Page 129 - GHES-3-2

Global Health Economics and
Sustainability
Community participation in primary health care

ensuring maternal and child healthcare services were 4.10. Challenges and barriers to WDC operations
accessible, even in remote areas. The study also found that The findings highlight the interplay between structural
60% of communities had volunteer service providers, while and functional factors in determining the effectiveness of
25% had volunteer mobilizers for public enlightenment WDCs. Committees with strong structural foundations,
and campaigns. These volunteers play instrumental roles such as regular meetings and sound financial systems,
in augmenting healthcare service delivery. Furthermore, demonstrated greater success in functional areas like
67% of communities have established ETS, a lifeline during community mobilization and resource management.
healthcare crises. Ingrained in community healthcare
frameworks, these systems facilitate the timely transfer Subgroup comparisons revealed significant disparities,
of pregnant women to PHCs during emergencies. suggesting that weaker committees require targeted
Consequently, maternal and child health outcomes capacity-building interventions. For instance, improving
improve, aligning with the overarching goals of healthcare financial literacy and promoting the maintenance of
delivery frameworks. bank accounts could enhance resource mobilization,
while standardizing meeting schedules may foster better
WDCs involvement echoes the principles of community community engagement. These observations align with
engagement and participation inherent in healthcare previous studies emphasizing the critical role of structural
systems strengthening frameworks. integrity in the functionality of health committees (McCoy

The study’s findings underscore the symbiotic et al., 2012; Njelita et al., 2023).
relationship between WDCs and PHCs and also Despite these structural insights, the operational
show some other community-based structures, like landscape of WDCs is fraught with several challenges
the volunteer corps and TBAs, which work within that undermine their effectiveness. Resistance from
communities to improve access to health services. These health providers emerged as a key barrier, with some
revelations emphasize leveraging local resources, fostering healthcare workers perceiving WDC oversight as intrusive,
community participation, and promoting transparency as particularly during supervisory visits. For example, one
key strategies for effective healthcare implementation and PHC staff member reflected, “It felt like they were policing
ultimately improving health outcomes. us instead of supporting us. Over time, we realized they
4.9. Evidence-based success of WDCs were trying to improve services.” In addition, gaps in
community engagement were evident, with 15% of
The universal establishment of WDCs in all wards communities lacking awareness of WDC roles, limiting
highlights their pivotal role in community-driven health their ability to mobilize resources effectively. A community
care. These committees actively engage in supervisory member explained, “We didn’t know WDCs were
activities, with 98% routinely monitoring health facility supposed to help us with transport during emergencies.”
performance indicators. Notably, 94% of WDCs used this Financial sustainability also remains a pressing challenge.
data to inform evidence-based decision-making, resulting Although 91% of WDCs reported having the means to
in practical improvements such as increased community generate funds, only 16% had functional bank accounts,
confidence in healthcare services.
leading to informal financial handling and accountability
Social mobilization efforts led by WDCs achieved gaps. Addressing these barriers requires comprehensive
measurable outcomes. In communities where WDCs solutions such as financial management training and
organized immunization campaigns, child immunization access to microfinance institutions, which could bolster
rates increased by 40% compared to baseline levels. financial sustainability and accountability. Together, these
Similarly, the ETS established in 67% of wards facilitated structural and operational challenges underscore the need
timely access to care, with 80% of emergencies addressed for a multifaceted approach to enhance WDC functionality
within the first hour of notification. One community leader and impact.
remarked, “Our transport system has saved many lives by
ensuring patients reach the PHC on time.” 4.11. Limitations of the study
Financial contributions were another area of success. While this study provides valuable insights into the role of
Despite only 16% of WDCs maintaining bank accounts, WDCs and community structures in enhancing primary
91% reported independent means of generating funds. health care in Kebbi State, several limitations must be
This enabled the establishment of community-led DRF acknowledged, highlighting areas for future research
schemes in 33% of wards where no government DRF and improvement. Much of the data, such as meeting
existed, thereby improving the availability of essential attendance and financial contributions, were self-reported
drugs by 50%. by WDC members, thereby potentially introducing biases

Volume 3 Issue 2 (2025) 121 https://doi.org/10.36922/ghes.4945