Access to Primary Health Care: A Comparative Study of Rural and Urban Facilities in Rivers State

Abstract

Primary health care (PHC) is a global approach to health that focuses on providing care close to people’s homes. The study compares access to primary health care in rural and urban areas in Rivers State, Nigeria. The study involved 928 patients from sixteen primary health care facilities: MPHCs Okochiri, Ogan, Ayama, Ogbema, Ndele, Odohua, Ataba and Unyeada for rural facilities, and MPHCs Orogbum, Churchill, Ozuoba, Elelenwo, Aluu, Igwuruta, Ogale, and Akpajo for urban facilities. Access to PHC was assessed through semi-structured interviewer-administered questionnaires between November, 2024 and March, 2025. Access in terms of availability, affordability, accessibility and effectiveness were consistently better in urban facilities compared to rural facilities. The results showed that respondents were majorly females, and between the age of 26-30years old, with a higher proportion in the urban facilities. The proportion of PHC service availability was significantly higher in primary health care facilities in urban areas when compared with primary health care facilities in the rural areas (80.4% vs 67.7%; X2 =19.51; p = 0.0001). Most findings from the PHC facilities in the urban areas revealed a significantly greater proportion when compared to the rural areas, including availability of basic and essential medicines (96.6% vs 90.7%; p = 0.0001); affordability of Antenatal/Post-natal care services (66.6% vs 54.7%; p = 0.0001); ease to access treatment of common diseases (82.1% vs 73.9%; p = 0.003); and effectiveness of health education (84.7% vs 78.9%; p = 0.022), referrals (76.1% vs 57.5%; p = 0.0001).Improving PHC services are highly recommended.