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...
Autores principales: | , , , , , |
---|---|
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 |