INTRODUCTION
Differences in health status between industrialized and developing countries, as measured by indices such as newborn mortality, young and child mortality, and maternal mortality, have been documented throughout history. As we go from urban to rural areas in developing countries, the situation has gotten worse. Unfortunately, the causes of this distressing reality include illnesses that can be cured and fatalities that can be avoided with modest actions, but for which ineffective structures have served as a roadblock.
To justify the amount of money spent on health and the number of workers employed, serious attention must be paid to improving the quality of healthcare services while keeping costs in check, as well as planning health-care activities and performing effective management functions related to health-care delivery systems (HCDS).
This is impossible to achieve outside of the constraints of use. This is due to the fact that usage is the most activity-related problem, as it is consumer-oriented and has multiple dimensions in terms of demands, attitudes, and knowledge. The scale of the problem is crystallized to the extent that utilization includes the collaboration and invitation of persons outside the health system. Indeed, history and current situations around the world have justified utilization as a fundamental aspect in planning any health-care delivery system. WHO had warned at the outset of HFA/2000 that if its aims, support activities, administration, and execution were not tailored toward optimal usage, it could become obsolete. In the United States, hospitals and affiliated health facilities are required to have formal usage review procedures as a requirement of participating in health plans, and any institution seeking accreditation must have some kind of utilization review mechanism. The comprehensive National Health Scheme (NHS) of the United Kingdom is designed to ensure equity and encourage all citizens to seek out treatments. Even during the apartheid era in South Africa, health care were reconstructed under the ideas of accessibility, affordability, acceptability, equity, and efficacy, resulting in desegregation. Attempts have been made in underdeveloped nations to promote use in particular.
The provision of free medical treatments as a strategy of increasing utilization by removing financial obstacles has become a major political issue. Inadequate structures have hampered progress in this direction, resulting from a failure to tune planning and management activities toward utilization, a situation exacerbated by other issues such as
Population growth is accelerating.
Health-care demand is rising, but resources are diminishing.
Misallocation of scarce resources
Government health-care programs and services are inefficient on the inside.
Private health-care services are of poor quality.
Insufficient infrastructure support, such as water, electricity, and good roads.
These issues have resulted in ineffective architecture, inefficient resource allocation, and incongruent staff scheduling, which would not have occurred if potential utilization had been the foundation upon which the facilities were built. This situation necessitates restructuring, which can only be aided by examining the relationship between resource distribution, health problems, and utilization patterns, where identified determinants would reveal the services to be provided for the growing population as well as their magnitude.
The real coverage is classified as ambulatory medical care services (outpatient and home), inpatient medical care services (hospital), and preventative services. To attain optimal use levels, all three groups must engage the population’s participation and initiative, as well as that of health care providers. Previously, it was assumed that the Health Ministry and other health-care providers recognized the demand on their resources, on which planning was based, based on the number of persons who needed services. There is growing evidence that many more people are attempting to acquire such services but are unable to do so for a variety of reasons, particularly in poor countries. The disparity between what levels of health care utilization are and what they should be in Nigeria, particularly in Kwara State, is plainly visible.
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