Factors Influencing the Quality of Primary Healthcare Services in Southern Senatorial District of Cross River State, Nigeria

Abstract

Background: The aim of this study is to determine the factors influencing the quality of primary healthcare
services in southern senatorial district of Cross River State, Nigeria.
Materials and Method: A cross sectional descriptive study design with both qualitative and quantitative
method of data collection was used. Donabedian’s structure, process and outcome model guided the research
protocol. Ethical clearance for the study was obtained from Cross River State Ministry of Health Ethics
Committee. Two semi-structured questionnaires and a Focus Group Discussion Guide were used for data
collection. Four hundred and eighty clients and 144 healthcare providers from 12 primary healthcare centres
in the study area were selected by simple random sampling method. Statistical package for social sciences
version 20.0 was used to analyze the quantitative data while thematic coding was used to analyse the
qualitative data.
Results: The major structure factors mitigating the quality of care as observed by the healthcare providers
include insufficient manpower 58(40.28%), lack of basic amenities (light, water supply and good road)
58(40.28%), insufficient equipment 26(18.06%), insecurity and communal crises 22(15.28%). The
perceptions of the clients were similar to that of the healthcare providers. In terms of process factors; poor
attitude of some healthcare providers and clients was the main response of healthcare professionals. The
qualitative results were similar to that of quantitative. All the basic primary health care services (including
health education, health promotion, environmental sanitation, immunization, reproductive health, nutrition,
HIV/AIDS and oral care) were provided in the selected health centres except mental health.
Conclusions: The quality of healthcare services in the southern senatorial district,Cross River State, Nigeria,
is affected by structure and process factors of the Donabedian’s model.