Continuity of Care in Primary Health Care Affecting Control of Diabetes

Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect of continuity of care on control of diabetes mellites in primary health care centres. Objectives: 1) To assess the effect of Continuity of care on controlling haemoglobin (Hb A1C) and fasting blood Sugar (FBS);2) To compare the control of Diabetes by using (Hb A1C and FBS) indices on same patient before and after application of chronic illness clinic;3) To identify the relation between age and gender affecting continuity of care in diabetic patient. Methods: It is a Prospective cohort study design. Included both gender and diabetic patient age above 24 years old. The data extracted from health care specialty center (HCSC) clinics in National guard hospital at Riyadh, through HCSC data base on three phases: 1) Phase 1: the data extracted of diabetic patients from October to November 2022 including MRN, diabetic patient, age, Hb A1C, Fasting blood glucose. 2) Phase 2: the same MRN extracted from phase 1 was extracted again retrospectively for six months from April to September 2022, to compare the indices before implanting the chronic illness clinic including Hb A1C, Fasting blood glucose. 3) Phase 3: prospectively from December 2022 to September 2023. Results: Among diabetic patients aged 60 years old and above showed better control of HbA1C and FBS comparing to these patients below age of 60 years old, with significant improvement of HbA1C after implanting chronic illness clinic. Conclusion: The significant improvement in the control of diabetic patients followed in primary health care centers reinforce the evidence of the importance of continuity of care.

Effectiveness of Adherence to Standardized Hypertension Management by Primary Health Care Workers in China:a Cross-sectional Survey 3 Years after the Healthcare Reform

The standardized hypertension management provided by primary health care workers is an important part of China＇s recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.

Knowledge and Skills Gap of Midwives to Conduct Obstetric Ultrasonography Screening in Primary Health Care Facilities in Kajiado and Kisii Counties, Kenya

Background: Ultrasound remains a tool of much importance in maternity care with midwives regarded as key health professionals when it comes to care of pregnant mothers. There is however limited study on the knowledge and skills gaps of midwives in conducting obstetric ultrasonography screening. The purpose of this study was to assess the specific obstetric ultrasonography knowledge and skills gaps among midwives based in primary health care facilities. Methods: A cross-sectional study employing both qualitative and quantitative method was conducted between July and August 2019 with 274 midwives. A structured questionnaire was used to collect data while Focus group discussion and Key Informants Interview were used to collect qualitative data. Descriptive statistics were used to summarize the data test associations between variables while the qualitative data were used to compliment the questionnaire data in eliciting more information on the gaps. Findings: Almost all (94.5%) the midwives had never been trained on any basic obstetric ultrasound while six of those that had been trained in early stages by the project lacked equipment to practice the acquired skills. More than three quarters of the respondents opined that they wished to provide personalized care services to mothers/clients seeking Antenatal Care Services (ANC) in their community at a fee while only 13.9% had knowledge that obstetric screening should be done before 24 weeks gestation. Four out of ten of the respondents scored themselves a one (1) on the level of confidence they have using an ultrasound machines or technology. Conclusion: There still remains a huge gap as far as training of midwives on basic ultrasound screening is concerned. The lack of basic obstetric ultrasound screening skills is a barrier to rolling out Point of Care Ultrasound (POCUS) screening services. However, midwives are motivated and willing to learn basic ultrasonography skills to further the objectives of Universal Health Coverage (UHC). Concerted efforts should be made to train midwives on basic obstetric ultrasonography skills in addition to availing mobile/hand held ultrasound technology in Primary Health facilities for them to apply the transferred skills. A sustainable business model to enable mothers continuously afford the services is critical as well.

Anxiety Disorder in Adolescent and the Importance of Primary Health Care to Identify This Illness

Summary： Introduction： Adolescence, is a life stage characterized by constant emotional instability and psychological conflicts. Analyzing the age of psychological transition of these adolescents along with the environment demands that those ones live, in conclusion, there are conflicts between particularities of intern and extern environment, besides self-knowledge of these adolescents, ending up in what we call AD （anxiety disorder）. Objective： Raise reader’s awareness about the early recognition of ADs and stress. Methodology： Based on literature review. The virtual library Scielo and the Latin American Journal of Nursing were mainly consulted. Results： The AD is characterized as a mental health disturbance, which has as main symptoms feelings of preoccupation, anxiety or fear which are strong enough to interfere in daily activities. Its detection should be as early as possible, therefore, primary health care is the most efficient to prevent and detect this illness. Conclusion： It is possible to assure that primary health care （periodical medical check） has great impact on detecting and preventing the anxiety disorder in adolescent, since mental health professionals have used many working instruments which are useful for detecting this illness.

Factors Influencing Patient-Centered Care in the Primary Health Care Settings: The Impact of the Pandemic Crisis and Nurses’ Experience

Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.

Challenges for Nurses in Providing Patient-Centered Care in Rural Primary Health Care Clinics in Nigeria

Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in Primary Health Care (PHC), and have recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with challenges in achieving the desired results in the PHC system. Thus, the study aimed to explore the factors that influence PCC utilization in the PHC facilities in Nigeria. A qualitative exploratory-descriptive design was used for this study. Data collection was conducted with the nurses from PHC facilities through individual interviews. Data saturation was achieved with 35 participants from 30 PHC facilities in Osun State, Nigeria, using a purposive sampling technique. All interviews were audio-recorded, later transcribed verbatim, and analyzed using the thematic analysis approach. NVivo 12 software was used for data management. The results from this study were categorized into two factors: Organizational factors and individual factors. Six themes that emerged from the study include inadequate management support, insufficient opportunities for further training, work overload and time constraints, health personnel readiness to use PCC, dearth enthusiasm for change, and poor nurses’ Accountability. The study shows that nurses encountered diverse challenges in providing patient-centered care. To improve the quality of healthcare delivery in the PHC facilities, there is a need to reinforce adequate management support, education, continued training, and the internal motivation of nurses to achieve transformative health outcomes in the community.

How to Integrate Palliative Care Into Primary Health Care

Integration of Palliative Care into Primary Health Care will have a substantial amount of positive impact on Health Care in Nakuru County,Kenya.Consequently,all aspects of Palliative Care should be given to more than 2/3 population that suffer from cancers and chronic illnesses which sometimes overflow to some acute conditions.While Palliative Care focuses on Holistic Care encompassing physical,psychological,social,and spiritual aspects to adults and children,Primary Health Care operates on the principles of equity,solidarity,universal access to services,multisectoral action,social justice,centralization,and community participation.Thus,there are similarities in Palliative Care and Primary Health Care putting into consideration that the latter is based on practical,scientifically sound and socially accepted methods and technology.It is affordable,universally accessible to individuals and families in the community.Universal Health Coverage ensures that all people and communities have access to promotive,preventive,curative,rehabilitative,and palliative health services they need,of sufficient quality to be effective while also ensuring that the use of these services does not expose the users to financial hardships.The 60%of the Nakuru County population are in need of Palliative Care services,but only about 20%access these services.They suffer from cancers,non-communicable diseases,dementia,and frailty.Geographical challenges,staff shortages,and lack of Palliative Care knowledge are the main barriers to provision of care.

Prenatal of Pregnant Adolescents Performed by Nurses in Primary Health Care

This study aims to identify the actions performed by nurses of the Family Health Strategy with the pregnancy cycle of adolescents and analyze if the actions developed by these nurses are focused on risk prevention in pregnancy and childbirth. It is a qualitative and exploratory research in basic health units with 12 nurses. A semi-structured interview technique was applied, and the speeches were analyzed using content analysis. In the analysis of the results, it was identified two thematic categories in which it was noted that nurses during the prenatal make the reception of pregnant adolescents differently and conduct guidelines on examination, signs and symptoms of possible complications during the pregnancy and still emphasize the importance of educational activities as groups of pregnant women to be a chance of coexistence and exchange of experiences, doubts, and anxieties among themselves. It is concluded that the care provided by nurses is fundamental for the pregnant adolescents having prenatal with more quality.

Assessment of the Accessibility of Users in Primary Health Care

Objectives: The goal of this project was to evaluate the quality of the accessibility of the adult population to services in Primary Health Care, with a view to contribute to the development of measures that will propose improvement in the offered assistance. Methods: This is a quantitative and evaluative study made in the municipality of Santa Cruz, State of Rio Grande do Norte, Brazil, with a sample of 180 people. The study was approved by the Ethics and Research Committee of the Federal University of Rio Grande do Norte under Opinion number 152/2012. Results: It was found that the adult population classified the quality of care from regular to good, showing an association with the waiting time, time spent from the unit to one’s house and the reception. Conclusions: It could be concluded that this study contributes to the development of strategies able to provide a full and equitable care to the adult population in the primary health care network, since this is the gateway to other levels of care, because it aims to promote adult health and prevent diseases.

High performing primary health care organizations from patient perspective:a qualitative study in China

Background There is a global call to build people-centred primary health care(PHC)systems.Previous evidence suggests that without organization-level reform efforts,the full potential of policy reforms may be limited.This study aimed to generate a profile of high performing PHC organizations from the perspective of patients.Methods We conducted semi-structured interviews with 58 PHC users from six provinces(Shandong,Zhejiang,Shaanxi,Henan,Shanxi,Heilongjiang)in China using purposive and snowball sampling techniques.Transcription was completed by trained research assistants through listening to the recordings of the interviews and summarizing them in English by 30-s segments to generate the narrative summary.Informed by the Classification System of PHC Organizational Attributes,thematic analysis aimed to identify domains and attributes of high performing PHC organizations.Results A profile of a high performing PHC organization with five domains and 14 attributes was generated.The five domains included:(1)organizational resources including medical equipment,human and information resource;(2)service provision and clinical practice including practice scope,internal integration and external integration;(3)general features including location,environment and ownership;(4)quality and cost;and(5)organizational structure including continuous learning mechanism,administrative structure and governance.Conclusions A five-domain profile of high performing PHC organizations from the perspective of Chinese PHC users was generated.Organizational resources,service delivery and clinical practices were most valued by the participants.Meanwhile,the participants also had strong expectation of geographical accessibility,high quality of care as well as efficient organizational structure.These organizational elements should be reflected in further reform efforts in order to build high performing PHC organizations.

Factors affecting access to primary health care services for persons with disabilities in rural areas:a“best-fit”framework synthesis

Background:Access to primary health care(PHC)is a fundamental human right and central in the performance of health care systems,however persons with disabilities(PWDs)generally experience greater barriers in accessing PHC than the general population.These problems are further exacerbated for those with disabilities in rural areas.Understanding PHC access for PWDs is particularly important as such knowledge can inform policies,clinical practice and future research in rural settings.Methods:We conducted a synthesis of published literature to explore the factors affecting access to PHC for PWDs in rural areas globally.Using an adapted keyword search string we searched five databases(CINAHL,EMBASE,Global Health,Medline and Web of Science),key journals and the reference lists of included articles.We imported the articles into NVivo and conducted deductive(framework)analysis by charting the data into a rural PHC access framework.We subsequently conducted inductive(thematic)analysis.Results:We identified 36 studies that met our inclusion criteria.A majority(n=26)of the studies were conducted in low-and middle-income countries.We found that PWDs were unable to access PHC due to obstacles including the interplay of four major factors;availability,acceptability,geography and affordability.In particular,limited availability of health care facilities and services and perceived low quality of care meant that those in need of health care services frequently had to travel for care.The barrier of geographic distance was worsened by transportation problems.We also observed that where health services were available most people could not afford the cost.Conclusion:Our synthesis noted that modifying the access framework to incorporate relationships among the barriers might help better conceptualize PHC access challenges and opportunities in rural settings.We also made recommendations for policy development,practice consideration and future research that could lead to more equitable access to health care.Importantly,there is the need for health policies that aim address rural health problems to consider all the dimensions and their interactions.In terms of practice,the review also highlights the need to provide in-service training to health care providers on how to enhance their communication skills with PWDs.Future research should focus on exploring access in geographical contexts with different health care systems,the perspectives of health care providers and how PWDs respond to access problems in rural settings.

Delivery of public health services by community health workers(CHWs)in primary health care settings in China:a systematic review(1996–2016)

Background:Community Health Workers(CHWs)have been widely used in response to the shortage of skilled health workers especially in resource limited areas.China has a long history of involving CHWs in public health intervention project.CHWs in China called village doctors who have both treatment and public health responsibilities.This systematic review aimed to identify the types of public health services provided by CHWs and summarized potential barriers and facilitating factors in the delivery of these services.Methods:We searched studies published in Chinese or English,on Medline,PubMed,Cochrane,Google Scholar,and CNKI for public health services delivered by CHWs in China,during 1996-2016.The role of CHWs,training for CHWs,challenges,and facilitating factors were extracted from reviewed studies.Results:Guided by National Basic Public Health Service Standards,services provided by CHW covered five major areas of noncommunicable diseases(NCDs)including diabetes and/or hypertension,cancer,mental health,cardiovascular diseases,and common NCD risk factors,as well as general services including reproductive health,tuberculosis,child health,vaccination,and other services.Not many studies investigated the barriers and facilitating factors of their programs,and none reported cost-effectiveness of the intervention.Barriers challenging the sustainability of the CHWs led projects were transportation,nature of official support,quantity and quality of CHWs,training of CHWs,incentives for CHWs,and maintaining a good rapport between CHWs and target population.Facilitating factors included positive official support,integration with the existing health system,financial support,considering CHW’s perspectives,and technology support.Conclusion:CHWs appear to frequently engage in implementing diverse public health intervention programs in China.Facilitators and barriers identified are comparable to those identified in high income countries.Future CHWs-led programs should consider incorporating the common barriers and facilitators identified in the current study to maximize the benefits of these programs.

Assessment of Comprehensive Health Care of the Elderly in Primary Health Care

Objective: To assess comprehensive care in the elderly population, as well as the quality of care in Primary Health Care. Methods: This is an exploratory descriptive study with a quantitative approach, conducted from July to December 2012, in the city of Santa Cruz, Rio Grande do Norte, Brazil. A sample of 130 subjects chosen by drawn was calculated, and data collection was performed at their homes. Results: There were interviewed 130 people, 92 (70.8%) women and 38 men (29.2%), with a minimum age of 60 and maximum of 96 years, with a mean of 72.8, median of 72.0 and a standard deviation of 8.3. Regarding the quality of care ratings of the PHC team, 48.5% (n = 63) of respondents stated this to be good, while 32.3% (n = 42) rated this as fair. Conclusions: In this perspective, one of the most appreciated meanings that were given to comprehensive care by health care professionals refers to holistic knowledge of each patient, resulting in the non-fragmentation of care. Thus, it is noticed that comprehensiveness has some weaknesses that need to be corrected, which shows the need for education and training of professionals assigned to primary health care services.

Lifestyle, Biological Risk Markers, Morbidity and Mortality in a Cohort of Men 33 - 42 Years Old at Baseline, after 24-Year Follow-Up of a Primary Health Care Intervention

Objective: To study changes in lifestyle and biological risk markers in a 24-year follow-up study, and occurrences of cardiovascular diseases (CVD), cancer and total mortality from official registers. Design: A 24-year follow-up survey and register study of a cohort of men 33 - 42 years old, examined with a health profile at baseline. With the health profile based on lifestyle, biological risk markers, self-rated mental stress and mental health, the men were separated in different risk groups. Setting: Primary health care center of Habo in Sweden. Subjects: All 757 men, 33 - 42 years old, and living in the community of Habo in Sweden in 1985. Main Outcome Measures: Lifestyle, biological risk markers, morbidity from CVD and cancer, and total mortality. Results: Smoking and physical activity decreased during follow-up time while alcohol consumption increased. Biological risk markers, except diastolic blood pressure, deteriorated significantly with age. Based on three- lifestyle groups, 16 % of the men had a more favorable lifestyle and 19% had a less favorable life-style at follow-up compared with baseline. The men, who had been classified as high-risk, based on the health profile at baseline, had a significantly higher incidence of CVD and cancer in the register study compared to men in a low-risk group. The baseline non-participant group had a significantly higher incidence of CVD and a higher mortality compared to the low-risk group. Conclusion: A health profile with a combination of lifestyle factors and biological risk markers can already at the age of 33 - 42 years predict incidence of CVD and cancer on group level among men after 24 years.

Strengthening the primary health care for non-communicable disease prevention and control in the post-pandemic period:a perspective from China

Non-communicable diseases(NCDs)have become the leading cause of deaths in China and many other countries worldwide.To call for actions in strengthening primary health care(PHC)and accelerate NCD prevention and control in the post-pandemic era in China,the 2023 Duke Kunshan Health Forum focused on innovative approaches and lessons learned during the pandemic that can be applied in addressing NCD challenges.In this article we summarize key points discussed by the participants in three areas:PHC as the foundation and ultimate solution for NCD prevention and control,post-pandemic opportunities to accelerate the NCD program with innovative approaches,and an action framework proposed by the Forum collaborators to address remaining challenges and achieve NCD control objectives in China.The core of the suggested action framework is to offer people-centered,lifetime,comprehensive,continued,and quality NCD prevention and control services,which rely on an integrated healthcare system connecting the primary,secondary,and tertiary levels of care.To achive this objective,six interconnected actions are recommended in the framework:prioritizing and integrating NCD in PHC and Universal Health Coverage(UHC)framework,engaging multiple stakeholders,directing resources to PHC for quality NCD services,leveraging advantages of new technology,encouraging the use of PHC and improving services,and strengthening best practice sharing.

Primary health care in China:A decade of development after the 2009 health care reform

Over 40 years ago,primary health care(PHC)was defined in the Alma-Ata Declaration as a critical component of the health care system to address the basic health demand of the people.In China,the Government attaches great importance to health care at the primary level.After the launch of the historical Reform of the Medical and Health Care System in 2009,the PHC system in China has witnessed major progress and breakthroughs,especially in its steadily increased capacity,continuously improved accessibility,and betterment in equality.In this review,we summarized published literatures and official policies,synthesized data from the electronic registration information system of the National Health Commission,national statistical reports,and yearbooks in health care.The review is intended to describe the systematic development of PHC in China in the last decade.The main results include:the solid national policy foundation,increasing number of PHC institutions and workforce,better training of PHC professionals,major achievements in primary health indicators,government financial support to PHC institutions,improved PHC budgeting and insurance coverage,and the advancement of supporting technologies.Challenges and prospects are also discussed.

Importance of Primary Health Care in Medicine: Simultaneous Analysis of Two Colleges, under the Vision of Teachers and Students

Introduction: The involvement of undergraduate student at the beginning of their training in activities based on Primary Health Care (PHC), provides preventive and health promoting actions, and ensures the evaluation of the vulnerability of communities and people. Objectives: To analyze the opinion of students and teachers of two medicine higher education institutions on the relevance of Primary Health Care in this course. METHODS: Students and teachers should be effectively enrolled in order for the study to be conducted, being chosen in a random manner and without interferences on the part of the researchers so that the work was as reliable as possible. A cross-sectional study was conducted with interviews structured in questionnaires about what they thought about PHC. To some students and teachers of the medical course of Valen?a and Grande Rio University (UNIGRANRIO). Before receiving the questionnaire, all interviewed signed a Free and Informed Consent Term, which included the objectives and methodology of the work. Results: 310 students and 51 teachers participated in the study, where 91.43% of the students and 100% of the teachers affirmed that primary care plays a fundamental role in medical education. 94.86% of students and 97.91% of teachers, claimed that the discipline allows a greater contact between undergraduates and community. When questioned about the encouragement that teachers give to students to pursue a career in PHC, 57.87% of the students and 70.83% of the professors said they lacked in such a stimulus. Conclusion: PHC is still very neglected by governmental policies, educational institutions and by the own teachers, that often, turn they attention only to tertiary medicine and, as a consequence, a discouragement of this area occur. Therefore, a higher PHC value is necessary, allowing a more humane look at the patient, valuing their feelings, anguishes and their pathological framework.

Building quality primary health care development in the new era towards universal health coverage:a Beijing initiative

Primary health care(PHC)is the most effective way to improve people’s health and well-being,and primary care services should act as the cornerstone of a resilient health system and the foundation of universal health coverage.To promote high quality development of PHC,an International Symposium on Quality Primary Health Care Development was held on December 4-5,2023 in Beijing,China,and the participants have proposed and advocated the Beijing Initiative on Quality Primary Health Care Development.The Beijing Initiative calls on all countries to carry out and strengthen 11 actions:fulfill political commitment and accountability;achieve“health in all policies”through multisectoral coordination;establish sustainable financing;empower communities and individuals;provide community-based integrated care;promote the connection and integration of health services and social services through good governance;enhance training,allocation and motivation of health workforce,and medical education;expand application of traditional and alternative medicine for disease prevention and illness healing;empower PHC with digital technology;ensure access to medicinal products and appropriate technologies;and last,strengthen global partnership and international health cooperation.The Initiative will enrich the content of quality development of PHC,build consensus,and put forward policies for quality development of PHC in China in the new era,which are expected to make contributions in accelerating global actions.

Exploration on the Implementation of the Integration of Medical and Preventive Model in China’s Primary Health Care Institutions

Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.

Modelling geographic accessibility to Primary Health Care Facilities:combining open data and geospatial analysis

Ensuring healthy lives and promoting well-being for all ages is the 3rd Sustainable Development Goal(SDG).Inequality in access to health care remains one of the primary challenges in achieving the goal.With the ever-increasing expansion of urban areas and population growth,there is a need to regularly examine the pattern of accessibility of basic amenities across regions,States and urban areas.This study examined geographic access to Primary Health Care Facilities(PHCF)in Nigeria using the combination of open data and geospatial analysis techniques.Thus,showcasing an approach can be replicated across different regions in Sub-Saharan Africa due to issues of information gap.Data on elevation,location of health care facilities,population and network data were utilised.The result shows that PHCF aggregate at certain locations,e.g.major urban agglomerations,and transit route leading to these places.High concentrations are found in the capital city.The average travel time to the nearest PHCF is about 14 min(Standard Deviation±13.30 min)while the maximum is about 2 hours.Pockets of low accessibility areas exist across the Akwa Ibom State in the Niger Delta region of Nigeria.There is an indication that most places have good geographic access.Across the 1787 settlements identified in our dataset,98.3%are with good access(<30 min),27 settlements are located in the poor access class(31–60 min),while two settlements are within the very poor access class(>60 min).Geographic access is not the main limiting factor to health care access in the region.Therefore,computation of access to health care should take into consideration other dimensions of accessibility,to create a robust measure which will support effective and efficient health care planning and delivery.