Rural health facilities are common sites in most Nigerian villages and towns; however, most of them are grossly under-utilized by the rural end-users. Reasons for under-utilization stem from outright ignorance, poor education, lack of knowledge of existence of health facility, non-availability of qualified health personnel, lack of drugs, poor advocacy, poor political will, poor power and water supply. The present study did a five year interventional programmes geared towards improving or correcting the poor utilization of a rural health facility at Ukpo, South-East Nigeria. Here, a five-year study period (2006 to 2011) was adopted. An observer-checklist method was carried out to ascertain the available health programmes and level of utilizations. Intervention programmes like development of a strategic plan, advocacy visits to the management, active stakeholder and community involvement as well as support were then undertaken. At the end of the fifth year, a comparative evaluation of data was undertaken to assess the rate of immunization, general outpatient clinic attendance, HIV counselling and testing, antiretroviral (ARV) clinic attendance, geriatric and antenatal clinics attendance and community outreach activities. Results were presented as percentages and students-t test was used to determine the degree of significance. P-value less than 0.05 were adjudged significant. The results revealed that annual clinic attendance to General Outpatient Department increased from 305 in 2005 to 6752 (˃2000%; P≤0.001) in 2011. Attendance to anti-retroviral clinic which hitherto had a zero annual attendance moved up to 514 (˃500%; P=0.000) in 2011. Immunization rate moved from 80 to 100% while Voluntary Counselling and Testing moved from zero to 500 (˃500%; P=0.000) within the five-year period. Attendance to geriatric clinic rose from zero to 560 (˃500%; P=0.000) while attendance to antenatal clinic moved up to 1572 from an annual attendance of 215 (˃700%; P≤0.001) in 2005. Although women deliveries at the centre improved from an initial 10 in 2005 to 140 in 2011; it remained poor (˂10%) compared to the number of antenatal cases of the same study period. The applied interventional programs led to overwhelming community participation, improved infrastructural changes, improved access cum attendance to quality healthcare services and gave rise to an effective partnership collaboration and coordination mechanisms. Deliveries however remained comparatively low and require further input.
Keywords: Rural healthcare, interventional programs, primary healthcare