CHAPTER ONE

1.0   INTRODUCTION

1.1   BACKGROUND OF STUDY

Health services delivery in Nigeria had its historical antecedents. It had evolved through a series of developments including a succession of policies and plan, which had been introduced by previous administrations. Previous administration here refers to the unorganized administration of the colonial and post-colonial administration in Nigeria.

Oyewo (1991) traced the historical epoch of Nigerian health sector beyond the organized colonial period and asserted that maternal and child care of pre-colonial period through primitive, compared to the orthodox medical care, served the people with precise efficiency which was proportional to their level of development. He further identified the beginning of a meaningful health service policy with the first Ten year National plan (1946 - 1956) wherein health was put on the concurrent legislative list with both Federal and Regional government exercising defined powers within their areas of direct administrative control. Similarly, many published and unpublished works remarked that Public Health Services in Nigerian and other West African Protectorates originated from the British Army Medical Services. When the army became integrated with the colonial government, medical care was extended to the local civil servants and their relatives and eventually to the local population, especially those living close to government station. At the same time various religious bodies especially Christian Missionaries and private agencies made spirited efforts to established hospitals, dispensaries and maternity centres in different parts of the country, particularly in the South and the Middle Belt.

The first Ten-year National plan (1946 – 1956) whose proponents were mainly expatriate officials had a number of deficiencies, especially in the health services. The health policy at the Second National Development Plan (1970–1974) focused in part at correcting some of the deficiencies in the health delivery services. There was a deliberate attempt to draw up a comprehensive national health policy dealing with such issues as health man-power development, provision of comprehensive health care based on basic health care service scheme, disease control, efficient utilization of health resources, medical research and health planning.

The local government is essentially created as a viable political and administrative organ for the transformation of all communities and for delivery of essential services to the citizens. Local government plays a central role in enabling the achievement of development at the grassroots level. Governments should therefore continuously seek new and better ways to build service institutions that have the capacity to champion and advance the course of development. Local government must create an appropriate and conducive environment for the people at the local level through efficient and effective service delivery.

1.2   STATEMENT OF THE PROBLEM

The study on problems and prospects of health service delivery at grass root level came about as a result of lack of infrastructure, lack of conducive environment in terms of war breakout, illiteracy of the local government citizens and lack of awareness, due to the fact that the people have not been given an awareness as to what health service delivery is all about, they might cause riot thereby leading to destruction of any infrastructure and equipments provided as well as lives. Finally, most of the research has been carried out health service delivery but not even a single research has been carried out on problems and prospects of health service delivery at grass root level.

1.3   AIMS AND OBJECTIVES OF STUDY

The main aim of this study is to determine the problems and prospects of health service delivery at grass root level. Other specific objectives of the study include:

1.          to determine the effect of lack of infrastructure on health service delivery.

2.          to determine the effect of the unskilled in health service delivery.

3.           to determine the extent to which local government authorities affect health service delivery.

4.          to determine the impact of health service delivery on the grass root citizens.

5.          to determine the effect of provision of adequate and effective health facilities and care on the entire population.

6.          to determine the factors affecting health care service delivery at grass root level.

7.          to determine the relationship between health service delivery and the grass root citizens.

8.          to proffer possible solution to the stated problems.

1.4   RESEARCH QUESTIONS    

1.          What is the effect of lack of infrastructure on health service delivery?

2.          What is the effect of the unskilled in health service delivery?

3.          What is the extent to which local government authorities affect health service delivery?

4.          What is the impact of health service delivery on the grass root citizens?

5.          What is the effect of provision of adequate and effective health facilities and care on the entire population?

6.          What are the factors affecting health care service delivery at grass root level?

7.          What is the relationship between health service delivery and the grass root citizens?

8.          What are the possible solutions to the stated problems?

1.5   STATEMENT OF RESEARCH HYPOTHESIS

H0:    Health care service delivery has no significant effect on the grass root citizens.

H1:         Health care service delivery has a significant effect on the grass root citizens.

1.6   SIGNIFICANCE OF STUDY

The study on the problems and prospects of health service delivery at grass root level will be of immense benefit to the entire local government citizens and as well as the local government authorities in the sense that it will enable them to utilize the solution that is stated in this study effectively which include; the local government authorities to employ an agency which will watch over the facilities of the health care centres to avoid theft, warn the youth, men and women of the communities not to cause riot as the implementation of health care service delivery is for their good. Finally the study will contribute to the body of existing literature and knowledge in this field of study and provide a basis for further research.

1.7   SCOPE OF STUDY

The study on the problems and prospect of health service delivery is limited to the grass root level.

1.8   LIMITATION OF STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

1.9   DEFINITION OF TERMS

Problems.It is a situation that is unsatisfactory and causes difficulties for people.

Prospect.The possibility or likelihood of some future event occurring.

Health.Is the ability of a biological system to acquire, convert, allocate, distribute, and utilize energy with maximum efficiency.

Service DeliveryThe action of helping or doing work for someone.

Grass root Level.the ordinary people as distinct from the active leadership of a party or organization: