Project – Assessment of Health Workers’ Attitude and Its Influence on Service Delivery in Primary Health Centres in Port Harcourt City LGA, Rivers State

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Health workers play a central role in the delivery of healthcare services, especially at the primary healthcare level, where they serve as the first point of contact between patients and the health system. Their attitude, professionalism, communication style, empathy, and responsiveness significantly influence the quality of care received by patients. Positive attitudes among health workers enhance patient trust, encourage healthcare utilization, and improve overall health outcomes, while negative attitudes can discourage patients from seeking care, reduce satisfaction, and weaken the effectiveness of the healthcare system.

Globally, quality of healthcare delivery is increasingly being measured not only by clinical outcomes but also by patient experience and satisfaction. The World Health Organization (WHO) emphasizes that respectful, dignified, and patient-centred care is a core component of quality health services. Studies have shown that the attitude of healthcare providers is a major determinant of whether patients return for follow-up care or adhere to treatment plans.

In many low- and middle-income countries, challenges such as staff shortages, burnout, inadequate remuneration, poor working conditions, and lack of motivation often contribute to negative attitudes among health workers. These challenges can manifest in behaviors such as delayed attention to patients, poor communication, lack of empathy, and unprofessional conduct, all of which negatively affect service delivery.

In Nigeria, the primary healthcare system is designed to provide accessible and affordable healthcare services at the community level. However, the effectiveness of these services is often influenced by the behavior and attitude of health workers. Reports from various studies have indicated that patient dissatisfaction with primary healthcare services is frequently linked to perceived negative attitudes of health workers, including rudeness, negligence, and lack of attentiveness.

In Rivers State, particularly in urban centres such as Port Harcourt City Local Government Area, primary health centres serve a large and diverse population. These facilities are expected to provide maternal and child health services, immunization, treatment of common illnesses, and health education. However, the increasing population pressure and workload on health facilities may influence the behaviour and performance of health workers.

Despite investments in healthcare infrastructure and training, there are ongoing concerns about the quality of service delivery in primary health centres in Port Harcourt City. Many patients reportedly experience long waiting times, poor communication, and unfriendly attitudes from some health workers. These issues raise questions about how health workers’ attitudes influence service delivery and patient satisfaction in the area.

Therefore, this study seeks to assess health workers’ attitude and its influence on service delivery in primary health centres in Port Harcourt City Local Government Area, Rivers State.

1.2 Statement of the Problem

Primary health centres are expected to deliver efficient, accessible, and patient-centred healthcare services. However, in many parts of Nigeria, the quality of service delivery in these facilities is often compromised by human factors, particularly the attitude of health workers.

In Port Harcourt City Local Government Area, patients frequently report dissatisfaction with services received at primary health centres. Complaints often include poor communication, lack of empathy, delayed attention, unfriendly behavior, and perceived negligence by some health workers. These negative experiences can discourage patients from returning to health facilities or adhering to medical advice.

Poor attitudes among health workers can significantly undermine the effectiveness of primary healthcare delivery. When patients feel disrespected or ignored, they are more likely to self-medicate, seek care from unqualified providers, or delay seeking treatment until conditions worsen. This contributes to increased morbidity, preventable complications, and unnecessary burden on secondary and tertiary healthcare facilities.

Although various interventions such as training, supervision, and policy reforms have been introduced to improve healthcare delivery, the problem of negative attitudes among health workers persists in some facilities. However, there is limited empirical evidence specifically examining how health workers’ attitudes influence service delivery in primary health centres within Port Harcourt City LGA.

Furthermore, factors such as workload, job satisfaction, remuneration, and institutional support may contribute to the attitudes of health workers, but their combined effect on service delivery in the study area has not been adequately explored.

It is against this background that this study assesses health workers’ attitude and its influence on service delivery in primary health centres in Port Harcourt City Local Government Area, Rivers State.

1.3 Objectives of the Study

The main objective of this study is to assess health workers’ attitude and its influence on service delivery in primary health centres in Port Harcourt City LGA, Rivers State.

Specifically, the study aims to:

1. Examine the attitude of health workers in primary health centres in Port Harcourt City LGA.
2. Assess the level of service delivery in primary health centres in the area.
3. Determine the relationship between health workers’ attitude and service delivery.
4. Identify factors influencing health workers’ attitudes in primary health centres.

1.4 Research Questions

1. What is the attitude of health workers in primary health centres in Port Harcourt City LGA?
2. What is the level of service delivery in these health centres?
3. Is there a relationship between health workers’ attitude and service delivery?
4. What factors influence health workers’ attitudes in the study area?

1.5 Research Hypothesis

H₀: There is no significant relationship between health workers’ attitude and service delivery in primary health centres in Port Harcourt Local Government Area.

H₁: There is a significant relationship between health workers’ attitude and service delivery in primary health centres in Port Harcourt City Local Government Area, Rivers State.

1.6 Significance of the Study

This study is significant because it will provide empirical evidence on how health workers’ attitudes influence service delivery in primary health centres. The findings will assist health administrators and policymakers in improving staff management, motivation, and supervision strategies. It will also help healthcare workers understand how their behavior affects patient satisfaction and health outcomes. Additionally, the study will contribute to academic literature on healthcare service delivery and human resource behavior in Nigeria’s health sector.

1.7 Scope of the Study

This study is limited to primary health centres in Port Harcourt City Local Government Area, Rivers State. It focuses on health workers’ attitude and its influence on service delivery, including patient interaction, communication, responsiveness, and overall quality of care.

1.8 Operational Definition of Terms

Health Workers’ Attitude: The behavior, perception, and disposition of healthcare providers towards patients and their work.

Service Delivery: The process of providing healthcare services such as diagnosis, treatment, and patient care in health facilities.

Primary Health Centre: A basic healthcare facility that provides first-level medical services to the community.

Patient Satisfaction: The degree to which patients are content with the healthcare services received.

Project – Assessment of Health Workers’ Attitude and Its Influence on Service Delivery in Primary Health Centres in Port Harcourt City LGA, Rivers State