PATRONAGE PATTERN OF HEALTH CARE FACILITIES IN ESAN CENTRAL LOCAL GOVERNMENT AREA OF EDO STATE
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This is a research essay work on the patronage pattern of health care facilities, it talks about the location of some these health centres, how the inhabitants of areas patronize the hospitals. An attempt was also made to know the factors responsible for the variation in patronage of the health centres.
In Esan Central Local Government area, which is this case study, an insight field work was made to known the location of these centres whether, it is centrally or not centrally located. Factors behind such location, their distribution, types of health care centres whether private or public in their respective locations. Also discussed in this essay were the various sources for data, methods and problems encountered in gathering this data. After the research, the researcher then comes out with these findings which are distance, high population and level of health sensitization. As a factors influencing the patronage Based on finding, some recommendations where made.
A healthy nation is a wealthy nation. The rural population exhibits a greater of number of infrastructural problems that tend to be more adverse. This is obviously associated with the poor health facilities, quality and quantity of infrastructural facilities, services in the rural areas and is undoubtedly associated with individual low income and healthy care problems. Poor infrastructural provision of a good health care facilities leads to high mobility rate. Most of there members of the society are also denied basic amenity such as good health care facilities. However, any single measure is not enough to reveal the complete state of poor conditions of these health facilities. There is no gain saying the fact that infrastructure is vital in a community. The health of the inhabitants of any nation is fundamental to the present and future development of that country.
From the above facts, most developing countries have devotes a substantial amount of totality concerned towards the expansion of health care facilities. This is usually a planned expansion designed to obtain the maximum return from a limited investment, this planned process.
The real output of this is an emphasis on projection expansion for example, the total number of health facilities, the number of doctors and auxiliary medical personal’s and ration. But within the most efficient aggregate pattern of health provision, there exist the possibility for considerable variation in spatial pattern of expansion and patronage pattern within any nation, for example over 70% of health care facilities in most developing countries like Nigeria is concentrated in the urban centres where less than 20% of the total population live ONOKERHOYE (1978).
1.2 STATEMENT OF RESEARCH PROBLEM
In spite of the federal government and all the states and local government council laudable plans of solving the problem of health care facilities in the country at any particular time, the few available health care facilities are within the reach of not even only those urban area in all parts of the country.
There came up a number of problems, one of such problems is the distance people are willing to travel in order to be able to utilize these facilities available at different types of health centres, the patronage pattern of this health centres. Available research showed that users may not be prepared to go beyond their limit to attend a particular health centres for example in 1974, it was noticed that in some parts of the former western states of Nigeria, the critical distance limit for a dispensary is between 5km and 8km for hospital it goes beyond 32km Adejuyigbe (1974).
In view of the situation described in the proceeding paragraph, their necessity to ensure that the different types of health centre should be established in a country in future are located in such a way as to achieve maximum utilization by the population.
In Irrua the headquarters of Esan Central local government area, there is considerable variation in patronage pattern of health centre one would see along this research. This patronage pattern of health care facilities in other words. Known as distance and if distance was the only factor affecting attendance at the institution, the suggestion in the foregoing paragraph would be easily implemented through simple mathematical calculations.
But attendance of health centre is also greatly affected by social attitude. A person may choose to walk along distance to attend a relation health centre rather than attending the one closer to him/her.
The implication of this is that, if health care facilities are to be properly utilized their location ought to take account of such social attitude, that is should located to coincide with movement zone of the people they are expected to serve.
The spatial distribution of this health care facilities affects their patronage patter, it is assumed that the main reason for the provision of certain service by the public authorities in an local government area to be make sure that no person should be deprived of the access to such facilities become of the geographical location or lack of finance.
The spatial aspect of medical care facilities must receive adequate attention in health planning of Esan Central local government area.
1.3 AIM AND OBJECTIVES
- To examining the distribution of the already existing health care facilities in relation to the population in different parts of the entire Esan Central local government areas.
- To identify the spatial and social constraints affecting the patronage of health care facilities in the areas.
- To suggest a distribution of health care units which will take into account the existing movement pattern and the critical distance people are prepared to travel to enjoy these facilities.
1.4 AIMS AND OBJECTIVES OF STUDY
Would be easily implemented through simple mathematical calculations.
But attendance or patronage pattern of health care centre is also greatly affected by social attitude. A person may choose to walk a long distance to attend a relation health care centre rather than attending the one closer to him/her.
The implication of this is that, if health care facilities are to be properly utilized, their location ought to take account of such social attitude, that is should located to coincide with movement zone of the people they are expected to serve.
The spatial distribution of this health care facilities affects their patronage pattern, it is assumed that the main reason for provision of certain service by the public authorities in an local government area to make sure that no person should be deprived of the access to such facilities because of the geographical location or lack of finance. The spatial aspect of medical care facilities must receive adequate attention in health planning of Irrua the headquarter of Esan Central Local government area.
The aims around which the essay centred on are:
- To examine the distribution of the already existing health care delivery facilities in relation to the population in different parts of the areas.
- To identify the spatial and social constraints affecting the patronage of health care facilities in the areas.
- To suggest a distribution of health care units which will take into account the existing movement pattern and the critical distance people are prepared to travel to enjoy these facilities
The hypotheses are as follows:
Ho: That patronage pattern of health care facilities does not decrease with distance.
Hi: That patronage pattern of health care facilities decreases with distance.
Ho: That there is no relationship between the population of a clan, harmlet community and the number of patients patronized health care facility centre.
Hi: That there is relationship between the population of a clan harmlet community and the number of patients patronized the health care facility centres.
1.6 STUDY AREA
Esan central Local Government Area is located in Edo State. It was curved out from the former Okpebholo local government in the defunct Bendel State of Nigeria. Esan central local government area is located within latitude 8035E and 8030N and longitude 8021E and 8035E (2006 census). The area has estimated area coverage of about 33.2kmsq.
Esan Central local government area is one of the 5 senatorial district in Edo State. Esan central local government area has a common boundary with Etsako West and South by Esan West local government. It is also bounded in the east by two local government which are Esan North East and Igueben local government.
Esan central local government with headquarters of Irrua is located in East plateau under lain by the lignite group of rocks consisting of clay, fine grained sand and carbonaceous shaky clay. Most part of the relief in this region have an elevation of between 356 and 400 metre above sea level. There is no significant river in the areas though the Ugbalo water scheme was constructed. But there are number of streams following radically to river Osse in Agbede. Esan as a case study is endowed with a lake popularly called Agua-lake.
The terrain is relatively plain, this probably contributed to the number of large settlements like Esan Central (the administrative headquarters) Ewu, Opoji and Ugbegun amongst others.
The local government has a total number of four settlements. These are Ewu, Opoji, Ugbegun and Irrua. Esan central local government belong to the region which experience the humid tropical climate characterized with wet and dry season. The dry season which last between November and March usually coincide with the period of low sun while the wet season lasts between April and October which also coincide with the period of high sun.
The common vegetation of these area is the most deciduous forest which is very rich in timber resources.
According to Adejuwon (1971) in western Nigeria, evidence of savannah patchers abound in this vegetation belt. This could be the direct effects of traditional methods of farming which are the rotational type and the bush fallow system of excessive cultivation of land. When abandoned, it is normally covered by grasses and subsequently gives rise to a new type of vegetation known as the derived savannah.
The cover formed by the vegetation is more open than in the rainforest region, characterized with tropical hardwood, like timber, Iroko, Obeche, Agber Walnut Mahogany while industrial and food crops find in this area include the following: palm fruits, rubber maize, yam cassava, cocoyam, plantain and other varieties of local fruits.
This forest product, are the basis of raw materials for the industries in the area (traditional industries).
An agriculture and industries product is a major source of living of the people. Apart from the flour mill at Ewu and pure water company, variety of small and medium scale industries abound in the study area. Unlike the urban centre, there are predominantly agro-based industries such as rice and cassava processing mills.
The spatial distribution of roads in the study area is poor, coupled with a low density of road work for instance; Esan central has about five major roads linking the major settlements. These roads are Benin-Auchi road which is a federal road, cut across two major settlements, in Esan central that is Irrua and Ewu. The other roads are the Irrua Atuagbo road which cut across settlement like Eidenu, Ibore, Ugbalo, and Ujabhole. Others are Usugbenu Igueben road via Ugbegun and Irrua-Opoji road.
Some of these roads are tarred which makes it motorable all through the year. Among those that are not motorable all the year round is the Usugbenu Ugbegun road which is presently under construction under the Government of Aliyu Adam Oshiomole. This inaccessibility is especially for the transportation of agricultural products produced in these areas, thereby reducing the level of interaction. Some of these roads are too bad because the old age are prone to erosion attack which makes it to be easily washed away.
Considering the size of the entire region understudy, Esan central (i.e. Irrua) is the only urban area compared to others, this can be attributed to its function as an administrative centre and the presence of such social amenities like electricity, telephone, post office, court, hospitals, police station and a particular single bank. As a result of the facilities present in this area, movement of both intra and inter regional activities are attached to this area of study.
From the above description of the area of study, it could be seen that both the physical and human factor including political, social attributes, not centrally locating of any health care facility in Esan Central local government area are likely to affect the patronage pattern of health care facilities.