CHAPTER ONE

GENERAL INTRODUCTION

Health care is one of the fastest growing industries in Nigeria, and the hospital is the corner stone of the  health care industry, there is over 6,500 hospitals in this country, and their services are expanding  with corresponding increase in cost.

The health care industry and its hospital component employ more than 3 million fulltime  equivalent employees. The nations total health care  bill amount  to N150.4 billion 10.6% of the nation gross national product  which is the  equivalent  of Nigeria spending more than N1 billion  each day on their health care.  (Health Care Administration UUTH).

Historically, in Akwa Ibom State, hospitals were developed as  voluntary free standing  units. The traditional systems of healthcare delivery  was network of private  physicians, groups practices, clinic, hospital  intended care and treatment decision were made primarily by physicians on a free-for-services basis,  thus most patient  had little, if any to contribute in their medical treatment decision.

Hospitals were in control of the system over the last 20 years, because they had financial security under the federal and the state reimbursement system of medical care and medical aids (health care administration principles and practice).

In recent years, a lot of money have been voted for the industry which have experienced major difficulties in maintaining their autonomy and financial security.  For many reasons, the health care delivery system in the state is evolving into a highly competitive and extremely volatile industry. Recent legislative and regulatory changes in the state have placed limits on the amount of government fundings on health care service thus many hospitals and private clinics do not have adequate capital resources to renovate  or replace  outdated facilities nor invest in expensive  medical technology.

With recent changes that is permeating every aspect of the healthcare industry, hospital management board have realized the need for diversification and  re-organization as an important  tools for the development  and structuring of the ministry.

This has made the hospital management board to effectively seek for a better plan so as to meet the objectives of the sector.

This project considers the application of geospatial information system (GIS) as a decision support tools in health information management (HIM). This involves a wide variety of functions that are critical to the operation of the healthcare in each local government area in the state.

Geospatial information system as a computer based technology and methodology  for collecting, managing, analyzing, modeling and presenting a geospatial and non spatial  data for a wide range of  application (Davis 2001),With Geospatial Information System, decision makers can locate, create and maintain accurate  and comprehensive  spatial data base and  records. These database records are  quite  invaluable in tracking the inventory of every health institution in the state.

This database can also be used to generate a demographic map of the present and future availability of any health institution. With GIS, a common platforms can be developed  for convergence of multi diseases, in standardized  georeferencing of epidemiological data,  the process provides an excellent means of  analyzing epidemiological data, revealing trends, dependencies and interrelationships that would otherwise remain hidden in data  shown only in tabular format.

1.1   STATEMENT OF PROBLEMS

It is common to hear pertinent complaining about non availability of medical staff in some hospitals, and insufficient drugs for the patient consumption in the health care and clinics. These trends start from the village level. This is a result of the decision makers having little or no adequate information concerning the  institution and the population figure in the area.

Legislative regulation for the distribution of facilities and medical  aids have become a major issue in the healthcare industry. Hence the need to  access monitor and evaluate a suitable approach for each  institution using geospatial  information system.

Using  geospatial information system technology for the management of the healthcare  industry  enables the  health administrators to integrate location base  data into  demographic  analysis, such as;

1. Management process in legislative planning and operating .
2. Equity in the distribution of drugs
3. Improve productivity of all health workers?
4. Improve utilization of healthcare  resources
5. Improve quality of care
6. Others planning and problem solving tasks.

1.2   AIM AND OBJECTIVE OF THE RESEARCH

The broad aim of this project is to demonstrate the application  of geospatial information system as a decision support tool  in legislative regulatory planning and management  of health  institution in the state.

The objectives include;

1. To identify and spatially locate the healthcare institution and facilities in each of the study areas.
2. To delineate the coverage of the catchments area of each of the healthcare institutions
3. to identify villages and settlement that are not covered with health care facilities
4. To suggest a possible location for healthcare institution.
5. To demonstrate how this information can be synthesized to support the planning and decision making needs of the public health sector.

1.3   SCOPE OF THE PROJECT

The research considers the following local governments, namely, Eket, Esit Eket, and Onna with the aim of carrying out a comparative study among them.

This work also intends to determine the health administrators regulatory involvement  in drugs distribution, base on the population figures and personnel available in the study area.

Also this work covers the aspect of the healthcare management in  terms of  spatial  database creation, data management  analyse and modeling.

1.4   SIGNIFICANCE OF THE STUDY

Management planning is a key issue in the delivery of the healthcare services, a good management design is not just desirable,  but a consistence  development that needs to pass through one step to the other. It is a pre-requisite for the workable cost effective for the health care administrators.

The continuous increase in the demand for the healthcare  services  in  Nigeria is a result  of corresponding increase in affected  person by many unknown  or newly diagnose disease.  Bearing in mind the competitive environment in which these services are provided, healthcare administrators therefore needs a more effective  and efficient  approach  to.

1. Improve availability of appropriate information for decision making
2. Improve productivity of all health workers.
3. Improve new healthcare facilities
4. Expand the existing healthcare institutions.
5. Improve quality of the healthcare delivery. From the above, there is need to ensure adequate models and effective maintaining techniques by using a dynamic information base, thus spatial analytical tool becomes imperative.

1.5   THE STUDY AREA

The study area of the project work is Eket, Esit Eket, Onna Local Government area of Akwa Ibom state. The area is bounded in the western coastal region of the state. Their terrain is relatively flat with height in the range of 60m above mean sea level. (Mbeke 2005).

The 2006 national population census put the population distribution of the study area of about 172,557,  63,707  and 123,373 respectively. The area  comprises of villagers and wards were  all the  health institution  are being sited.

The study area basically is where Industries and company, such as ALSCON  EXXON – Mobil and other small companies  are located. Most importantly, it is a result  of enormous industrial pollution and prevalence disease affecting these areas that attributed the choice of this areas for studies.

1.6   DEFINITION OF TERMS

ARCVIEW: This is one of the GIS software used in processing,                   designing and processing of geospatial data

HMIS:      Health Information Management System

MIS:         Management information system

DATA:      These are raw collection of facts

DBMS:      Database  management  system digitizing. The process of converting  analogue maps and other sources of data  to a computer readable form.

Data Directory: A folder or area on the hard  drive of your computer or  your networks  computer that is available and data that  you create geospatial information system (GIS):an organized  collection of computer hardware, software, geographic data, and personal designed to efficiently capture, store, update, manipulate, analyse and display all forms of  geographically referenced information.

Hardcopy: a copy of textual or graphic information produced  our paper.

Identifier Or Label:  these are tags attached to individual entity  of GIS coverage.

One to One: This is a relationship whereby one primary key relates with one foreign key.

One to Many: A relationship of one primary key connecting many  foreign  keys.

Primary Key: This is a field that identifies a record in a table uniquely. Frequently it is a separate field added to each record.

Raster: Data expressed as an array of pixels with spatial position implicit in the ordering of the pixels

SQL: Structural query language.

Theme: A data  layer   relating  to a specific  subject or topic  of interest

Thematic Layers: a logical separation of geographical information such that each layer represent a different them. For example a composite digital  map may consist of a land boundaries  layer, rivers and streams layers, roads layers etc.

Topology: is an impact the mathematical method used to define spatial relationships. Topology describes the spatial  relationship of geographical  features such as point, lives and polygons to other features.

VECTOR: positioned data on the from of coordinate of the ends of lives segments,  points text  position etc.

Epidemiological data: the scientific process and study of the spread and control of diseases.