1.0 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 mained. 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 Of 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 health care 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, helth care equipment and qualified and well trained health personnels to handle all health care 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 health care service, Olubenga, (2010).
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