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Impact of Health Information Ambassadors on Awareness of Available Primary Healthcare Services among Rural Residents in Nigeria

Abstract

Awareness of available primary healthcare services is essential for appropriate healthcare utilization, disease prevention, early treatment, and improved community health outcomes. Rural residents in Nigeria may have limited knowledge of the primary healthcare services available within or near their communities because of inadequate health information, geographical barriers, low health literacy, language differences, cultural beliefs, and limited interaction with healthcare providers. Health information ambassadors, comprising trained community members or health communication volunteers, can serve as a link between primary healthcare facilities and rural residents by providing information about available services, explaining how and when to access them, addressing misconceptions, and directing community members to appropriate healthcare facilities. Against this background, this study investigates the impact of health information ambassadors on awareness of available primary healthcare services among rural residents in Nigeria. The study will be anchored on the Health Literacy Framework, Social Ecological Model, and Social Cognitive Theory. The Health Literacy Framework emphasizes residents' ability to access, understand, evaluate, and apply information about available primary healthcare services. The Social Ecological Model recognizes the influence of individual, interpersonal, community, organizational, and environmental factors on access to healthcare information and service utilization. Social Cognitive Theory explains how observational learning, social interaction, reinforcement, self-efficacy, and role modelling may influence residents' awareness and healthcare-related behaviour. Collectively, these theoretical perspectives provide a suitable framework for explaining how health information ambassadors may influence awareness of available primary healthcare services among rural residents in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adults aged 18 years and above residing in selected rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, rural communities, households, and eligible participants. Health information ambassador activities will be assessed using indicators such as number of active ambassadors, training received, frequency of community engagement, household visits, health talks, distribution of health information, referral guidance, use of local languages, communication channels, community mobilization activities, follow-up contacts, and collaboration with primary healthcare facilities. Awareness of available primary healthcare services will be assessed using indicators such as knowledge of immunization, maternal and child health services, family planning, antenatal and postnatal care, childhood illness management, malaria services, health screening, health education, treatment of common illnesses, infectious disease prevention, referral services, and other services available at primary healthcare centres. Data will be collected using structured questionnaires, healthcare-service awareness assessment tools, ambassador activity records, household visit registers, referral records, primary healthcare facility service directories, and relevant community health programme documents. Descriptive statistics will be used to summarize participants' characteristics, exposure to health information ambassadors, and awareness scores. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of health information ambassadors on awareness of available primary healthcare services. Where a quasi-experimental design is adopted, awareness scores before and after introduction of health information ambassadors may be compared with those of a comparison community to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that health information ambassadors have a significant positive impact on awareness of available primary healthcare services among rural residents in Nigeria. Residents who regularly interact with trained health information ambassadors are expected to demonstrate greater knowledge of available services, service locations, eligibility requirements, operating procedures, and appropriate healthcare-seeking pathways than residents without comparable exposure. Ambassadors may improve awareness by providing information in locally understood languages, using culturally appropriate communication methods, correcting misconceptions, distributing health materials, and directing residents to nearby primary healthcare facilities. Their presence within communities may also provide repeated opportunities for residents to ask questions and obtain clarification about available services. However, inadequate training, limited supervision, insufficient incentives, misinformation, communication barriers, poor referral linkages, and limited availability or quality of services at primary healthcare facilities may reduce their effectiveness. The study therefore expects adequately trained, supported, supervised, and community-accepted health information ambassadors to contribute significantly to improved awareness of available primary healthcare services among rural residents in Nigeria. The study is expected to contribute to the literature on health information ambassadors, primary healthcare awareness, community health communication, health literacy, rural healthcare, health promotion, community mobilization, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, local government health authorities, primary healthcare centres, community health workers, community leaders, development partners, and policymakers regarding strategies for improving awareness of primary healthcare services in rural communities. The study will also provide evidence-based recommendations for recruiting and training health information ambassadors, strengthening their supervision and referral linkages, using local-language communication, engaging community leaders, providing appropriate support and resources, and integrating health information ambassadors into routine primary healthcare and community health programmes across rural Nigeria.

Keywords: Health information ambassadors, primary healthcare services, health awareness, rural residents, health literacy, community health communication, healthcare utilization, community mobilization, primary healthcare, Nigeria, public health.