1.1 Introduction
The Primary Health Care (PHC) acts as the most basic medical treatment available to all people worldwide. However, despite PHC facilities being established in both rural and urban areas with the objectives of equity and easy access, Nigerians living in rural areas are sadly neglected in comparison to those living in metropolitan areas. All PHC components must to be made available to Nigerians, as the majority of them reside in rural areas. Primary health care was to be made available for universal health care by the year 2000 and beyond (FAO, 2022).
This chapter will address the background information that motivated this study, the challenges that prompted it, its aim, and its objectives as a preface to subsequent sections of the study. Additional factors include the study's significance, scope, limitations, research questions and hypotheses, and the definition of technical terms.
1.2 Background of Study
Over the years, good health care is a fundamental right that should be enjoyed by all citizens of emerging nations. Despite the fact that primary health care (PHC) facilities are pretty evenly distributed throughout local authority areas, Nigerians living in rural regions tend to underuse basic health services. A new social structure based on more fairness and human dignity may be constructed by responsible health professionals, and by the year 2015, everyone's health including that of rural populations will no longer be a pipe dream but a reality. Enhancing community empowerment and capacity building via community organization, mobilization, and training in the areas of information exchange, training, and ongoing communication might increase rural residents' use of primary health care services.
According to Rifkin (as cited in Barnes et al., 2005), there are three approaches to community participation in health care. The first is the medical method, which places the onus of control on the medical practitioner and aims to treat sickness. The second approach pertains to health services, wherein people are encouraged to participate more actively in the provision of care. The third strategy is community development, which involves the community as a participant in decision-making on health improvement (Barnes et al., 2005).
Governments are actively searching for ways to enhance the performance of their healthcare systems in a global setting. As primary care is the initial point of interaction between patients and the health care system, its importance as the cornerstone of an integrated health care system has gained more recognition since the 1978 Alma-Ata Declaration. Primary care has been described as the cornerstone of efficient health care delivery and can help improve responsiveness and continuity of treatment (Figueras et al., 1997; World Health Organisation, 2002, as referenced in Boerma, 2006).
In a 2005 study, Barnes and colleagues evaluated the definitions of primary care and primary health care in a larger context. They discovered that both definitions recognise prevention and health promotion as crucial components of health and well-being and reflect the philosophies of equality and justice. The definitions' objectives and points of emphasis, however, vary. Treatment, the return of physical health and function, and referrals to the secondary and tertiary sectors is the main goals of primary care. Primary healthcare is centred on preventative care, intersectoral collaboration, access, and consumer empowerment. It is driven by a population-based approach where services are determined by the community.
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to know the Critical Issues and Strategies for Enhancing the Use of Primary Health Care Services by the Rural Communities.
1.3 Statement of Problems
Investigation revealed that the great majority of Nigerians resides in rural regions and frequently has little to no access to basic services. of the estimated 23,640 health institutions in the nation, primary health care facilities make up 85.5% of the total. Even though the bulk of the population is served by these institutions, particularly in rural regions, they are unable to offer basic and affordable services.
According to Adeniyi et al. (2014), a number of issues, such as inadequately staffed and equipped health facilities, a lack of clearly defined duties and responsibilities, a lack of political commitment, and a lack of accountability, are to blame for this poor performance (Adeniyi et al., 2014).
Although attempts to address treatment quality as a contributing reason to the nation's poor health outcomes receive less attention, improving quality at primary health care institutions is crucial. Because of this, the goal of this study is to evaluate Nigeria's primary healthcare system by focusing on important problems and methods for improving rural people' usage of healthcare.
1.4 Aim and Objectives of Study
The aim of the study is to assess the Critical Issues and Strategies for Enhancing the Use of Primary Health Care Services by the Rural Communities in Nigeria. In achieving this aim, the following specific objectives were laid out as follows:
- To find out the current status and gaps in PHC services in rural communities;
- To identify the critical issues in primary health care services in Nigeria; and
- To determine the strategies for enhancing the use of PHC services by rural communities.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What are the critical issues in primary health care services in Nigeria?
- What are the current status and gaps in PHC services in rural communities?
- What are the strategies for enhancing the use of PHC services by rural communities?
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