A 5-YEAR REPORT OF THE HEALTH SERVICES AT THE KOLA-DAISI FOUNDATION PRIMARY HEALTH CARE CENTRE (KDFC) AND CENSUS SURVEY OF KDFC CATCHMENT AREA O.O Ogunbode*, A.O Adebiyi, O.C Uchendu, S. Ahmed, E.T Owoaje, T.O Alonge. Department of Community Medicine University College Hospital, Ibadan, Nigeria. UK FACULTY OF PUBLIC HEALTH ANNUAL CONFERENCE, TELFORD 2017

Outline of Presentation Background on Primary Health Care (PHC) in Nigeria. Brief History of KDFC Census Survey of KDFC Catchment Area (Introduction, Methodology, Summary of Results and Future Steps) Five-year Report of KDFC programmes and services. Future Steps UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 PHC in Nigeria Implementation of PHC in Nigeria has been sub-optimal contrary to the expectations at Alma Mata Evidence exists that less than one third of the PHC facilities in the country are functional It was against this back-drop of poor performance that the Federal Ministry of Health mandated all tertiary health facilities to adopt at least one primary or secondary health care facility. UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 Brief History of KDFC Public private partnership discussion and concept paper – March 2010. Search for suitable site with full community participation – April 2010. Memorandum of Understanding – November 2010. Full commissioning and opening – February 2011. Tripartite public private partnership. Major stakeholders are Kola Daisi Foundation, University College Hospital through the Department of Community Medicine and Yemetu community (Ward 3 of Ibadan North Local Government Area) UK Faculty of Public Health Annual Conference, Telford 2017

KDFC Programmes and Services In-patient clinical services Out-patient clinical services Immunization Antenatal Care (ANC) Community Health Programmes Home visit Environmental Health Work Demographic, Housing and Health Survey Training & Research Resident doctors Medical students Nursing students Midwifery students UK Faculty of Public Health Annual Conference, Telford 2017

Census Survey of KDFC Catchment Area In order to provide a true model of primary health care service delivery to Yemetu community, de jure census was conducted by my Department. The goal was to provide baseline data on the demographic and health characteristics of the population served. The exercise was conducted in two phases: house numbering and survey administration. De jure : Counting of people who normally reside in an area irrespective of whether they are physically present or not. De facto : Counting of only those who are physically present in an area within a designated time frame UK Faculty of Public Health Annual Conference, Telford 2017

Census Survey of KDFC Catchment Area II The steps involved in the methodology were: Community mobilization Planning Mapping House numbering exercise De jure census exercise & data management Dissemination and utilization of report UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017

Summary of Results of Census Survey A total of 2663 buildings were numbered during the exercise. These included 330 non-residential buildings and 2333 residential buildings. In all 5452 households were listed. UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 Summary of Results of Census Survey II Table 1: Socio demographic characteristics of respondents in Ward 3 IBNLG, 2015   Characteristics Categories Frequency (n) Percentage% Gender Male 9181 49.0 Female 9541 51.0   Age group <18 years 7856 42.0 18-39 years 6423 34.3 40-64 years 3362 18.0 >=65 years 1064 5.7 Marital status Married or living together 7184 38.5 Divorced/ separated 290 1.6 Widowed 844 4.5 Never married & Never lived together 10360 55.5 Level of Education Pre-primary/ kindergarten 1752 10.5 Primary 4865 29.3 Secondary/ Technical 7871 47.4 Higher 2116 12.7 Don't know 7 .0 UK Faculty of Public Health Annual Conference, Telford 2017

Summary of Results of Census Survey III The average monthly family income reported by household heads was 20,000. With respect to housing, the most common type of housing unit was face to face (94%) followed by Bungalow/flat (3%) The most frequently reported source of cooking fuel was kerosene (93.0%). Regarding sanitary facilities, 55.8% and 31.3% reported use of pit latrine and water closet respectively. The most common means of solid waste disposal was by approved dump site (58.7%). Most residents lived in rented apartments (71.4%) UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 Summary of Results of Census Survey IV Table: 2 Prevalence of chronic conditions among respondents in Ward 3 IBNLG, 2015   Yes No Chronic Condition Frequency Percentage Hypertension 349 1.9 18373 98.1 Diabetes 51 0.3 18671 99.7 Tuberculosis 20 0.1 18702 99.9 Sickle cell anaemia 10 18712 UK Faculty of Public Health Annual Conference, Telford 2017

Summary of Results of Census Survey V Table 3: Prevalence of physical disabilities among respondents in Ward 3 IBNLG, 2015   Disability Yes No Frequency Percentage Blind in one/ two eyes 311 1.7 18411 98.3 Deaf in one/ two ears 89 0.5 18633 99.5 Dumb/slurred speech 32 0.2 18690 99.8 Problem with movement(use of crutches) 114 0.6 18608 99.4 Problems with mental functioning 22 0.1 18700 99.9 UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 Future Steps Longitudinal studies for disease pattern of non-communicable diseases. Rate of Migration At risk register UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 5-YEAR REPORT OF THE HEALTH SERVICES AT KDFC UK Faculty of Public Health Annual Conference, Telford 2017

Clinic Utilization of new patients Figure 1: Annual distribution of new patients between 2011 and 2015 UK Faculty of Public Health Annual Conference, Telford 2017

Clinic Utilization of out-patient clinic Figure 2: Annual age and sex distribution of out-patient clinic attendance between 2011 and 2015. UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 Admission Figure 3: Annual distribution of admitted patients between 2011 and October 2015 UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 Disease Pattern Figure 4: Graph showing common indications for admission from 2011 to 2015    UK Faculty of Public Health Annual Conference, Telford 2017

Maternal Health Services Figure 5: Yearly distribution of New ANC attendees and Number of Deliveries UK Faculty of Public Health Annual Conference, Telford 2017

Home visit 2011 2012 2013 2014 2015 Jan 7 2 5 Feb 3 1 Mar 10 6 4 Apr 8 Table 1: Monthly distribution of number of home visits from 2011 to 2015   2011 2012 2013 2014 2015 Jan 7 2 5 Feb 3 1 Mar 10 6 4 Apr 8 May 13 Jun July 14 9 Aug Sep Oct Nov Dec Total 39 63 53 25 Commonest indication for home visit: Childhood malnutrition UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 Future Steps Health related research. Malaria resistance and Enteric fever studies presently ongoing UK Faculty of Public Health Annual Conference, Telford 2017

UK Faculty of Public Health Annual Conference, Telford 2017 THANK YOU... UK Faculty of Public Health Annual Conference, Telford 2017