Effectiveness of Global Fund C19RM-RSSH Communication Strategies in Strengthening Primary Healthcare Centres in Anambra State, Nigeria
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Abstract
Primary Health Centres (PHCs) are vital to achieving universal health coverage in Nigeria, yet their operations remain constrained by infrastructural deficits, resource shortages and weak community engagement. This study evaluated the effectiveness of communication strategies deployed under the Global Fund COVID-19 Response Mechanism–Resilient and Sustainable Systems for Health (C19RM-RSSH) project in strengthening selected PHCs across Anambra State, Nigeria. Anchored in Rogers’ Diffusion of Innovations Theory, the study adopted a mixed-methods research design. Quantitative data were collected through structured questionnaires administered to 376 randomly sampled adults across five local government areas, yielding a 94.0% response rate, while qualitative data comprised 13 in-depth interviews with key stakeholders and direct facility observations. Quantitative data were analysed using descriptive statistics, while qualitative data were subjected to descriptive content analysis. Findings revealed that approximately 66% of respondents perceived improvements in facility staffing, drug availability and physical infrastructure. Furthermore, the communication strategies fostered strong community ownership and participation, with positive consensus ranging from 79.5% to 84.3%, driven by institutionalised leadership structures such as Ward Development Committees, community-based organisations and traditional leaders acting as trusted change agents. Public satisfaction with healthcare quality was similarly high, ranging from 64.1% to 82.7%, particularly in relation to maternal and child care, waiting times and staff behaviour. The study concludes that multi-channel health communication serves as an important catalyst for community mobilisation and service uptake. However, communication alone cannot fully overcome systemic supply-side deficits. Strategic health communication should therefore be institutionalised alongside sustained investments in clinical infrastructure, staffing and operational logistics.
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