Sustainability of primary healthcare services through community participation: Assessing the role of ward development committees in northwestern Nigeria
This study assessed 191 ward development committees (WDCs) and 200 primary healthcare center (PHC) catchment communities in Kebbi State, northwestern Nigeria, to determine the status and functionality of WDCs and their level of engagement with PHCs. The existence of other community structures relevant to primary health care was also explored. The study employed a cross-sectional design involving questionnaire survey with members of WDCs, health facility workers, and community members, in addition to reviewing records and documentation at PHCs and in the communities. The study found a pervasive existence and functioning of WDCs in all wards in Kebbi State. Almost all WDCs hold regular monthly meetings, with meeting notes available for the majority. While most of the WDCs had independent means of generating funds, the majority of them did not have functional bank accounts. We found that most WDCs performed key roles and activities, including supervision of health facilities, social mobilization, monitoring performance indicators, and using data for decision-making. We also found that the majority of the communities had other community-level structures, such as traditional birth attendants, volunteer community health workers, and the existence of a community emergency transport system to transfer pregnant women to PHCs during emergencies. WDCs and other community-based structures can potentially improve primary healthcare services in Kebbi State. However, efforts to optimize their performance are needed, including strengthening WDCs’ capacity for financial management and encouraging a more widespread existence of other community-based health-related initiatives. Primary healthcare services in Kebbi State can be improved by optimizing the performance of WDCs and other community-based structures, leading to better health outcomes for the population.
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