 100.0
Religion
42.2% (152) were married, closely followed by 37.8% (136).
We had 19.4%(70) widowed/widowers with 0.6% (2) divorced
respondents
87.22% Christians, 10.83% Muslims and 1.94%
respondents from other faiths.
17. 17
RESULTS AND DISCUSSION CONT.
PHC services available
PHC services available yes no Total
N % N % N %
Mother and child care including family planning 244 67.9 116 32.1 360 100
Provision of adequate nutrition 321 89.3 39 10.7 360 100
Provision of safe drinking water and sanitation 334 92.9 26 7.1 360 100
Health education on the prevention of prevailing illnesses 320 89 40 11 360 100
Control and prevention of communicable diseases and injuries 241 67 119 33 360 100
Vaccination against the major infectious diseases(E.P.I) 360 100 0 0 360 100
Treatment of injuries and minor ailments 219 61.1 141 38.9 360 100
Provision of essential drugs 299 83.3 61 17.7 360 100
18. 18
RESULTS AND DISCUSSION CONT.
PHC services available
Generally, there was a general acceptance of public health services being
available in the area in the following proportion. 67.9% indicated the
availability of mother and child health care including family planning. The
demographics indicates more females than males in the study area, who use
the mother and child care public health service, and are open to becoming
housewives than the male counterpart. This is in line with a study by Marko,
2020 which shows that the female are much more open to becoming mothers if
idle than when employed. (Marko,2020) Regarding the availability of
adequate nutrition, 10.7% said there was no provision of accurate nutrition.
This is inline with a study carried out by FNG, 2021 which shows that, about
48% of Cameroonians cannot afford a diet that meet their nutritional
requirements.
19. 19
RESULTS AND DISCUSSION CONT.
PHC services available
Moreover, 24% cannot afford a diet that meets just their energy needs.
However, the World Food Programme (WFP) in collaboration with the
Cameroon government is now providing food to the IDPs of the study area as
of the time of this study. The study found out that regarding the provision of
safe drinking water and sanitation, 92.9% agreed while the remaining 7.1%
said no. This high percentage is due to the fact that community water is
provided in most areas of Bamenda community by the policy makers of the
town. In 1968 Cameroon created the National Water Supply Company of
Cameroon (SNEC, Société Nationale des Eaux du Cameroun) to provide water
supply across the country This is in line with a study by Goudge, 2016 where
he stated that water was the most available public health care resource to the
people of South Africa according to the BMC health services.
20. 20
RESULTS AND DISCUSSION CONT.
PHC services available
89% said there was the availability of health education on the prevention of
communicable diseases and injuries, with a 100% record on the availability of
vaccination against the major infectious diseases. This goes to support the fact that
what Onyeneho,2016 about vaccines is true. The researcher stated that Vaccines reduce
risks of getting a disease by working with your body's natural defences to build
protection. When you get a vaccine, your immune system responds. Given that
Cameroon government does door to door vaccination campaigns, the research study is
in confirmation of this act. As per the treatment of injuries and minor ailments, 38.9%
said it was not available and 83.3% said there was the provision of essential drugs as a
public health service in the area. This shows that sensitization is needed in the area as
many people records shows education on PHC is lacking in the area.
21. 21 RESULTS AND DISCUSSION CONT.
Frequency of utilization of
PHC services
V. frequent Frequent I don’t know Not frequent Never used
N % N % N % N % N %
Mother and child care
including family planning
9 2.6 53 14.9 103 28.2 51 14.3 144 40.0
Provision of adequate
nutrition
19 5.3 64 17.9 15 3.8 44 12.3 218 60.7
Provision of safe drinking water and
sanitation
259 72.1 38 10.8 30 7.1 36 10.0 0 0
Health education on the
prevention of prevailing illnesses
215 59.9 41 11.4 40 10.7 14 4.1 50 13.9
Control and prevention of
communicable diseases and injuries
252 70.0 49 13.8 6 1.3 53 14.9 0 0
Vaccination against the major
infectious diseases(E.P.I)
328 91.3 10 2.8 0 0 22 5.9 0 0
Treatment of injuries and minor
ailments
32 8.9 58 16.3 16 3.9 252 70.1 2 0.8
Provision of essential drugs 197 54.8 44 12.4 77 20.7 30 8.6 12 3.5
Frequency of utilization ofPHC services
22. 22 RESULTS AND DISCUSSION CONT.
Frequency of utilization of PHC services in Nkwen Health District.
The respondents data was collected, and regarding how frequent the health
services available are being used, we had the following results. 40.0% said they
don’t know about mother and child care while 2.6% said they use it very
frequent. This however shows that even though mother and child care is being
provided, most of our respondents do not use it as they ought to. Most
mothers are preoccupied with house works and farming, that services such as
clinical visits are often neglected by mothers in the study area. When it came to
adequate nutrition, 60.7% said they had never used it as a public health
service, and a few, 5.3% actually indicated they use it very frequently. Even
though the World Food Program in association with the Cameroon
government provides food to households in the study area, there are
procedures to be followed, such as registration which most of them skip, and
as a result they do not receive the benefit of nutritional provision as a public
health care service
23. 23 RESULTS CONT
Frequency of utilization of PHC services in Nkwen Health District.
Regarding safe drinking water and sanitation, 72.1% indicated they use it very
frequently, and there was no case of any individual who does not use this particular
public health service in the district. Audrey Hepburn,1993 said Water is life, and clean
water means health. Therefore, it is not surprising that 72.1% of the study population
use safe drinking water provided, and as per sanitation, the HYSACAM company
carries the trash in the neighborhood to the appropriate location. This then prevents
dirt related diseases in the area. 59.9% of respondents use health education on the
prevention of illnesses, and there was no case of those who have never used control
and prevention of communicable diseases and injuries. The study showed that 91.3%
have used the vaccination service before, and 54.8% have frequently used the
provision of essential drugs to the public. The government of Cameroon provides
vaccination for children and adults in hospitals, as well as during doorto-door
campaigns. The results shows most of our respondents do use the vaccination services
provided by the government. The most recent being the COVID-19 vaccine which was
provided by the Public Health Ministry to the population.
24. 24
Sub factors N %
Factors influencing accessibility of PHC
service
Availability resources of health
care
310 86.2
Low cost of care 230 64.0
Transportation system 72 20.0
Health insurance coverage 38 10.8
Factors influencing quality of PHC services
Increase in health professionals 284 79.1
Collaboration 73 20.5
Proper planning 283 78.8
Effective management of resources 230 64.0
Availability of resources 111 30.9
Factors influencing affordability of PHC
service
knowledge and skills 353 98.1
Income
Transportation cost
360
165
100
45.9
Price or cost of use 353 98.2
Waiting time 118 32.9
Quality of care 46 12.9
Factors influencing accessibility, quality and affordability of PHC in Nkwen Health District.
25. 25
Factors influencing accessibility, quality and affordability of PHC in Nkwen
Health District.
Accessibility was generally positive as most of the PHC services could be easily
accessible especially health care resources, (86.2%). (310) of them ticked availability of
health care resources as a factor influencing accessibility, with 64.0% indicating the
percentage of low cost of care being a factor affecting accessibility of health care
services. Government hospitals in Cameroon give out health care services at very low
cost, and also during campaigns and other community outreach programs. As per
transportation system, 20% agreed and health insurance coverage recorded 10.8 of
respondents. The ambulance with the number 119 is accessible to each member of the
study population, as such accessibility of the health care service is facilitated upon
during emergency cases. As per health professionals, 79.1% accepted that an increase
in health professionals will actually influence accessibility of health care services. It is
but normal that professionalism means a good impact on the accessibility of health
care services. This is in line with the division of labour theory which shows that
many hands can reach out to more people than few hands.
26. 26
Factors influencing accessibility, quality and affordability of PHC in Nkwen
Health District.
As per the factors affecting the quality of the health care services delivered, it shows
that proper planning (78.8%) and effective management of resources (64.0%) will go a
long way as shown by the agreed population. One of the major objectives of the
health sector third and fourth five years plans (1980-90) was to improve the quality
and to increase the coverage of the health care delivery system (GOB 1990). As per
resource management, it is advisable for the government to also implement
maintenance policies in order to deliver quality health care services. Rani et al. (2015)
advises that government should do three types of maintenance, namely unplanned
(corrective) or planned (preventive), and predictive maintenance approaches.
Corrective maintenance (CM) occurs when a component is going out of function and
needs intervention in the form of repair or replacement (Higgins et al., 2002). On the
other hand, Preventive maintenance (PM) includes planning of periodical repairs or
replacements at specified time intervals (Gross, 2002) such as monthly, quarterly or
annually. Looking at the factors influencing affordability, there was a 100% agreed on
income, and 98% on cost of use
27. 27
Sub factors N %
Ways of improving accessibility of PHC services
Increase efficiency of the workforce
Ensure adequate funding of children’s health insurance
program and retain Medicaid expansion
162
85
45
23.6
Stabilize individual insurance 37 10.3
Ways of improving the
quality of PHC services
Address physician shortage 243 67.7
Collaboration
Proper planning
113
301
31.8
83.7
Effective management of resources 324 90
Availability of resources 3 0.9
Ways of improving
affordability of PHC services
Education and training 270 75
Promote virtual healthcare
Poor sections of society must be provided free medicines
20
287
20.4
79.9
Regulate the prices of drugs 295 82.1
People should be allowed to buy health insurance from
company
46.44 12.9
Door to door distribution should be encouraged
276 76.9
Ways of improving accessibility, quality and affordability of Primary Health Care services.
28. 28
Ways of improving accessibility, quality and affordability of Primary Health Care
services.
The responses to the various suggestions to improve affordability, quality and
accessibility of primary health care services indicates that, as per improving
affordability, a lot of emphasize was laid on price regulation on drugs (82.1%). This
was closely followed by poor sections of society having free medicines, 79.9%. The
least percentage came from insurance, with 12.9% ticking to allowing people to buy
insurance from other companies. According to Kessler, 2014, the primary goal of
drug price regulation is to reduce expenditures by cutting prices. This will intend
make the drugs very much affordable to the general public. Boiling down to ways of
improving quality of public health services, proper planning, 83.7% and effective
management of resources, 90% was highest. Availability of resources recorded a
0.9%. Talking about ways of improving accessibility, hiring more people or
addressing physician shortage scored 67.7%, followed by increasing the efficiency of
workforce
29. 29 CONCLUSION
Every citizen has a right to have access to healthcare services
(Cameroon constitution, 1960). This discussion has shown how
affordability and accessibility can influence the usage of healthcare
services. Accessibility is not only the distance an individual must
travel to reach the health service point but more so the utilization of
these services.
As per the availability of the Public health care services, generally,
there was a general acceptance of public health services being
available in the area with the most being vaccination, then safe
drinking water, closely followed by mother and child care. The least
available public health service in the area was the treatment of
ailments.
30. 30 CONCLUSION CONT
Regarding the Frequency of utilization of these services, most of
our respondents use safe drinking water frequently which is
provided by CAMWATER, and the sanitation taken care of by
HYSACAM. Even though mother and child care is available, its
frequency of utilization is rather low.
Looking at the factors influencing accessibility, quality and
affordability of PHC in Nkwen District Area availability of health
care resources, transportation system, and an increase in health
professionals will actually influence accessibility of health care
services. Regarding the quality, it shows that proper planning and
effective management of resources are the main factors affecting the
quality of public health care services in the area.
31. 31 CONCLUSION CONT
Looking at the factors influencing affordability, there was a 100%
agreed on income, and 98% on cost of use. Most of the users of the
health care services were housewives, and especially the mother and
child services. Given they are housewives, the challenge of income is
but understandable in this study, and the cost of usage can also be
burdensome
Looking at ways of improving affordability, a lot of emphasize was
laid on price regulation on drugs. The least percentage came from
insurance. And in order to improve quality, proper planning, and
effective management of resources, should be taken into
consideration. Talking about ways of improving accessibility, hiring
more people will be increasing the efficiency of workforce
32. 32 RECOMMENDATIONS
The government should provide medication for free especially
to the low and middle class residents of her country.
At present doctors who fail to fulfill their duties have little fear
of any penalties, and enjoying higher income from
government practice. There are no direct financial incentives to
provide higher quality services. As such provision of
incentives for better performance and disincentives for
irresponsibility need to be introduced effectively.
33. 33
Electricity problems disturbed the realization of this study during
the report writing, and printing phases
Most households were scared of receiving the researcher due to the
insecurity issues in the area which is as a result of the Anglophone
crises
Poor roads especially in the quarters where the research is carried
out was a hindrance to the study
LIMITATION OF STUDY
34. 34
Economic impact of public health services on the country
Evaluation of the performance of public health practitioners in the
community
SUGGESTIONS FOR FURTHER STUDIES
35. 35
AKNOWLEDMENTS
I would like to express my gratitude to my supervisor Prof. Gerald Ngo Teke for the
time and dedication he put to ensure the best out of this work.
The Dean, administrative staffs and lecturers of the Faculty of Health Sciences of the
University of Bamenda, for the training for these two years.
Much thanks to the department of Public Health, Faculty of Health Science and
University of Bamenda for granting me the opportunity to bring out this piece of
work.
To all the participants of this study, thank you for accepting to take part in this study.
This piece of work would not have been realized without the support of my friends,
brother and sisters, classmates and family members. Your input is deeply
appreciated.
36. 36 REFERENCES 1/2
• 1. Ahmed, S.; Mbaisi, J.; Moko, D.; Ngonzi, A. Health is wealth: How lowincome people finance
health care. J. Int. Dev. 2005, 17, 388–396. Arpey NC, Gaglioti AH, Rosenbaum ME. How
Socioeconomic Status Affects
• Patient Perceptions of Health Care: A Qualitative Study. Journal of
PrimaryCare&CommunityHealth.July2017:169175.doi:10.1177/2150131917697439
• Atun, R.; de Andrade, L.; Almeida, G.; Dmytraczenko, T.; Frenz, P.; Garcia, P.; GómezDantés,
O.; Knaul, F.M.; Muntaner, C.; de Paula, J.B.; et al. Healthsystem reform and universal health
coverage in Latin America. Lancet 2015, 385, 1230–1247.
• Borrell C, Espelt A, Rodríguez-Sanz M, Navarro V. Politics and health. J
Epidemiol,Community,Health.2007;61(8):658-659. doi:10.1136/jech.2006.059063
• Collins, D.; Morduch, J.; Rutherford, S.; Ruthven, O. Portfolios of the Poor: How the World’s
Poor Live on $2 a Day; Princeton University Press: Princeton, NJ, USA, 2009.
37. 37
REFERENCES 1/2
• Papp, R., Borbas, I., Dobos, E. et al. Perceptions of quality in primary health care: perspectives
of patients and professionals based on focus group,discussions.BMCFamPract15,128(2014).
https://doi.org/10.1186/1471-2296-15-128
• Parmar, D.; De Allegri, M.; Savadogo, G.; Sauerborn, R. Do communitybased health insurance
schemes fulfill the promise of equity? A study from Burkina Faso. Health Policy Plan. 2014, 29,
76–84.
• Wagstaff, A.; Lindelow, M. Are Health Shocks Different? Evidence from a Multi-Shock Survey
in LAOS; World Bank Policy Research Working Paper 5335; World Bank: Washington, DC, USA,
2010; pp. 1–38.