Work Profile of Community Health Extension Workers in Cross River State and implications for achieving MDG 4 and 5.

Abstract

Introdution: The goal of significant reduction in maternal and child mortality could be achieved if national health services de-emphasizes vertical public health programs and services and strengthen community services9. Community based service are usually directed toward identification of at risk groups in the community such as pregnant women and children U5 years and provide them services not only in the health centers but also in the home. Studies have shown that those at greatest risk of high morbidity and mortality are least likely to make use of health services. A survey of caregiver knowledge of 19 key household and community practices in selected communities in Cross River showed that high proportion of mothers and caregivers lack appropriate health knowledge to correctly manage their sick children in the home7.
Onjective: To identify where community health extension workers work and what services they are providing in primary health care
Methodology: One hundred and forty one questionnaires were distributed among community health extension workers in two local governments in Cross River State. The instrument was simple structured self administered questionnaire.
Results: The study showed that most of the community health extension workers (91%) were fully engaged with activities in the health centres ( Table 2) The study showed that community health extension workers were responsible for immunization, growth monitoring, antenatal and pregnancy care, and curative care (table 3). Although majority of the community health extension workers were aware that they should be working in community but when asked why they did not, their reply was that there was insufficient number of staff in health centers. (Table 4)
Conclusion: Nigeria health system is concentrated on facility and curative based services. Community based health care is almost completely absent. The total involvement of community health extension workers in the health centres care rather than to work with mothers and caregivers will make the achievement of the millennium development goals for mothers and children as distant as it was 40 years ago when primary health care strategy was adopted for achievement of health for all in Nigeria. It is recommended that community health extension workers should be recruited to work in the communities.