AN EVALUATION OF THE PERFORMANCE OF COMMUNITY HEALTH ASSISTANTS AND AIDES IN PRIMARY HEALTH CARE DELIVERY IN OYO STATE

Abstract

The Community Health Assistant and Aides in Oyo State were studied to examine how well they performed the primary health tasks assigned to them and to identify the factors that influenced the quality of their job performance. The sample was made up of one hundred and seventy four Community Health Assistants and Aides (CHAs/Aides) in four local government areas of the State- Oranmiyan, Oyo, Oluyole and Irepodun. The questionnaire method of data collection was used. In addition the performance of one hundred and twenty six CHAs/Aides in primary health care institutions geographically representative of the selected local government areas were observed on selected primary health tasks. Data was analysed manually and mechanically using the computer. The student's t-test was used to establish statistical differences in mean scores in performance while the chi-square and the Product-moment (Pearson's), Correlation coefficient were used to determine relationships between and among variables in the study. The Spearman's (rank) correlation was used to assess relationship in ranking between groups of respondents and between responses. The data obtained indicated that although the quality of the CHAs/Aides job performance was good, they were not being properly utilised to provide primary health care; basic facilities needed for their job were in most cases lacking. Staff developmental training was neglected and career mobility frustrated. Salaries were perceived inequitable to Job demands and in some cases normal salaries were yet to be paid. In short, the policy creating this cadre of health workers was not being effectively implemented by the government. The managerial implications are obvious and recommendations were made to the effect that: A scheme or service be drawn for Community Health Workers whose members should be neglected from outside the remarks of existing health workers and with their co-operation of the recipient communities. Services of CHAs/Aides should be essentially rural community-based rather than urban institution-based. CHAs/Aides should be given clearly defined responsibilities matched with appropriate authority. They should be used as CBD agents. Premium should be placed on training, which should be periodic and either on or off the job to improve skills and modify attitudes. This will also act as an incentive and will enhance career mobility. Effects should be made to provide the CHAs/Aides with basic facilities needed for their job performance. Their supervisors should be exposed to seminars which will reorient them to fully accepting the CHAa/Aides as legitimate health care workers within the health care system. The recommendations above, if implemented, will reduce the often cried-of dearth in health personnel and the delivery of primary health care in Nigeria will be more effective.