Structural Deficits in Primary Healthcare Infrastructure: A Comparative Assessment of Location Suitability, Facility Resources, and Personnel Capacity in Public and Private Health Institutions in Ilesa East and Ilesa West Local Government Areas, Osun State, Nigeria
Olawale Sunday Asabi *
College of Health Technology, PMB 5042 Ilesa, Osun State, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Structural readiness of health facilities depends on accessible locations, adequate infrastructure, water, sanitation and hygiene services, and sufficient personnel.
Aims: To assess the structural readiness of public and private health institutions in Ilesa East and Ilesa West Local Government Areas (LGAs) of Osun State, Nigeria, with respect to location suitability, facility infrastructure, water and sanitation (WASH) services, and personnel capacity, in the context of Nigeria's Universal Health Coverage (UHC) goals.
Study Design: Descriptive cross-sectional survey.
Place and Duration of Study: Twelve health facilities across six wards of Ilesa East and Ilesa West LGAs, Osun State, Nigeria; data collected in 2012.
Methodology: Three wards per LGA were selected based on the concentration and diversity of health institutions. Within the selected wards, 12 health facilities (6 per LGA) were purposively selected to ensure representation of both private and government-owned facilities. Data were collected using structured questionnaires, observation checklists, and physical inspection and were analysed using descriptive statistics (frequencies and percentages).
Results: All facilities (100%) were located within residential environments with road access; however, only 50% had perimeter fencing and 66.7% lacked green belt vegetation. Ward-based operations were predominant (91.7%). X-ray equipment was unavailable in 66.7% of facilities, CT scanners in 75%, and MRI machines in 91.7%; boilers/autoclaves were unavailable in 58.3%. Water supply was absent in 33.3% of facilities, and 91.7% relied on pit latrines. Health Officer was the most common facility-head designation (41.7%), while 75% of facility heads were reported as qualified medical doctors. Qualified doctors were present in 9 facilities, with full-time, part-time, and consultancy engagement each reported in 33.3% of these facilities. Among the 9 facilities with adequate qualified nursing staff, all reported full employment of nurses; across all 12 facilities, 50% reported shift-duty operation. Only 33.3% of facilities employed other skilled personnel such as pharmacists and laboratory scientists.
Conclusion: While location suitability was generally adequate, significant infrastructure deficits and personnel capacity gaps persist, compromising the quality of healthcare delivery. These findings underscore the urgent need for integrated capital investment, workforce development, and policy enforcement to improve access to quality healthcare.
Keywords: Health facility assessment, health system strengthening, location suitability, personnel capacity, primary healthcare infrastructure, public-private healthcare, WASH services