Rural Health in Nigeria: The Case of Uvuru Health Center

Abstract

Rural communities in Africa have challenges in providing rural healthcare services. With over200 million people, Nigeria struggles to provide primary health care needs to its teeming population. Although the late Prof. Olikoye Ransome-Kuti, Health Minister of Nigeria, established primary healthcare following the Alma Ata declaration of 1978, Nigeria's rural healthcare is still a mirage. There is no access to adequately functioning immediate health care for numerous individuals and communities in Nigeria with inadequate personnel, medical equipment, and dilapidated infrastructure. Uvuru is a community in southeastern Nigeria with a health center, Uvuru Health Center (UHC), established in 1967. Functions of the health center have not been assessed or evaluated since its inception. Therefore, it is essential to determine the healthcare needs of the Uvuru people and the health center's role in addressing these needs. We conducted a study that employed a phenomenological framework to capture individual experiences using in-depth and semi-structured interviews. We recruited participants using a snowball selection method. We identified 12 potential participants; 11 responded and agreed to the discussion. Interviews were conducted using telephone, zoom platform, and text messages. Questions were based on participants health care related experiences and observations. Responses to initial and in-depth, probing, follow-up questions were recorded. Three people coded the data. We produced 136 codes that were condensed into the following six themes. (1) UHC seemed to be abandoned by the government, and its current ownership and financial status are obscure and contested. (2) Corruption at the level of the government has led to deteriorated infrastructure, looting, and unpaid labor of health workers. (3) The political insurgency in the area has created an atmosphere of fear for personal safety and undermined the facility's security. (4) The low level of political power among the Ibo people (Uvuru Health system users) has contributed to long-term poverty. (5) Private practitioners across the community are happy to provide services at high prices and have captured most of the market share (and are reluctant to support the public sector facility). (6) There are glimmers of hope in the local Uvuru Development Union (UDU) and the Uvuru community members, which are stepping up to improve the situation. Our research indicates that engaging community members may shed light on the state of health centers and relevant deficiencies of their function. Further, it can enhance building of a coalition needed to rehabilitate and revitalize the centers. These efforts can advance rural health in low-resource settings.