Examining Key Issues with the Utilization and Quality of Services in Primary Healthcare Facilities in Rural and Urban Areas in Nigeria

Abstract

Background: Utilization and quality of services in primary healthcare (PHC) facilities in Nigeria are a source of concern due to the essential role of  primary healthcare in providing key health care services and achieving universal health coverage.
Objective: This study examined the perception of service users on utilization and quality of services in rural and urban areas of south east Nigeria.
Methods: A cross sectional quantitative survey was conducted in one rural and one urban local government area in southeast Nigeria; in eight (8) PHC facilities. A pre-tested interviewer - administered questionnaire was used to collect data on utilization and perceived quality of services. Data was analyzed with SPSS Version 16.
Results: Most visits (86.6%) to facilities were for outpatient services. Antenatal care (27.2%) and child health services (23.0%) were the predominant  services in urban and rural areas. Educational level, being married, purpose of visit and attending health worker were all associated with utilization  while affordability, waiting time, presence of a doctor and laboratory services were positively associated with perception of quality.
Conclusion: This study indicates that utilization of healthcare at PHC facilities was suboptimal for key healthcare services. Underlying health system  challenges must be addressed with appropriate recommended reforms if the utilization and quality of services at PHC facilities will be significantly  improved.