AN APPRAISAL OF PRIMARY HEALTH CARE SERVICES IN REHABILITATION AND TRAINING CENTRES IN LAGOS METROPOLIS, NIGERIA

Abstract

Primary Health Care (PHC) is an approach in Nigeria for making individuals, groups’ communities such as Rehabilitation and Training Centres (RTC). Economically and socially productive, there are two RTCs in Lagos metropolis located in Isheri (RTC) and Majidun (RTCM). The appraisal of the PHC services provided in these centres has not been conducted. The study therefore, assessed rehabilitates' perception of availability and adequacy of PHC services provided at the centres. The study involved the use of proportional random sampling technique in selecting 446 rehabilitates (RTCM-89.7%; RTCI-10.3%). A validated questionnaire was used for quantitative data collection, while two Focus Group Discussions (FGDs) were conducted among the rehabilitates in each centre. The quantitative data analysis was done using descriptive and Chi-square statistics. The FGDs were tape-recorded, transcribed and subjected to content analysis. The respondents' mean ages were 38 ± 11.1 and 25.5 ± 3.7 years at RTCM and RTCI respectively. Slightly above half ( 52.1%) had secondary education in RTCM, while proportion with this qualification at RTCI was 4.9%. Mental health problems accounted for the admission of 62.3% of the respondents. Out of the 12 PHC services normally provided in Nigeria, only immunization was not available in either centre. The respondents perceived the following elements of PHC to be adequately provided; Health education on personal hygiene (RTC-89.7%; RTCI-2.9%); control of locally endemic diseases with a focus on malaria RTCM-88.8%, RTCI-4.5%); food supply (RTCM-87.9%M, RTCI-2.5%), mental health services (RTCM-83.8%; RTCI-7.2%); management of minor ailments and injuries (RTCM-87.7%, RTCI-6.7%) supply of drugs (RTCM-89.5%); RTCI -2.9%) and dental care (RTCM-88.8%, RTCI-0.9%). Services considered to be inadequately provided included family planning (RTCM-87.3% RTCI-8.2%); education on AIDS (RTCM-88.6%; RTCI-6.2%); water supply (RTCM-89.0%; RTCI- 2.5%) and eye care (RTCM- 87.9%; RTCI-7.2%). Most respondents in RTCM (94.0%) and 6.0% of their counterparts in RTCI were very satisfied with the overall cleanliness of the centres, but the toilets were described as few and dirty by 86.1% (RTCM) and 13.9% (RTCI). Part-time doctors were the main sources of health education among 86.7% respondents and 13.0% of their RTCI counterparts. Sixty one percent of RTCM and 17.4% of RTCI respondents received first-aid services provided in the centres by nurses. Majority of RTCM (89.4%) respondents and 10.6% of RTCI disclosed that doctors from clinics to which the centres were affiliated visited the centres only at fixed times during the week. Overall respondents at RTCI (93.6%) were more satisfied with the PHC services compared to those in Isheri (6.4%) (p<0.05%). Most FGD discussants in both centres were of the view that health services provided for them needed some improvements. Inadequate availability of drugs was a major concern which cuts across the discussants in both centres. Most of the Primary health Care services were perceived to be available at the centres. However, there were some challenges especially in Rehabilitation and Training Centre, Isheri. Policy advocacy is needed to address the observed inadequacies.