Integrating Health Promotion and Disease Prevention Into Community Practice: A Comprehensive Review of the Evolving Role of Community Health Practitioners in Nigeria
Chapter One
OBJECTIVE OF THE STUDY
The objective of this study is to examine the evolving role of community health practitioners (CHPs) in integrating health promotion and disease prevention into community practice in Nigeria.
Specific Objectives
The study specifically seeks to:
- Assess the extent to which community health practitioners currently integrate health promotion and disease prevention into their routine practice in Nigeria.
- Identify the key health promotion and disease prevention strategies being implemented at the community level by CHPs.
- Examine the challenges and barriers faced by community health practitioners in carrying out preventive and promotive health services.
- Analyze the policy frameworks and institutional supports (e.g., National Health Act, Task-Shifting Policy, CHIPS programme, IDSR strategy) that guide the roles of CHPs in Nigeria.
- Evaluate the impact of CHPs’ evolving role on improving access to preventive services, early disease detection, and overall community health outcomes.
CHAPTER TWO
REVIEW OF RELATED LITERATURE
Community Health Practitioners
Community Health Practitioners (CHPs) are frontline healthcare providers who play a critical role in bridging the gap between communities and formal health systems, particularly in resource-limited settings. They are trained health workers responsible for delivering essential preventive, promotive, curative, and rehabilitative services at the community level (World Health Organization [WHO], 2020). Their work is often focused on primary healthcare, health promotion, and disease prevention, making them indispensable in achieving universal health coverage (UHC).
According to the Community Health Practitioners Registration Board of Nigeria (CHPRBN), CHPs are mid-level healthcare professionals trained in community health programs to provide both preventive and basic curative services in rural and underserved communities (CHPRBN, 2021). They typically include cadres such as Community Health Officers (CHOs), Community Health Extension Workers (CHEWs), and Junior Community Health Extension Workers (JCHEWs), who operate within the framework of primary health care (PHC).
The concept of CHPs is rooted in the Alma-Ata Declaration of 1978, which emphasized primary health care as the cornerstone of achieving “Health for All.” The declaration recognized the importance of community-based health workers in ensuring equitable access to healthcare, particularly in rural and marginalized communities (WHO & UNICEF, 1978). Since then, CHPs have been regarded as the backbone of PHC delivery across developing nations, including Nigeria.
In Nigeria, the role of CHPs is particularly significant given the shortage of doctors and nurses, especially in rural areas. They provide essential maternal and child health services, immunizations, health education, disease surveillance, and referrals to higher levels of care (Adebayo et al., 2020). Their training equips them with both clinical and public health skills, allowing them to adapt to diverse community health challenges.
Beyond their clinical duties, CHPs also serve as health educators and advocates within their communities. They are positioned to foster behavioral change, promote hygiene and sanitation practices, and mobilize communities during health interventions such as vaccination campaigns or outbreak responses (Oladepo & Brieger, 2019).
Advertisements
CHAPTER THREE
METHODOLOGY
This chapter outlines the methodological approach adopted for the study titled Integrating Health Promotion and Disease Prevention into Community Practice: A Comprehensive Review of the Evolving Role of Community Health Practitioners in Nigeria. It describes the research design, sources of data, methods of data collection, inclusion and exclusion criteria, method of data analysis, validity and reliability, as well as ethical considerations.
Research design
The study adopted a systematic review research design. A systematic review design was considered appropriate because the study sought to synthesize existing scholarly works, policy documents, and empirical studies that discuss the integration of health promotion and disease prevention into community practice, with a specific focus on the role of Community Health Practitioners (CHPs) in Nigeria. Unlike primary data collection, a systematic review design enables the researcher to collate, evaluate, and summarize existing evidence to provide a comprehensive understanding of the research problem.
Population of the study
The population of the study comprised all published and unpublished materials related to health promotion, disease prevention, community health practice, and the role of CHPs in Nigeria. These materials included peer-reviewed journal articles, dissertations, books, government policy documents (such as the National Primary Health Care Development Agency guidelines and CHIPS programme documents), and reports by international organizations like the World Health Organization (WHO), UNICEF, and the Nigerian Ministry of Health.
CHAPTER FOUR
DATA PRESENTATION, ANALYSIS, AND DISCUSSION
This chapter presents the data collected in response to the research questions on the extent to which community health practitioners (CHPs) in Nigeria integrate health promotion and disease prevention into their community practice, and the specific strategies implemented at the community level. Data collected from structured questionnaires, interviews, and document reviews were analyzed using descriptive statistics and thematic interpretation. The findings are presented and discussed in line with the research questions.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
This study examined the integration of health promotion and disease prevention into community practice with a focus on the evolving role of Community Health Practitioners (CHPs) in Nigeria. The study was guided by two major research questions: (1) To what extent do community health practitioners in Nigeria integrate health promotion and disease prevention into their routine community practice? and (2) What specific health promotion and disease prevention strategies are currently being implemented by CHPs at the community level? The study adopted a review-based and descriptive design supported by empirical literature, theoretical insights, and policy frameworks relevant to Nigeria’s primary health care system.
The findings revealed that CHPs significantly contribute to the integration of health promotion and disease prevention in community practice, though the extent of this integration varies across regions due to disparities in resources, training, and institutional support. Evidence showed that CHPs engage in key activities such as health education, immunization campaigns, nutrition counselling, sanitation promotion, maternal and child health services, HIV/AIDS and malaria control programs, as well as Integrated Disease Surveillance and Response (IDSR) activities. These interventions align with the principles of Primary Health Care and have helped improve awareness, early disease detection, and uptake of preventive services in underserved communities.
However, the findings also indicated that several challenges impede the optimal performance of CHPs in Nigeria. These include limited financial and infrastructural resources, shortages of essential drugs and supplies, inadequate training and refresher courses, work overload due to task-shifting, poor supervision, and weak policy implementation at local government levels. In some rural areas, cultural and religious beliefs also constitute barriers to preventive practices, reducing the effectiveness of CHP-led health promotion efforts.
The review highlighted that Nigeria’s health policy frameworks, including the National Health Act (2014), the Task-Shifting and Task-Sharing Policy (2014), the Community Health Influencers, Promoters and Services (CHIPS) programme (2018), and the Integrated Disease Surveillance and Response (IDSR) strategy, provide institutional backing for CHPs to function as frontline providers of preventive and promotive health services. These policies have strengthened the role of CHPs by legitimizing their expanded responsibilities and enhancing community-level access to care. Nonetheless, the impact of these frameworks is often undermined by weak implementation, inadequate funding, and insufficient monitoring.
Conclusion
From the analysis, it can be concluded that the evolving role of CHPs is pivotal in improving health outcomes in Nigeria. Their contributions to health promotion and disease prevention have led to measurable improvements in immunization coverage, maternal and child health indices, community participation in health programs, and early disease outbreak detection. The integration of health promotion and disease prevention into community practice through CHPs therefore holds great potential for reducing the burden of preventable diseases and achieving Universal Health Coverage (UHC) in Nigeria.
Recommendation
Based on the findings, the following recommendations are made:
- Continuous training and refresher courses should be provided for CHPs to equip them with modern skills in health promotion, disease prevention, and emerging public health threats.
- Federal, state, and local governments should ensure adequate funding, provision of essential drugs, and infrastructural support to enable CHPs function effectively at the grassroots.
- The government should strengthen supervision mechanisms and ensure accountability to improve the quality of CHP-led health services.
- CHPs should be supported with tools and strategies to address socio-cultural and religious barriers that limit preventive health practices.
- Stronger political will is required to fully implement the National Health Act, Task-Shifting Policy, CHIPS programme, and IDSR strategy to maximize the impact of CHPs in community health.
- The use of mobile health (mHealth) tools should be expanded to support CHPs in disease surveillance, reporting, and health education at the community level.
REFERENCES
- Abimbola, S., et al. (2015). The National Health Act 2014 and Nigeria’s PHC system. Health Policy & Planning, 30(8), 1105–1112.
- Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.
- Damschroder, L., et al. (2009). A consolidated framework for advancing implementation science. Implement. Sci., 4, 50.
- Doctor, H. V., et al. (2020). Community-based strategies to reduce maternal/newborn mortality in Nigeria. Global Health: Science & Practice, 8(4), 617–629.
- Federal Ministry of Health (FMoH). (2014). Task-Shifting/Sharing Policy for Essential Health Services in Nigeria.
- Glasgow, R. E., et al. (1999; 2019). RE-AIM past and future. Am J Public Health, 89; Frontiers in Public Health, 7, 64.
- Gilson, L. (2003). Trust and the development of health care as a social institution. Social Science & Medicine, 56, 1453–1468.
- Green, L. W., & Kreuter, M. W. (2005). Health Program Planning: An Educational and Ecological Approach.
