RECEPTIVITY OF PREGNANT WOMEN IN LAGOS STATE TO COMMUNICATION CAMPAIGN MESSAGES ON ADOPTION OF INSECTICIDE TREATED NETS FOR MALARIA PREVENTION BY AMOBI THERESA IFEOMA MATRIC NO: 839009031 B.A. (HONS) Mass Comm., (UNN); MPA (UNILAG); M. Sc. Mass Comm., (UNILAG) Department of Mass Communication, School of Postgraduate Studies, University of Lagos, Lagos, Nigeria March, 2012 1 2 RECEPTIVITY OF PREGNANT WOMEN IN LAGOS STATE TO COMMUNICATION CAMPAIGN MESSAGES ON ADOPTION OF INSECTICIDE TREATED NETS FOR MALARIA PREVENTION BY AMOBI THERESA IFEOMA MATRIC NO: 839009031 B.A. (HONS) Mass Comm., (UNN); MPA (UNILAG); M. Sc. Mass Comm., (UNILAG) Department of Mass Communication, University of Lagos, Lagos, Nigeria THESIS SUBMITTED TO THE SCHOOL OF POSTGRADUATE STUDIES, UNIVERSITY OF LAGOS, IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF DOCTOR OF PHILOSOPHY (Ph.D.) IN MASS COMMUNICATION MARCH, 2012 3 DECLARATION I, Theresa Ifeoma Amobi, declare that this Ph.D. thesis was originally written by me, and that to the best of my knowledge, this research has not been submitted to any other school or university for any other degree. I also declare that both published and unpublished materials used in this study are appropriately acknowledged. Name: Theresa Ifeoma Amobi Signature....................................................................... Date: 4 CERTIFICATION 5 TABLE OF CONTENTS Content Page First title page i Second title page ii Declaration iii Certification iv Table of contents v List of Acronyms vii List of tables/figures viii List of appendices x Dedication xi Acknowledgments xii Abstract xv CHAPTER ONE: INTRODUCTION Background to the study 1 Statement of the problem 11 Aims and Objectives 14 Research questions 14 Significance of the study 15 Scope of the study 16 Operational definition of terms 17 References 20 CHAPTER TWO: LITERATURE REVIEW Introduction 25 Conceptual framework 25 Review of empirical studies 45 Theoretical framework 53 6 References 77 CHAPTER THREE: METHODOLOGY Introduction 92 Research design 92 Population of study 95 Sample selection and techniques 95 Research instruments 107 Validity of survey research instrument 108 Procedure for data collection 109 Limitations of the study 111 References 112 CHAPTER FOUR: DATA ANALYSIS AND RESULT PRESENTATION Introduction 114 References 133 CHAPTER FIVE: SUMMARY AND DISCUSSIONS OF FINDINGS Introduction 135 References 149 CHAPTER SIX: CONCLUSIONS, RECOMMENDATIONS CONTRIBUTIONS TO KNOWLEDGE AND SUGGESTIONS FOR FURTHER STUDIES Conclusion 151 Recommendations 152 Contributions to knowledge 153 Suggestions for future research 155 Bibliography 156 Appendices 173 7 LIST OF ACRONYMS ITN------------------------------------------------------Insecticide Treated Net RBM----------------------------------------------------Roll Back Malaria FMOH-------------------------------------------------Federal Ministry of Health WHO--------------------------------------------------World Health Organization UNICEF--------------------------United Nation’s Children’s Education Fund NDHS--------------------------------------Nigeria Demographic Health Survey NMCP-----------------------------------National Malaria Control Programme CFSC------------------------------Communication For Social Change Theory NMIS------------------------------------------Nigeria Malaria Indicator Survey CDC-------------------------U.S. Centres for Disease Control and Prevention IMPAC------------------------Massive Promotion and Awareness Campaign FBOs---------------------------------------------------- Faith based organizations MDGs--------------------------------------------Millennium Development Goals UNDP--------------------------------United Nations Development Programme NGOs------------------------------------------Non Governmental Organizations SES------------------------------------------------------------Socioeconomic Status IEC--------------------------------Information, education and communication 8 LGAs-----------------------------------------------------Local Government Areas FGD--------------------------------------------------------Focus Group Discussion INEC-----------------------------Independent National Electoral Commission NPC---------------------------------------------National Population Commission LIST OF TABLES/FIGURES Table Title Page 1 Reported malaria in pregnancy cases in Lagos state 2 2 ITN coverage from household surveys, 2007-2009 7 3 The 16 Local Government Areas in Lagos Metropolis (Urban) 105 4 4 Local Government Areas in rural Lagos 105 5 Focus Group Participants 110 6 Distribution of respondents by education 115 7 Distribution of respondents by income 115 8 Respondents’ exposure to health/ITN messages in the mass media 117 9 Respondents’ first source of information on the adoption of ITNs 118 10 Most frequently used persons, institutions or places by respondents as 121 their source of information on ITNs 11 Basic Knowledge/Awareness of the deadly nature of Malaria and ITN 122 12 Respondents’ perceived attitudes to Malaria and ITN related issues 123 13 Household ownership and respondents who were sleeping under ITN 124 14 Respondents’ frequency of sleeping under the ITN 124 15 Percentage of respondents who slept under the ITN the night before 125 16 Persons, places, things, institutions that influenced respondents’ 126 responses to ITN messages 17 Persons, things, institutions or places that influenced respondents’ 126 decision most to sleep under ITNs 18 Respondents’ who use ITNs because their friends or relatives are using 126 them 19 Relationship between geographical location and sleeping under ITNs by 127 9 respondents 20 Relationship between geographical location and respondents’ frequency 127 of sleeping under ITNs 21 Relationship between respondents’ academic attainment and their 128 sleeping under ITNs 22 Relationship between respondents’ academic attainment and their 128 frequency of sleeping under ITNs 23 Relationship between respondents’ income and their sleeping under the 129 ITNs 24 Relationship between respondents’ income and their frequency of 129 sleeping under the ITNs 25 Barriers to pregnant women’s receptivity of communication messages 130 on the adoption of ITNs 26 Matrix of responses from FGD Sessions with respondents 131 LIST OF FIGURES S/N Figures Page 1 Lasswell’s Linear Model of Communication 27 2 Integrated Model of Communication for Social Change 69 3 Modified Integrated Model, 2011 73 4 Map of Lagos 106 5 Respondents’ major source of information on ITN 119 6 M ass media of information most frequently used by respondents as 120 major source of information on ITN 10 LIST OF APPENDICES S/N Title Page 1a Sample Malaria/ITN Billboard Message 173 1b Sample Malaria/ITN Billboard message2 174 1c Sample RBM Television message 175 2a List of government hospitals in the five selected LGAs 176 2b List of private hospitals and maternity homes in the selected five LGAs in Lagos State 177 3a Questionnaire for pregnant women in selected LGAs 192 3b Focus Group Interview Schedule for pregnant women 202 3c Interview Schedule for Communication/Health Officials 204 11 4a Full text of interview with UNICEF Communication officer 205 4b Full text of interview with Matron, NAF Hospital, Shasha 208 4c Full text of interview with Commander, NAF Hospital, Shasha 211 4d Full text of interview with Communications officer, RBM Secretariat, FMOH, Abuja 213 DEDICATION Who is like unto thee oh Lord? From generation, to generation, thou art God. To you Alpha and Omega, the author and finisher of my faith, the- I am that I am, I dedicate this study. But for you, this study would have remained a largely unfulfilled dream. To my Lord and Saviour, Jesus Christ, the King of Kings and Lord of the universe may your name be praised, honoured and glorified for all eternity. Papa, I say thank you and to you the most holy Trinity, the three persons in one God, I dedicate this work. I also dedicate this work to the most loving and unforgettable memory of my father, Chief, (Sir) S. M. Ebuzeme (Ichie Odumegwu 1 and Traditional Prime Minister of Oba, Anambra State). Papa, my greatest and indescribable pain and regret is your absence at this auspicious time to 12 share the fulfilment of the dream which you initiated. In heaven where I know that you are papa, with my most beloved son Eric Gerard and brother George, I am proud to say to you that I finally made it and to thank you both for being my father and my son. Papa, I would never have wished for another and if there is another life, may you still remain my father. 13 ACKNOWLEDGEMENTS First and foremost, I acknowledge the Almighty God who has been my strength and shield over these years. He provided me with the knowledge, wisdom, good health and understanding as well as the resources to accomplish this task. Words alone cannot describe the depth of my gratitude, respect and admiration for my supervisor, Prof. Ralph Akinfeleye, the foremost professor of Journalism in Nigeria, a communicator of international repute, who God in his infinite wisdom has crowned the Chair and Head of the Department of Mass communication, University of Lagos. I appreciate his intellectual and meticulous guidance, criticisms, and direction at every stage of this work. I thank him for his utmost confidence in my abilities, and his encouragement and reassurances in the face of trials. I am also indebted to Dr. Victor Ayedun-Aluma my second reader, for his intellectual insights and erudite suggestions which enhanced the quality of the work. I appreciate Dr. Oloruntola