Healthcare Workers' and Patients' Perspectives on Barriers to Effective Service Delivery at Bayero University, Kano Health Centre

Abstract

Background: University health centres serve as critical primary care access points for students and staff, yet their effectiveness is often undermined by multifaceted barriers. Understanding these barriers from both healthcare workers' and patients' perspectives is essential for strengthening service delivery and advancing universal health coverage goals in Nigerian tertiary institutions.

Methods: A mixed-methods cross-sectional study was conducted at Bayero University, Kano Health Centre. Quantitative data were collected from 118 healthcare workers using a structured questionnaire and from 392 patients using an exit survey. Qualitative data were obtained through 14 in-depth interviews with healthcare workers and 22 focus group discussions with patients. Data were analysed using descriptive and inferential statistics, with thematic analysis for qualitative data.

Results: Healthcare workers identified inadequate staffing (88.1%), poor remuneration (81.4%), drug shortages (77.1%), and inadequate funding (84.7%) as the most significant barriers. Patients identified long waiting times (82.4%), drug unavailability (74.5%), poor staff attitudes (69.1%), and inadequate facilities (62.4%) as major barriers. Significant differences were observed between healthcare worker and patient perceptions regarding staff attitudes (p<0.001). Qualitative findings revealed systemic challenges including workforce attrition, inadequate infrastructure, and the spillover effects of regional insecurity on health service delivery. Compliance with primary healthcare minimum standards in Kano State was found to be below 50% across facilities, with major gaps in infrastructure, human resources, and essential medicines.

Conclusion: The study reveals significant barriers to effective service delivery in university health centres from dual perspectives. Addressing these barriers requires comprehensive interventions including improved staffing, enhanced remuneration, consistent drug supply, infrastructure upgrading, and security measures. These findings have implications for achieving universal health coverage in Nigerian university communities and beyond.