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Medical Laboratory Science

The locational distribution of public and private health care facilities in Owerri Urban

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ABSTRACT

The study examined “The locational distribution of public and private health care facilities in Owerri urban”, the study has three research questions and three objectives. The structure of this research work follows the pattern of defining and explaining the study population, sample population and sample size determination, sampling techniques, data collection procedure and methods of data analysis. The research design also involves an AutoCad design of the study area (Owerri urban), showing the boundary, and the spots heights. All Government and private owned Health care facilities operating in Owerri urban constitute the population for this research. Field survey was carried out to obtain information on the availability or otherwise of healthcare facilities. Findings gathered from the research shows that there are inequalities in the spatial location/distribution of health care facilities within the study area i.e some areas    have less than a fair share distribution of health care facilities within the study area, which basically implies that some areas are having inadequate health care delivery, while others have adequate health facilities serving them.  The study therefore recommends that efforts should be intensified to build more health facilities for greater percentage of people in  Owerri West L.G.A  living around Obogwe, Uborgi, Avu Umuecheta, Obougwu, Amapum, Amafor,Umukiri, Umejerem, Ezeogwu,  Okolochi, Emeabiam, and Oboku. The places listed above are lacking health care facilities. More health workers should be employed to work in the facilities so as to give the people the best and also to save lives most especially in the primary facilities.  Relevant Authorities should ensure that health care facilities are located not more than 4km from residential area in line World Health Organization policy; WHO(1997) An area with a population of 500 people should have access to at least one health facility WHO (1997).

CHAPTER ONE

INTRODUCTION

1.1     BACKGROUND TO THE STUDY               

The provision of health care facilities in Nigeria is a concurrent responsibility of the three tiers of government in the country (https://en.m.wikipedia. org/wiki/Health-in-Nigeria. However, due to the fact that Nigeria operates a mixed economy, private providers of medical health care have been part of health care delivery. The Federal Government plays a visible role but its role is mostly constrained to coordinating the affairs of the University teaching hospitals, Federal Medical Centers (Tertiary Health Care), while the State Government controls the various general hospitals (Secondary Health Care) and Local Government concentrates on dispensaries (Primary Health Care) which are regulated by the Federal Government. The total expenditure on health care is 4.6% of GDP, while the percentage of federal government expenditure on health care is about 1.5% (Wikipedia, 2009). Mapping therefore, becomes necessary to better articulate and appreciate the spatial distribution of health care facilities. Mapping allows professionals to understand complex spatial relationships visually so as to plan effectively and efficiently. Similarly, Hirschfield ,A.Brown,P and Bundred, P (1995) estimated that nearly 80% of the information need of local health system decision and policy makers involves geographical positioning. Health mapping utilizes the technology of Geospatial Information System (GIS) technique to add value to information for public and private health planning and decision making. Geospatial Information Systems (GIS) provides useful techniques regarding capturing, maintaining and analyzing of spatial data. For effective and functional health care delivery, spatial data is required on location and changes taking place within and around the communities to be able to carry out planning. Hence there is a need to introduce mapping technique that would reveal the impact and essence of monitoring the health care facilities. And this mapping technique is Geospatial Information Systems (GIS).

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Geospatial Information Systems (GIS) technique is a valuable tool to assist health research planning, monitoring and evaluating health systems. Geospatial Information Systems can be defined as the science and technology related to gathering, storage, manipulation, analysis and visualization  of geo-referenced data (Burrough, 2001). It has been used by several scholars to merged different data and produce  information  required for decision making in health management. In 1854, John Snow demonstrated the utility of mapping disease outbreaks to gain insight as to their cause. Snow, an anesthesiologist, mapped the highest density of cases that occurred in households, which used the public pump on Board street as their water sources (Law,M.R and Morris, J.R. 1998). Okafor , F.C and  Onokerhoraye,A.G.C (1977) analyzed the spatial distribution and efficiency of health centers in the old Bendel (now Edo and Delta) states. He created a database of all health centers in Benin and found that there were discrepancies between the population distribution and the distribution of health centers. Adejuyigbe, (1973) used Geospatial Information Systems (GIS) Technique to demonstrate the relationship between distance and patronage of health centers in Ife, Osun state. He noted that attendance at each health center in Ife region is a function of both type of service available there and the distance from other centers providing similar services. The World Health Organization (2004), describes GIS as an excellent means of analyzing epidemiological data, revealing trends, dependences and interrelationships that would be more difficult to discover using traditional tabular approach. The creation of health care facilities database and mapping help in showing the spatial distribution and information about location and there physical relationship to each others.

1.2     STATEMENT OF PROBLEM

As the saying goes that “A Healthy Nation is a Wealthy Nation” and “a healthy man is a wealthy man”. It would be stated that what necessarily promote good health is the quality and accessibility of health care facilities which must be within few walking distances. It is no gain saying that there is unplanned and chaotic distribution of health facilities in Nigeria. Information released by the National Population Commission (2006), shows that the Nigerian population is over 140 million. This numerical figure calls a need for increased and improved health care facilities across the 36 states of the federation and Abuja. Furthermore, Nigeria is a signature to the Millennium Development Goals (MDGS). The Millennium Development Goals consist of eight point agenda, among which three are accrued to health issues, these include but not limited to; Reduction of child Mortality, improvement of maternal health, combat HIV/AIDS, malaria and other diseases (USAID, 2005).  These agenda of Millennium Development Goals have compelled the health sector to be greatly engrossed in the establishment of more health care facilities and it has also engineered several researches to be carried out to investigate the distribution, accessibility and utilization of health care facilities in different part of the country. This does not signify that there has not been any related research work done before the era of millennium development goals. Much attention has not been paid to the spatial distribution of health care facilities in Owerri Urban and the surrounding rural areas. No research has properly documented the spatial distribution of health care facilities within the study area. In the previous research conducted in Owerri urban though the spatial distribution of the facilities was part of a major concern, there was no graphical presentation of their outcome in form of map, which could have made understanding easy. Also, GIS tool was not employed which would have helped to display the pattern of distribution, establish a database from which the distance from one facility to the other can be determined through survey. It is this gap in research that this study intends to fill.

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The research seeks to answer the following questions;

  1. How many public and private health care facilities were in the study area?
  2. What was the spatial pattern of health care facilities?
  3. What were the categories of services rendered by these health care facilities

1.3     AIM AND OBJECTIVES OF THE STUDY

The aim of the research is to map the spatial distribution of health care facilities in Owerri urban for the purpose of producing up-to-date digital map of the facilities which will assist policy-makers in health sector to make appropriate decisions regarding where future health facilities should be sited. And secondly, to use Geospatial Information System (GIS) technique to carry out spatial queries, buffer and area coverage analysis, and analyze the  distribution of the facilities.

OBJECTIVES

The following objectives were used to achieve the aim;

  1. Identify all public and private health care facilities in the study area.
  2. Examine the spatial distribution of health care facilities in the study area.

iii.      Categorize the health care facilities into primary, secondary and tertiary.

1.4               SCOPE AND DELIMINATION OF THE STUDY

This project research covered Owerri urban which consists of three local government areas namely; Owerri municipal, Owerri North, and Owerri West. The study examined the locational distribution of public and private health care facilities which have been created since the inception of the towns (i.e. the study area) till date. It is believed that right from the period of its creation, facilities for the well-being of the inhabitants were put in place. The study was also limited to public and private health care facilities including laboratories and maternities as these are regard as the basic form of health care as it provides the least expensive source of medical treatment to the greater population of people resident in the study area.

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1.5     THE STUDY AREA

Owerri is the capital of Imo State and is situated between latitudes 5o 32’N and 5o 15’N and longitudes 6o 58’E and 6o 59’E. It has an elevation of 159 meters above mean sea level. Owerri is a big town in Nigeria and Imo State with a projected 2016 population of 582,071 (NPC, 2006). Owerri is set in the heart of Igbo land and consists of three Local Government Area namely;

  1. Owerri Municipal
  2. Owerri North and
  3. Owerri West

Otamiri River and Nworie River are two main Rivers in Owerri and Owerri has a land mass of 535km2.

1.5.1  OWERRI MUNICIPAL

Owerri municipal is located in the South-Eastern Igbo speaking area of Nigeria along latitudes 5o 24’N and 5o 33’N and longitudes 6o 58’E and 7o 06’E. Like other towns in Nigeria, it has two distinct climatic seasons, viz dry (November to March) and (April to October) seasons. A period of cold, dry, dusty winds otherwise referred to as “Harmattan” occurs from December to February annually. It has a mean temperature ranging from 24oc to 34oc with a relative humidity of 70% in dry months and 90% in wet months, with a projected 2016 population of 168,158 people (NPC, 2006).

1.5.2  OWERRI NORTH

Owerri North is one of the Local Government Areas in Nigeria, Imo State. It is situated between latitudes of 5o 32’N and 5o 19’N and longitudes 7o 04’E and 7o 02’E with a projected 2016 population of 231,849 people (NPC, 2016). Owerri North has an area of 198km2.

1.5.3  OWERRI WEST

Owerri West is one of the Local Government Areas in Nigeria, Imo State. It is located along latitudes 4o 14’N and 6o 15’N and longitudes 6o 15’E and 8o 09’E with a projected 2016 population of 131,214 people (NPC, 2006). Owerri West has an area of 295km2.

Fig.1:- Study Area Map

Source: State and L.G.A map digitized from the Admin map of Nigeria while Owerri urban map was digitized from SPOT 5 satellite image. All obtained from OSGOF

1.6     JUSTIFICATION OF THE STUDY

Lopsidedness in distribution of facilities is of essential meaning especially in a developing country like Nigeria with dilemma of insufficient facilities and low personal mobility. It could be stated that fairness in the distribution of fundamental development needs is evidence of the level of receptiveness of population to such services and facilities. Therefore, intelligence on the spatial distribution of health care facilities is necessary in comprehending the degree of   success of health care delivery system in Nigeria. It is for this purpose that this study is undertaken to have a good familiarity or understanding about the Health Care distribution pattern in Owerri Urban so that places that are underserved with health care facilities will be put into consideration in future planning.


Pages:  49

Category: Project

Format:  Word & PDF         

Chapters: 1-5                                 

Material contains Table of Content, Abstract and References.

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