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Community Involvement in Health Care Programmes in Umunze Orumba South Local Government Area Anambra State

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Community Involvement in Health Care Programmes in Umunze Orumba South Local Government Area Anambra State i COMMUNITY INVOLVEMENT IN HEALTH CARE PROGRAMMES IN UMUNZE ORUMBA SOUTH LOCAL GOVERNMENT AREA ANAMBRA STATE PROJECT REPORT SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE AWARD OF A MASTER OF EDUCATION DEGREE IN PUBLIC HEALTH EDUCATION OF THE UNIVERSITY OF NIGERIA, NSUKKA BY OKEREKE CHINYERE IJEOMA PG/MED/SD/04/35227 JULY, 2011 ii Title Page Community Involvement in Health Care Programmes in Umunze Orumba South Local Government Area Anambra State A Project Report Submitted to the Department of Health and Physical Education, University of Nigeria, Nsukka in Partial Fulfillment of the Requirements for the Award of A Master of Education Degree in Public Health Education By Okereke Chinyere Ijeoma Pg/Med/Sd/04/35227 July, 2011 iii iv Certification Okereke, Chinyere Ijeoma, a post graduate student in the Department of Health and Physical Education, with Registration Number PG/MED/SD/04/35227, has completed the requirements for course and research work for the degree of M.Ed in Health Education. ............................................. ………………… Okereke, Chinyere Ijeoma Prof. Chuks Ezedum Candidate Supervisor …………………. …. ……………………… Date Date v Dedication I dedicate this project to our Almighty God, my darling husband Mr. Daniel Okeke, my beloved father Mr. Abel Okereke, my late Mother Mrs. Eunice Okereke, My Son Nwachukwu Fidelis Okeke and my loving brother Basil Okereke Onyebuchi vi Acknowledgements I wish to acknowledge with deep sense of appreciation and gratitude to all the people who in one way or the other contributed to the success of this project. Firstly, my profound gratitude goes to Prof Chuks Ezedum my project supervisor, for his patience, counsel, constructive, criticisms, advice, corrections and suggestions which made this work a reality. Also, I would like to thank the entire members of Umunze communities for their contributions towards completion of this study. I would like to particularly acknowledge the assistance of three people Prof Umeakuka, Tr. Prof. E.S. Samuel, and Mr Alex Okoli who encouraged me and provided useful pieces of advice all through. I also wish to thank members of my family especially my son Nwachukwu Fidelis Okeke for his love and concern, and also to my brother in-law Ernest Okeke and his family, my brother Basil Okereke and my sisters Udoka Okoye and her family, phoebe Nnabude and her family, Nikky Okereke and my relations who through their encouragement enable me to produce this piece of work. My thanks also go to my follewing friends Ogonna and Cecilia, for their moral support and encouragement. I also express my thanks to the whole HPE lecturers, staff and students. This will be incomplete if I do not acknowledge effort of my beloved husband Mr. Daniel Okeke S. who played an active part in my admission, management of the home, and finance. I appreciate all his support and that of my son Nwagod and the other members of my family Mmesoma, Temple and Gideon. Finally, I would like to express my utmost thanks to the Almighty God for His infinite mercy health, grace and love to complete this project. I am grateful. Thanks you all. vii Table of Contents Title Page ii Approval Page iii Certification iv Dedication v Acknowledgements vi Table of Contents vii List of Tables ix Abstract x CHAPTER ONE: Introduction 1 Background to the study 1 Statement of the Problem 6 Purpose of the Study 7 Research Questions 7 Research Hypotheses 8 Significance of the Study 8 Scope of the Study 9 CHAPTER TWO: Review of Related Literature 10 Conceptual Framework 10 Primary health care (PHC) 11 Community participation 12 Community involvement in health (CIH) development 13 Mechanisms of promoting community involvement in health care services 17 Socio-cultural factors affecting community involvement in health 19 Demographic factors associated with CIH programmes provision and utilization 20 Theoretical Framework 21 The top down model 21 Alternative development model 21 Urban development model 22 Integrated rural development mode 23 Empirical Studies on Community Involvement in Health care Programme 23 Summary of Literature Review 27 CHAPTER THREE: Methods 29 Research Design 29 Area of Study 29 Population for the Study 29 Sample and Sampling Techniques 29 Instrument for Data Collection 30 Validity of the instrument 30 Reliability of the instrument 31 Method of Data Collection 31 Method of Data Analysis 31 CHAPTER FOUR: Results and Discussions 33 Results 33 Summary of Major Findings 52 Discussion 54 Extent of community involvement in preventive, promotive and viii curative health programmes in Umunze 54 Reasons behind the extent of community involvement in health 56 Agencies behind community involvement in health programmes in Umunze 56 Age/Gender differentials in community involvement in health programmes in Umunze community. 57 Relative involvement of the various Umunze Village in health programmes 57 CHAPTER FIVE: Summary, Conclusions and Recommendations 58 Summary, 58 Conclusions 59 Recommendations 60 Suggestions for Further Studies 60 Limitations of the Study 60 References 61 Appendix I: The Questionnaire 66 Appendix II: Key Informants Interview (KII) Schedule 71 ix List of Tables Tables 1. Mean Ratings of Umunze Community on Extent of Involvement in Preventive Health Programmes in Umunze 2. Mean Rating of Umunze Community on Extent of Involvement In Promotive Health Programmes in Umunze 3. Means Ratings of Umunze Community on Extent of Involvement in Curative Health Programmes in Umunze 4. Percentage Distribution of Respondents on Community Involvement on Reasons Behind Community Involvement in Health Programme in Umunze 5. Percentage Distribution of Responses on Agencies / Agents Behind Community Involvement in Health Programme in Umunze 6. Gender Differentials in Preventive Health Programmes in Umunze 7. Gender Differentials in Promotive Health Programmes in Umunze 8. Gender Differentials in Curative Health Programmes in Umunze 9. Age Differentials in Community Involvement in Preventive Health Programmes in Umunze 10. Age Differentials in Community Involvement in Promotive Health Programmes in Umunze 11. Age Differentials in Community Involvement in Curative Health Programmes in Umunze 12. Relative Involvement of Umunze Villages in Preventive Health Programmes 13. Relative Involvement of Umunze Villages in Promotive Health Programmes 14. Relative Involvement of Umunze Villages in Curative Health Programmes 15. T-test of difference between male and female community involvement in health programmes 16. F-ratio of difference in community involvement in health according to Age. 17. F- ratio Relative Involvement of Umunze Villages in Community Health Programmes x Abstract This work investigated Community Involvement in Health Care (CIH) programmes in Umunze, Orumba South Local Government Area of Anambra State. The study specifically verified the extent of involvement of the community in preventive, promotive and curative components of health programme; reasons behind the extent of community involvement in health programmes, community agencies behind community involvement in health programmes; gender and age differences in community involvement in health programmes; community agencies behind community involvement in health programmes; and relative involvement of the various villages in Umunze in health programmes. The population for study comprised twenty-two health workers and 37409 adult members of the population in Umunze. A cross-sectional survey design was employed in the study. A sample of 300 adults (comprising 150 males and 150 females) was used in the study. Data were collected using structured questionnaire and key informants interview. The mean (x), standard deviation, t-test and analysis of variance (ANOVA) were used for data analysis. Results showed that the community involvement in the various components of health programmes varied: The community was involved in preventive health to a great extend; promotive health to a little extent; and curative health programme to a very great extent. The results also revealed, among others, that several reasons were behind community involvement in health programmes such as availability of qualified health personnel, awareness of health needs, presence of female caregiver. The hypotheses tested at.05 level of significance showed that there was significant difference in the extent of community involvement in health programmes according to gender, age and villages. Females were more involved than males in preventive and curative health programmes. The age brackets 18 – 25 and 46 – 55 were more involved than others in curative health. Among the villages, Ugwuano and Amuda villages led in the various health programmes. The need for the use of local and modern media to promote greater community involvement in promotive health; and greater empowerment of women and certain age groups for greater participation in matters concerning health programmes, were recommended. xi CHAPTER ONE Introduction Background to the Study Good health is basic to human welfare and a fundamental objective of social and economic development (Ukwu, 1993). It is not by accident therefore that three of the eight Millennium Development Goals (MDGs) adopted by world leaders in September 2000 are on health. These are to reduce child mortality (MDG-4); improve maternal health (MDG-5) and combat HIV/AIDS, malaria and other diseases (MDG- 6). Nigeria is signatory to this pledge targeted for achievement before 2015. While government and donor agencies are stepping up efforts to strengthen
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