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CHAPTER ONE
BACKGROUND TO THE STUDY
Introduction
This study examines the contributions of tertiary health care to the community health care in Benin City. Tertiary Health Care (PHC) is one of the advance level meant to address the main health problems in the community, by providing, preventive, curative and rehabilitative services.1 There is a growing awareness and demand for quality health care across the 36 state in Nigeria; hence the need to describe the level of health care and services provided to meet the patient centered care by the frontline stake holders.2 Thus, this study seeks to elucidate the impact of University of Benin Teaching Hospital to community health care in Benin City. The concept of the University of Benin Teaching Hospital originated in 1969 with Colonel Samuel O. Ogbemudia, the then Governor of the Midwestern State of Nigeria, and Prof. Tiamiyu Belo-Osagie. The desire to establish a befitting medical center in the Midwestern Region of Nigeria was developed after the governor paid private visits to the Island Maternity Hospital, Lagos and the Lagos University Teaching Hospital.3
University of Benin Teaching Hospital (UBTH) is a multi-specialty healthcare service provider in West Africa. The hospital is located in Ugbowo, Benin City and was established on May 12, 1973 following the enactment of an edict (number 12) of the Nigeria National Health Act. As the sixth of the 1st generation Teaching Hospitals in Nigeria, its establishment was to complement her sister institution, University of Benin, and to provide secondary and tertiary care to the then Mid-western Region (now Edo and Delta State) and its environs.4 It provides facilities for the training of a high- and middle-level workforce for the health industry. UBTH spearheads research opportunities for lecturers in the University and others who study the burden of economic morbidity a s well as other research issues. Through the Community Health Centres in Ogbona and Udo, and the General Practice Clinic that came on stream later, UBTH equally provides some avenues for primary health care to the immediate communities. University of Benin Teaching Hospital offers an internship training for medical professionals from various medical fields such as Medicine, Pharmacy, Physiotherapy, Ophthalmology, Medical Laboratory scientist, Nursing, Radiography, Dentistry, Nutrition and Dietetics, amongst other professions.5
Aim and Objectives
The aim of the study is to examines the impact of UBTH in the promotion of community health care in Benin City; while the objectives includes
i. To examines the historical antecedence of community health care in Nigeria.
ii. To survey the emergence, operational mode and activities of UBTH.
iii. To examine the contributions and impact of UBTH in the promotions of community health care in Benin City and Edo State at large.
iv. To identifies the shortcoming UBTH providing community health in Benin City.
Scope of the Study
This study will cover the impact and contributions of University of Benin Teaching Hospital in providing and promoting community health care in Nigeria from 2006-2019.
Methodology
For the purpose of attaining a dear and comprehensive Research the historical method will be applied both primary and secondary sources. These sources will be analyzed in order to reach a comprehensive historical research work.
Primary Source
The primary sources are oral interview with doctors and nurses in UBTH, lecturers from medicine and pharmacy department of the University of Benin. Also Archival material will also be consulted from UBTH school of Nursing.
Secondary Source
Secondary sources such as books, journal, newspapers, internet and other documented materials will be analyzed in this study.
Literature Review
Christie E Omorogbe, work titled “Socio-Economic Factors Influencing In-Patient Satisfaction with Health Care at the University of Teaching Hospital (UBTH), Benin City, Nigeria,”6 posits that previous studies have focused largely on waiting time, cost of treatment and not much has been documented on in-patient outcome of health care seeking in a tertiary institutions from the point of view of the patient themselves. The author, investigates the socioeconomic factors that determine in-patient satisfaction with care at the University of Benin Teaching Hospital (UBTH), Benin City, Nigeria. The author show that, 61.4% were female, 70.0% were married, 42.0% had secondary school education, and 90% were Christians. Ninety-five percent indicated moderate level of satisfaction from the use of health care. Forty-seven percent indicated that economic constraint has influence on their use and satisfaction with the health care provided. Also, cultural beliefs, recipients’ age, spousal roles, access to multiple doctors, and staff-patient relationship, health education, income and occupation influenced their satisfaction. She later recommended that socioeconomic factors as they affect outcome of in-patients’ and utilization of the available health care services be integrated into their medical services in the hospital organization providing health care services especially in teaching hospital. It is important for health care professionals to give consideration to cultural beliefs and economic issues of recipients who are seeking health care in the teaching hospital.7
Isaac Omojiade Oboh, work titled “The Impact of Job Satisfaction on Job Performance among Health Workers: A Study of Some Selected Health Institutions in Nigeria, ISTH and UBTH Edo State,”8 examined job satisfaction amongst clinical staff of Tertiary Health Institutions in Edo State. The two Tertiary Health Institutions examined are Irrua Specialist Teaching Hospital, Irrua and The University of Benin Teaching Hospital, Benin City. The author later captures that the results on the workers satisfaction shows that the majority of the respondents (51.94%) were satisfied with their job generally, especially with the organizational career policy (77.62%) and staff trainings (57.13%). The major factors perceived to be affecting the workers’ job performance were the nature of the job (75.03%), level of job remuneration (69.96%) and the boss leadership style (66.31%). The majority (66.78%) of the respondents rated high in their job performance.9
M.E. Odunvbun G.A. Akenzua, in their work titled “Assessment of the Pattern of Childhood Malignant Diseases seen at the University of Benin Teaching Hospital (2004-2008), Benin City, Nigeria,”10 asserts that malignant diseases have been reported in children worldwide. Pattern of these diseases vary from continent to continent and even in the same country from region to region. Pattern of malignant diseases have been described from various parts of Nigeria, but none from Benin. In a bid to accurately document Cancers at the University of Benin Teaching Hospital, a cancer registry was established in the unit as all cases are usually managed in the unit. All cases of childhood admissions for malignant diseases were documented in the cancer registry.11
Israel Osazee Enabunene, article titled “Effect of work Stress on service Delivery of Health workers in University of Benin Teaching Hospital, Benin City Nigeria,”12 The author examines work stress and service delivery among health workers in University of Benin Teaching Hospital Benin City. The author revealed that work overload has nexus with service delivery of the health workers of University of Benin Teaching Hospital. The author also recommended among other things that University of Benin Teaching Hospital (UBTH) should deploy more student doctors in their residency programmes who would be closely supervised by their superiors in order to reduce the workload on existing doctors in their provision of health services. The work schedule for medical and health workers at the University of Benin Teaching Hospital (UBTH), should be made more flexible to accommodate the peculiarities in female medical personnel, especially married women, nursing mothers and those that are pregnant. The government should do better in the disbursement and payment of hazard allowances to medical and health workers in order to encourage their selfless services to God and humanity through the provision of quality healthcare services.13
A. E. Nwachukw, work titled “Contributions of the University of Benin Teaching Hospital to Economic Development through the Effective Management of the Health of People Living with Hiv/Aids (Plwhas),”14 The work was carried out in the University of Benin Teaching Hospital (UBTH) Benin-City, Nigeria, to find out the HIV/AIDS management services in that Institution particularly for the economically-productive population, living with HIV/AIDS.15
Rita Okoebor, article “Patients’ Perception and Satisfaction of Waiting Time and Healthcare Givers’ Attitude: Outcome of Patients’ Compliance and Continued Utilization of Health Care Services at the University of Benin Teaching Hospital and Central Hospital, Benin City Edo State, Nigeria,”16 asserts that the growing concern of the importance of patients satisfaction as an important tool in assessing the quality of care is a recent trend in the health sector in Nigeria. Health institutions in developed countries of the world are patient centered. The same cannot be said of developing countries like Nigeria, Ghana and others. The author evaluated patients satisfaction of the quality of service delivery in a tertiary and secondary health institutions in South – South Nigeria. It was quantitative and a qualitative study carried out on 200 inpatients and out – patients from February 2013 to November 2013 at the University of Benin Teaching Hospital (UBTH) and central Hospital both located in Benin City, Edo state, Nigeria.17
P.A. Ahmed work titled “Level of Health Care and Services in a Tertiary Health Setting in Nigeria,”18 describes and provides information on the level of care and services process as a measure of quality, with a focus on the health care workers response to patient – care. The health workers agreed that his/ her patients’ medical needs for care, which included identification and treatment, were mostly met. Core clinical staff may not have enough knowledge of the workings in the administrative section and verse visa, because our hospital operates the traditional departmental lines of care, organized into skill areas and professional scopes of practice. Non- clinical staffs have limited contacts with patients, however with improved communication and information flow across departments, this creates better decision making, and helps moves an organization from a silos type to a processes based trend. Another limitation of this report is that only the health workers own perspective is provided.19
All the books and article reviewed have been able to cover only some parts of my research. Therefore this proves to a reasonable extent that a proper study has not been carried out on the impact of UBTH in the promotion of community health care in Benin City. This research seeks to fill that vacuum that has been created for a long while by various scholars.
CHAPTERS OUTLINE
CHAPTER ONE
BACKGROUND OF THE STUDY
CHAPTER TWO
BRIEF HISTORY OF UNIVERSITY TEACHING HOSPITAL
CHAPTER THREE
IMPACT AND CONTRIBUTIONS OF UBTH IN COMMUNITY HEALTH CARE IN BENIN CITY
CHAPTER FOUR
CHALLENGES FACED BY UBTH IN PROVIDING COMMUNITY HEALTH CARE
CHAPTER FIVE
CONCLUSION