Cargando…

The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis

As chronic diseases, non-communicable diseases (NCDs) require sustained person-centred and community-based care. Given its direct link to communities and households, Primary Health Care (PHC) is well positioned to achieve such care. In Nigeria, the national government has prioritized PHC system stre...

Descripción completa

Detalles Bibliográficos
Autores principales: Ajisegiri, Whenayon Simeon, Abimbola, Seye, Tesema, Azeb Gebresilassie, Odusanya, Olumuyiwa O., Peiris, David, Joshi, Rohina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021956/
https://www.ncbi.nlm.nih.gov/pubmed/36962373
http://dx.doi.org/10.1371/journal.pgph.0000566
_version_ 1784908620651036672
author Ajisegiri, Whenayon Simeon
Abimbola, Seye
Tesema, Azeb Gebresilassie
Odusanya, Olumuyiwa O.
Peiris, David
Joshi, Rohina
author_facet Ajisegiri, Whenayon Simeon
Abimbola, Seye
Tesema, Azeb Gebresilassie
Odusanya, Olumuyiwa O.
Peiris, David
Joshi, Rohina
author_sort Ajisegiri, Whenayon Simeon
collection PubMed
description As chronic diseases, non-communicable diseases (NCDs) require sustained person-centred and community-based care. Given its direct link to communities and households, Primary Health Care (PHC) is well positioned to achieve such care. In Nigeria, the national government has prioritized PHC system strengthening as a means of achieving national NCD targets. However, strengthening PHC systems for NCDs require re-organization of PHC service delivery, based on contextual understanding of existing facilitators and barriers to PHC service delivery for NCDs. We conducted a mixed method case study to explore NCD service delivery with 13 PHC facilities serving as the cases of interest. The study was conducted in two northern and two southern states in Nigeria–and included qualitative interviews with 25 participants, 13 focus group discussion among 107 participants and direct observation at the 13 PHCs. We found that interprofessional role conflict among healthcare workers, perverse incentives to sustain the functioning of PHC facilities in the face of government under-investment, and the perception of PHC as an inferior health system were major barriers to improved organisation of NCD management. Conversely, the presence of physicians at PHC facilities and involvement of civil society organizations in aiding community linkage were key enablers. These marked differences in performance and capacity between PHC facilities in northern compared to southern states, with those in the south better organised to deliver NCD services. PHC reforms that are tailored to the socio-political and economic variations across Nigeria are needed to improve capacity to address NCDs.
format Online
Article
Text
id pubmed-10021956
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-100219562023-03-17 The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis Ajisegiri, Whenayon Simeon Abimbola, Seye Tesema, Azeb Gebresilassie Odusanya, Olumuyiwa O. Peiris, David Joshi, Rohina PLOS Glob Public Health Research Article As chronic diseases, non-communicable diseases (NCDs) require sustained person-centred and community-based care. Given its direct link to communities and households, Primary Health Care (PHC) is well positioned to achieve such care. In Nigeria, the national government has prioritized PHC system strengthening as a means of achieving national NCD targets. However, strengthening PHC systems for NCDs require re-organization of PHC service delivery, based on contextual understanding of existing facilitators and barriers to PHC service delivery for NCDs. We conducted a mixed method case study to explore NCD service delivery with 13 PHC facilities serving as the cases of interest. The study was conducted in two northern and two southern states in Nigeria–and included qualitative interviews with 25 participants, 13 focus group discussion among 107 participants and direct observation at the 13 PHCs. We found that interprofessional role conflict among healthcare workers, perverse incentives to sustain the functioning of PHC facilities in the face of government under-investment, and the perception of PHC as an inferior health system were major barriers to improved organisation of NCD management. Conversely, the presence of physicians at PHC facilities and involvement of civil society organizations in aiding community linkage were key enablers. These marked differences in performance and capacity between PHC facilities in northern compared to southern states, with those in the south better organised to deliver NCD services. PHC reforms that are tailored to the socio-political and economic variations across Nigeria are needed to improve capacity to address NCDs. Public Library of Science 2022-07-01 /pmc/articles/PMC10021956/ /pubmed/36962373 http://dx.doi.org/10.1371/journal.pgph.0000566 Text en © 2022 Ajisegiri et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ajisegiri, Whenayon Simeon
Abimbola, Seye
Tesema, Azeb Gebresilassie
Odusanya, Olumuyiwa O.
Peiris, David
Joshi, Rohina
The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis
title The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis
title_full The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis
title_fullStr The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis
title_full_unstemmed The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis
title_short The organisation of primary health care service delivery for non-communicable diseases in Nigeria: A case-study analysis
title_sort organisation of primary health care service delivery for non-communicable diseases in nigeria: a case-study analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021956/
https://www.ncbi.nlm.nih.gov/pubmed/36962373
http://dx.doi.org/10.1371/journal.pgph.0000566
work_keys_str_mv AT ajisegiriwhenayonsimeon theorganisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT abimbolaseye theorganisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT tesemaazebgebresilassie theorganisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT odusanyaolumuyiwao theorganisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT peirisdavid theorganisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT joshirohina theorganisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT ajisegiriwhenayonsimeon organisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT abimbolaseye organisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT tesemaazebgebresilassie organisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT odusanyaolumuyiwao organisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT peirisdavid organisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis
AT joshirohina organisationofprimaryhealthcareservicedeliveryfornoncommunicablediseasesinnigeriaacasestudyanalysis