Page 123 - GHES-3-2

Global Health Economics and
Sustainability
Community participation in primary health care

management. Moreover, WDCs provide a structured 2.2. Study population
framework for communities to hold healthcare providers The study was conducted in Kebbi State, Nigeria, which
accountable, thereby improving transparency and trust in has a total of 225 wards. Each ward has a designated “one
the healthcare system. Understanding the value of WDCs functional PHC per ward,” and these were the target PHCs
offers actionable insights for policymakers and stakeholders for this study. Therefore, WDCs, their corresponding
to strengthen these committees, ultimately improving PHCs, and the catchment populations of these focal PHCs
health outcomes through sustainable, community-driven were included in the study.
healthcare systems.
2.3. Data collection
1.1. Theoretical framework
This study is grounded in the framework of community Four data collectors were involved in the study. There was
participation in health governance, as articulated in the Alma- an orientation meeting with the data collectors who were
Ata Declaration of 1978, which emphasizes self-reliance and trained in using the data collection tool. The tool was pre-
community involvement as cornerstones of effective primary tested to ensure data is immediately received in Google
Sheets for subsequent analysis.
health care. As defined by the WHO, community participation
involves enabling individuals and communities to actively Quantitative data were collected using Google
engage in decision-making, planning, and implementing Forms administered to WDC members, PHC staff, and
health services that affect their lives. community members. Approximately three respondents
WDCs operationalize these principles through per ward completed the questionnaire.
structured roles and responsibilities that align with 2.4. Questions in the data collection tool
governance, accountability, and resource mobilization
frameworks. Specifically, the study adopts a focus on key The study questionnaire included the following variables,
dimensions of WDC functionality: adapted from the indicators used to assess the functionality
1. Governance and accountability: Reflecting their role as a of WDCs.
bridge between communities and health systems, WDCs • Establishment and functioning of WDCs
monitor PHC performance and ensure transparency • Frequency and documentation of WDC meetings
2. Community engagement: As participatory agents, • WDC involvement in PHC supervision and decision-
WDCs mobilize resources and support health making
initiatives, fostering grassroots ownership • Utilization of PHC service data by WDCs
3. Data-driven decision-making: Grounded in evidence- • Financial management capacity of WDCs
based practices, WDCs utilize PHC performance • Community-led initiatives, including Drug Revolving
indicators to prioritize health interventions. Fund (DRF) schemes
• Availability and functionality of PHC services
Although many studies have provided some • The presence of traditional birth attendants (TBAs)
information on community participation in primary and emergency transport systems (ETSs)
health care in some ways, mainly through community • Involvement of volunteer service providers and
health committees covering their roles, effectiveness, mobilizers
and challenges elsewhere, there is generally a lack of • The existence of community accountability committees
information on the functionality and depth of participation • Community ownership and accountability mechanisms
of such committees in Nigeria with little evidence of their for PHC services
evaluation in line with the mandate set by the NPHCDA.
This study aims to provide evidence-based information by 2.5. Validity and reliability of the data collection tool
assessing the functionality of the WDCs and determining
the depth of their engagement with and actions in health The validity of the data collection tool was ensured through
facilities in Kebbi State, Nigeria. a careful design process, aligning the questionnaire with
established indicators for assessing the functionality of
2. Research method WDCs and their impact on primary health care. Content
validity was achieved by covering all relevant aspects
2.1. Study design of WDC activities, while face validity was confirmed
A cross-sectional study design was employed to assess through expert review and pre-testing with data collectors.
the involvement and influence of WDCs and community Construct validity was strengthened by combining
structures on primary health care in Kebbi State from quantitative and qualitative data collection methods to
January 2020 to September 2021. comprehensively assess the WDCs’ roles.

Volume 3 Issue 2 (2025) 115 https://doi.org/10.36922/ghes.4945