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INVESTIGATING THE ROLE OF COMMUNITY-BASED ORGANIZATIONS IN IMPROVING HEALTHCARE ACCESS IN DELTA STATE
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INVESTIGATING THE ROLE OF COMMUNITY-BASED ORGANIZATIONS IN IMPROVING HEALTHCARE ACCESS IN DELTA STATE

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ABSTRACT

Access to quality healthcare remains a major challenge in Nigeria, where financial hardship, distance and weak primary health care services limit the use of essential health services, and community-based organizations (CBOs) have emerged as important actors in bridging these gaps. This study investigated the role of community-based organizations in improving healthcare access in Ughelli, Delta State. A descriptive cross-sectional design was adopted, guided by Penchansky and Thomas’s Theory of Access. Using Taro Yamane’s formula, a sample of 124 adult residents was drawn from two communities in Ughelli selected by simple random sampling, with respondents recruited through systematic household sampling; 120 validly completed questionnaires were retrieved, giving a response rate of 96.8 per cent. Data were collected with a validated self-structured questionnaire (test-retest reliability index r = 0.80) and analysed using frequencies and simple percentages presented in tables and charts. Findings showed that the CBOs most commonly involved in healthcare activities were faith-based organizations (76.7%), town/community development unions (70.0%) and women’s associations (63.3%). Their major roles were the organization of free medical outreaches (78.3%), health education campaigns (73.3%) and financial/welfare support to sick members (66.7%). Most respondents (70.0%) affirmed that CBO activities had improved healthcare access in their community, principally by reducing cost and information barriers. The major challenges confronting the CBOs were inadequate funding (80.0%), poor government support and collaboration (65.0%) and weak community participation (60.0%). The study concluded that CBOs play substantial roles in improving the availability, affordability and acceptability of healthcare in Ughelli and recommended stronger government-CBO partnership, capacity building and sustainable funding mechanisms. (NOTE: Findings are based on illustrative simulated data to be replaced with field data.)

Keywords: Community-based organizations, Healthcare access, Community participation, Primary health care, Ughelli.

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TABLE OF CONTENTS

CHAPTER ONE: INTRODUCTION……………………………………………………………………………. 1

1.1 Background of the Study……………………………………………………………………………………. 1

1.2 Statement of the Problem……………………………………………………………………………………. 3

1.3 Objectives of the Study………………………………………………………………………………………. 3

1.4 Research Questions……………………………………………………………………………………………. 4

1.5 Significance of the Study……………………………………………………………………………………. 4

1.6 Scope of the Study…………………………………………………………………………………………….. 5

1.7 Operational Definition of Terms…………………………………………………………………………. 6

CHAPTER TWO: LITERATURE REVIEW…………………………………………………………………. 7

2.1 Conceptual Review……………………………………………………………………………………………. 7

2.1.1 Concept of Healthcare Access………………………………………………………………………. 7

2.1.2 Concept of Community-Based Organizations…………………………………………………. 7

2.1.3 Roles of Community-Based Organizations in Healthcare…………………………………. 8

2.1.4 Community-Based Organizations and the Dimensions of Healthcare Access……… 9

2.1.5 Challenges Confronting Community-Based Organizations in Healthcare…………… 9

2.2 Theoretical Review………………………………………………………………………………………….. 10

2.2.1 Penchansky and Thomas’s Theory of Access……………………………………………….. 10

2.2.2 Application of the Theory to the Present Study…………………………………………….. 11

2.3 Empirical Review……………………………………………………………………………………………. 12

2.4 Summary of Literature Review and Research Gap………………………………………………. 14

CHAPTER THREE: RESEARCH METHODOLOGY…………………………………………………. 16

3.1 Research Design……………………………………………………………………………………………… 16

3.2 Research Setting……………………………………………………………………………………………… 16

3.3 Target Population…………………………………………………………………………………………….. 17

3.4 Sample Size Determination………………………………………………………………………………. 17

3.5 Sampling Technique………………………………………………………………………………………… 18

3.6 Instrument for Data Collection………………………………………………………………………….. 18

3.7 Validity of the Instrument…………………………………………………………………………………. 19

3.8 Reliability of the Instrument……………………………………………………………………………… 19

3.9 Method of Data Collection……………………………………………………………………………….. 19

3.10 Method of Data Analysis………………………………………………………………………………… 20

3.11 Ethical Considerations……………………………………………………………………………………. 20

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS………………………………….. 21

4.1 Socio-Demographic Data of Respondents…………………………………………………………… 21

4.2 Answering the Research Questions……………………………………………………………………. 24

Research Question 1: What are the types of community-based organizations involved in healthcare-related activities in Ughelli, Delta State?……………………………………………………………… 24

Research Question 2: What are the roles of community-based organizations in improving healthcare access in Ughelli, Delta State?…………………………………………………………………………….. 25

Research Question 3: What is the perceived effectiveness of community-based organizations in improving healthcare access among community members in Ughelli?…………………….. 25

Research Question 4: What are the challenges hindering community-based organizations in improving healthcare access in the study area?……………………………………………………………………… 26

4.3 Summary of Findings………………………………………………………………………………………. 27

CHAPTER FIVE: DISCUSSION OF FINDINGS, SUMMARY, CONCLUSION AND RECOMMENDATIONS…………………………………………………………………………………………… 28

5.1 Discussion of Findings…………………………………………………………………………………….. 28

5.1.1 Types of Community-Based Organizations Involved in Healthcare Activities….. 28

5.1.2 Roles of Community-Based Organizations in Improving Healthcare Access……. 29

5.1.3 Perceived Effectiveness of Community-Based Organizations in Improving Healthcare Access 29

5.1.4 Challenges Hindering Community-Based Organizations in Improving Healthcare Access         30

5.2 Implications of the Study for Nursing………………………………………………………………… 31

5.3 Limitations of the Study…………………………………………………………………………………… 31

5.4 Contributions to Knowledge……………………………………………………………………………… 31

5.5 Summary………………………………………………………………………………………………………… 32

5.6 Conclusion……………………………………………………………………………………………………… 33

5.7 Recommendations……………………………………………………………………………………………. 33

5.8 Suggestions for Further Studies…………………………………………………………………………. 34

REFERENCES………………………………………………………………………………………………………… 36

APPENDIX I: LETTER OF INTRODUCTION AND INFORMED CONSENT……………… 38

APPENDIX II: QUESTIONNAIRE……………………………………………………………………………. 39

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