The Role of Community Health Workers in Enhancing Rural Primary Healthcare and Health Outcomes in Nigeria: A Review
Lukman Ademola Adepoju *
Department of Medical Laboratory Science, University of Lagos, Lagos, Nigeria.
Bolade Atinuke Onafuye
Department of Healthcare Informatics, Middle Tennessee State University, Murfreesboro, USA.
Temitope Megbuwon
Department of Public Health-Epidemiology, University of Toledo, Ohio, USA.
Olusola Olabisi Ogunseye
Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA.
*Author to whom correspondence should be addressed.
Abstract
Healthcare is an essential right of every citizen and resident. Almost half of Nigerian population live in rural communities where access to healthcare is limited. The Federal government of Nigeria has done well to decentralize healthcare by creating more Primary Healthcare Centers (84.8%), 70% of which are in the rural communities. The heartbeat of Primary Health Care centers (PHCs) is the Community Health Workers (CHWs) with between 60% and 70% of the workforce in PHCs being CHWs. There are limited professional healthcare personnel in rural communities making CHWs perform functions outside their scope. This direct involvement ranges from providing support services to prescribing On the Counter (OTC) drugs. These extended services have significantly impacted both the quality of service (healthcare delivery) as well as the outcome (of diagnosis and treatment). The involvement of CHWs has helped in rapid response to reported health cases as well as in prevention of epidemics and management of pandemics. CHWs have also helped in reducing childbirth and in family planning issues. However, only about 20% to 30% of CHWs have formal training in healthcare management. This has often led to misinformation of patients and inaccurate diagnosis which have had serious negative impact on the outcome of patients’ health management. The government will do well to provide continuous training to CHWs, provide opportunities for advancement as well as financial motivation. The government should also provide infrastructures that will make their service delivery seamless. The introduction of Tele-Medicine into healthcare delivery in rural communities will also enable easy and rapid access to professional advice especially in times of emergency. This if put in place will ensure proper healthcare delivery and successful healthcare outcomes at PHCs in rural communities of Nigeria.
Keywords: Primary healthcare centers (PHCs), healthcare delivery, healthcare outcomes, rural communities of Nigeria, community health workers (CHWs)