Accessibility and Utilisation of Primary Health Care Facilities in the Dangme West District of the Greater Accra Region

Abstract

The thrust of this study was to identify the factors which influence accessibility and utilization of health care facilities in the Dangme West District, and to find solutions to problems which were identified. The study covered nine fully operational health centres and health posts in the district, as well as randomly sampled service providers such as nurses, personnel of NGOs. heads of some government departments, opinion leaders and the district director of health services. The method of data collection was by structured questionnaires administered to patients, and interview guides were used to collect information from the service providers, opinion leaders, and the heads of government departments. The data were analysed using the SPSS and ArcView GIS software packages to determine relationships and the spheres of influence of the health centers and posts. The study showed that factors which played important roles in accessibility and utilization of the Primary Health Care (PHC) facilities in the Dangme West District, were socio-demographic ones like age and gender, distance and institutional factors such as the number and distribution of health centers, inducements offered to patients, and quality of care. For example, the relatively high antenatal and postnatal coverage for the health center at Prampram is attributed to the free meals offered to children who use the service. The major community wide factor was the poor road network. Some factors which did not play an important role included the educational level and occupation of the respondents. Ways in which PHC can be strengthened in the district to make health care facilities accessible to all are recommended. These include the granting of greater autonomy to District Health Management Teams (DHMTs) to hire competent staff to ensure quality health delivery. It is also recommended that support for and supervision of the health posts should be increased. The need for effective networking among the government agencies and NGOs working in the health sector in the district was advocated.