Determinants of Health Education Programme Effectiveness in Rural Primary Healthcare Centres in North Central Nigeria: A Mixed Methods Analysis

Understanding the determinants of health education programme effectiveness in primary healthcare settings is critical for optimising public health interventions in underserved regions. This study employed a mixed methods sequential explanatory design to analyse the determinants of health education programme effectiveness in rural primary healthcare centres across North Central Nigeria, focusing on Benue, Kogi, and Plateau states. A structured questionnaire was administered to 310 health workers and community members, followed by qualitative interviews with 24 purposively selected health educators and local government health officers. Quantitative data were analysed using binary logistic regression, while qualitative data were subjected to thematic analysis. Results indicated that programme effectiveness was significantly determined by the frequency of health education sessions (odds ratio 3.2), availability of appropriate health education materials (odds ratio 2.7), and community involvement in programme design (odds ratio 2.5). Qualitative themes highlighted systemic constraints including staff shortages, inadequate supervision, and community apathy as key deterrents. Programmes integrating community health extension workers as co-facilitators yielded more sustained behavioural outcomes. The study recommends a multi-level framework for health education programme management in rural settings, emphasising community co-ownership, regular supervision, and contextualised communication strategies. Keywords: health education programme, effectiveness, rural primary healthcare, North Central Nigeria, mixed methods