THE QUALITY OF HEALTHCARE INFRASTRUCTURE AND LEVEL OF ACCESSIBILITY IN NIGERIA

CHAPTER ONE

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Owing to inadequate hospital design and distribution throughout the nation, public and private healthcare facilities have received the attention they need to close the infrastructural gap in Nigerian hospitals (Moedozie and John-Abebe, 2022; Agaja, 2012). Nigeria is widely acknowledged as one of the great African nations, yet despite changes and strategies to address the system's problems in both the local and state government sectors, the country's healthcare situation remains dire (Welcome, 2011; National Health Policy, 2016). According to Adeyinka and Olugbamila (2016), carelessness in the allocation of healthcare facilities is the reason Nigeria has a high population to facility ratio.High hospital costs, a lack of health insurance and services, ageing, and the availability of healthcare services are the most obvious obstacles to getting medical treatment(Moedozie and John-Abebe, 2022). Even during the coronavirus pandemic, Nigerian residents have been denied access to excellent health, one of their essential human rights.(Cohut, 2020). Several hospitals and centres limited services to just severe cases designated emergencies during this period due to a government mandate banning public gatherings, and other patient requirements were refused, making it more difficult than normal to receive care for non-emergency situations (Adeboyejo, 2020).

          Nigeria's health system, which combines orthodox and unconventional medicine, has only partially implemented health policies. This has resulted in resource optimisation issues and a failure to meet the Millennium Development Goals for health care.Any region's healthcare facilities' accessibility and utilisation are crucial since they impact the general health of the populace (Ephraim-Emmanuel, Adigwe, Oyeghe,and Ogaji, 2018). The accessibility issue that arises from the concentration of these facilities can be resolved by promoting even the dispersion of these crucial facilities.According to Fadahunsi et al. (2017), insufficient health care delivery has resulted from the majority of Nigerian states' healthcare facilities being located in areas that do not always match the demands of the populace. Regional differences in healthcare outcomes are a result of differences in healthcare facility accessibility and dispersion.Ensuring healthy lives and promoting well-being for all ages is the third Sustainable Development Goal (SDG) (WHO, 2022). In order to fulfil the third Sustainable Development Goal, it is essential to address disparity in healthcare requirements, particularly with regard to the accessibility to such services.

          On the other hand, low service quality, competition among healthcare providers, and limited accessibility are some of the reasons why many outlying public healthcare facilities are not being used (Anderson et al., 2007). Using the facilities that are available has both advantages and disadvantages in a number of areas, including cost, service delivery, cultural ethnicity, travel expenses, distance, road conditions, infrastructure, and service providers (staffing).Obstacles impeding the use of health care in hospitals and centres across demographic groups include the availability and calibre of staff, their attitude towards patients, scarcity of medications and the perception of expensive hospital bills, site of residence, and maternal education (Babalola et al., 2009; Salome et al., 2009; Nteta et al., 2010; John-Abebe andOsirike, 2015).

          Over the years, several studies on the calibre of healthcare service have been conducted. Determining whether the treatment given to patients is suitable and safe for the patient has piqued the interest of stakeholders.This is founded on the idea that recipients of health care services should receive high-quality care that complies with worldwide best practises (Ronda, 2008).The need for high-quality, reasonably priced healthcare is driven by the world's constantly changing political, epidemiological, and demographic landscapes as well as by the complexity of illness patterns and patient preferences.The level of patient-centered care that is offered by the healthcare facilities may be inferred from the patient's happiness following an interaction, which is now recognised as an indication of quality health care delivery. In reality, prior research has demonstrated a link between the calibre of medical services and the degree to which patients or consumers are satisfied with the treatment they receive (Kalinichenko, 2013). It is based on this background that this study seeks to review available evidence on the quality of healthcare infrastructure and level of accessibility in Nigeria.

2.0 Discussion of Literature Review

          As a guide to discussing the literature review, the research questions that were asked in this study were first determined the meanining of  quality health care, ways of achieving quality health care,and whether the quality health care in Nigeria has been  made accessible to the citizens.

          The inclusion criteria of this study included review related to the quality of health care delivery generally and in the Nigerian context; the key quality criteria were treatment effectiveness, acceptability, efficiency, appropriateness and equity. A totla of reviewed 15 relevant literatures which included retrospective studies, observational studies and reviews were dissected.

2.1 Quality Healthcare

          Healthcare facilities' perceived and technical quality criteria are typically used to categorise quality. In keeping with current care recommendations, the former pertains to the state of the health infrastructure and patient compliance with professionally specified practises and procedures; the latter is based on patient experiences and perceptions.The World Health Organisation (WHO) and other academics have created a number of metrics to evaluate the performance and infrastructure of healthcare institutions(Ibrahim, bin Mohtar and Dutse, 2015).These guidelines are also observed in Vietnam, where the quality of healthcare facilities is shown by the scores of hospitals and clinics in the country's quality evaluation(Ejughemre et al., 2015).