INTRODUCTION:
Health service research is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Health service is the multi-disciplinary field of scientific investigation that studies how social factors, financing system, organizational structures, and process health technologies and personal behavior affect access to health care.(Academy for health service research and health policy, 2000). Health service is concerned with problems in the organization, staffing, financing, utilization, and evaluation of health service. Health service is field of inquiry that examines the role of organization, financing manpower, technology, and prevention in the provision of health care service and their impact on utilization, costs, and quality care. The field draws on many disciplines to address this breath of research, include biostatistics, epidemiology, health economics, medicine, nursing, operation research, psychology, and medical sociology. (Stainwachs, 1991).
Health Facility: Are places that provides health care, they include Hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. Health facility provides preventive, diagonostic and treatment services to persons who came to the facility to receive services and depart from the facility on the same day.
Health Service: Examines how people get access to health care, how much care costs, and what happens to patient as a result of this care. The main goals of health service research are to identify the most effective ways to organize, manage, finance, and deliver high quality care to reduce medical errors and improved patient safety.
A Health center: is a clinic staffed by a group of general practitioners and nurses, typical service covered are family practice and dental care, but some clinics have expanded greatly and can include internal medicine, pediatric, women care, family planning, pharmacy, lab, and more. In 2006, the national association of communities’ health centers has implemented a model for offering free rapid HIV testing to all patients between the age of 13 and 63 during routing.
Health Facility Utilization: Is the use of something especially for a practical purpose. For the purpose of this study utilization refers to the people participation in modern health care programmes and attitudes there to. Health care facility refers to the facilities and attitudes relating to orthodox medicine.
The following are some factors militating against the proper utilization of health facility:
1. Widespread poverty, which makes it very difficult for many people not to have good health.
2. In many rural health centers, it is a common knowledge that qualified health personnels are often lacking. Most hospital do not have resident Doctors even where one is posted to such hospital, they prefer to operate from outside the community where there is electricity and pipe borne water.
3. Also most of these rural communities are so infrastructural and economically underdeveloped that they cannot attract qualified private medical Doctors from urban areas.
4. The far distance of the hospitals is being located is another factor influencing the proper utilization of health facilities, because is not every one in the community that afford the transport fare to where the hospital is being located.
HEALTH SYSTEM IN NIGERIA
Nigeria operates three tiers of health system. First is primary health service which is the basic unit closest to the people and fall under the jurisdiction of local government councils. Examples include dispensaries, clinic, health center, health post, and comprehensive health centers.
The second is the secondary health services this is a more comprehensive and supplicated health service that handles more serious cases that cannot be handle by the primary health services. And include a range of specialized services provided by general hospitals, specialist hospitals, specialized and cottage hospitals. Secondary tier of health services is usually under the jurisdiction of state government. The third tier is the tertiary health services, which deals with more difficult and complicated health services and health problems particularly referral cases from secondary tier and supervised by the federal government of Nigeria.
Teaching hospitals and highly specialized hospitals, like Orthopedic and Ophthalmic hospital or centers (Ransome – Kuti, 1991). In Nigeria and other countries of the world, the provision of adequate health services to majority of the people’s is so important, it was one of the major goals of the fourth National development plan (National population Bureau- and Federal ministry of health, 1997).
Since health services are usually provided in health facilities like hospitals and clinics, their spatial patterning is crucial. Like other health facilities provided service at fixed points (Onokohoraye, 1996) their location should be in such a way that patient have access to them. This bring us the issue of even and uneven distribution more importantly because as argued (Fitpatrick, 1994) those health care system are to the match the provision of health care to the population. Different tiers of health facilities have different service area; inequality in the distribution of health care facilities may result in different in the quality of health services as argued (1996).
In Nigeria the explicit consideration of has been given to the need for equity in the planning and distribution of health facilities over the years. This had lead to emergence of many regions within the country where both public and private health facilities are sparsely provided. Often regions with difficult terrain and physical environment are neglected (Onokerhoraye, 1999). Many people particularly academicians have over the years showed concerned on how health facilities are distributed and utilized ranging from the national level down to the local levels. Their studies invariably revealed inequity in the distribution with one region has full concentration of these facilities and others having very few or even neglected at all.
As far utilization, some of the facilities were found fully utilized and some underutilized. This is because utilization of any health facility is influenced by certain factors, even when available (WHO/UNICEF)
(Adamu, 2002) pointed out that availability of a health care facility does not necessarily guarantee utilization. Studies have often determined that physical proximity is an important factor in accessibility and utilization of health care resources (Mayeri, 1995). Closeness to a particular Doctor or facility is one of the main reasons for using that resource. The important of distance seems obvious but unfortunately, it has often been overlooked in planning decision (Melinda, 2000). This study attempted to look at the distribution and utilization of health facilities in Karasuwa Local Government Area, health facility in the local government are mainly primary and secondary there is no privately owned hospital.
1.1 BACKGROUND OF THE STUDY
Karasuwa Local Government Area, Yobe state was created on 21st December, 1996 and it headquarter at Jaji – Maji. It has total land area of 1,162 km and with a population of 106,992, according to 2006 National population census. Karasuwa Local Government constitute of twelve (12) wards which include Jaji – Maji, Karasuwa Galu, Wachakal, Waro, Karasuwa Garun-Guna, Gasma, Bukarti, Garin-Gawo, Faji Ganari, Tabawa, Shekke, and Mameram wards.
Karasuwa Local Government was bounded to the East and South with Bade Local Government, to the West by Nguru Local Government, and to the North by Yusufari Local Government area. The people’s and culture of Karasuwa Local Government, basically 70% were Manga by tribes which were originated from Sub-Kanuri tribes followed by Hausa/Fulani tribes. The socio-economic activities of Karasuwa people’s majority of them were peasant farmers, both in towns and the villages. And some were operating small scale business depending on the nature of environment for their livelihood.
1.2 STATEMENT OF RESEARCH PROBLEMS
Access to Health care facilities is a basic human need which must be satisfied if people’s health need to be kept in normal conditions. It is because of the important of health you often hear people’s saying “health is wealth” this is what draws my attention to conduct a research on health related issue. The distribution and utilization of public health facilities is a serious problem among rural areas, especially Karasuwa Local Government where the present research was carried out.
Despite improvement in medical and health care services all over the world, problem of health care services still persists in the area. This is because medical and health care facilities are more concentrated in the towns, making these facilities inaccessible in terms of distance to the rural areas or people. And even the urban Dwellers that live in slum areas, rural community where the majority of our people’ live and work. Health facilities are rare, poverty is at rib and scientific thoughts and actions are unknown.
As a result of little or no medical facilities there is high incidence of mortality among infant and elderly people in the rural areas. At the end of this study will show whether the people of Karasuwa have access to health care facilities or deprived of this facilities.
1.3 AIM AND OBJECTIVES
The main aim of this research is to examine the distribution and utilization medical facilities in Karasuwa Local Government area, Yobe state. This major aim is to be achieved through the following specific objectives.
§ To examine the distribution of health facilities in Karasuwa Local Government.
§ To examine the utilization of health facilities by the people of the study area.
§ To identify the factors that influenced both the distribution and utilization of health facilities.
1.4 RESEARCH QUESTIONS
§ What is the spatial location of health centers?
§ How is the health facilities distributed?
§ What are the factors influencing utilization of health centers?
1.5 SCOPE AND LIMITATION
This study is concerned with the distribution and utilization of medical facilities in Karasuwa Local Government Area, Yobe State. This means the study limits itself to only Karasuwa Local Government; anything outside of this is not my concern. Time is another limitation as the research has to carry out within the temporal frame work of two university semesters.
1.6 SIGNIFICANCE OF THE STUDY.
This study is necessary because it is an effort to find out what health facilities are available in Karasuwa community, and how adequate they are when compared with the standard set by the government. It is hoped that the information from this research may help the authorities of this area in the future plans for provision of health facilities.
It is therefore, hoped that the result of this study may lead to more emphasis on preventive rather than curative aspect of medicine by the members of the society as a result of whole. Beside necessarily result in accelerated population growth and improvement health would promote learning, reduced absenteeism, improved stamina, and increase energy output. Therefore, better health especially among adults would contribute to improving the economic status of the poor. The low life expectancy in community is due to largely to very high death rate among children and this due health condition.
EXAMINING THE DISTRIBUTION AND UTILIZATION OF MEDICAL FACILITIES, A CASE STUDY OF KARASUWA LOCAL GOVERNMENT AREA, YOBE STATE.
