Healthcare Workers’ Perceptions of Administrative Factors and PHC Implementation in Calabar, Nigeria

Abstract

Background: Primary Health Care (PHC) is the mainstay of healthcare delivery in many developing nations. Since the global recognition of PHC with the Alma-Ata Declaration, Nigeria has adopted PHC as a strategy for improving access to essential healthcare services. The National Primary Health Care Development Agency (NPHCDA) is responsible for coordinating PHC services across the nation. However, the implementation of PHC has been a challenge due to various administrative factors such as leadership, allocation of resources, communication, supervision, and motivation. Aim: This study sought to determine the perception of healthcare workers on administrative indices and their impact on the effective implementation of PHC services in the Calabar Education Zone of Cross River State, Nigeria. Methods: A descriptive cross-sectional survey design was adopted for the study. The participants for the study were healthcare workers from various PHC facilities within the Calabar Education Zone of Cross River State. The participants included Community Health Extension Workers, nurses, midwives, medical officers, and healthcare administrators. A total of 226 participants were recruited for the study from a population of 520 healthcare workers using a multistage sampling technique. A structured questionnaire was used to collect data from the participants. The data were analysed using descriptive statistics. Results: Out of 226 questionnaires distributed, 214 were returned (94.7% response rate). Leadership effectiveness (mean = 3.41) and communication systems (mean = 3.12) were rated moderately effective. Supervision practices recorded a mean score of 3.05, indicating irregular monitoring. Resource availability (mean = 2.68) and staff motivation (mean = 2.71) were perceived as inadequate by many respondents, highlighting key administrative constraints affecting PHC service delivery. Conclusion and Recommendations: The study concluded that administrative indicators play an important role in the effective implementation of PHC. The study recommends that resources should be allocated effectively and supervision mechanisms should be strengthened. Training for PHC administrators and health workers should be provided to motivate them.