A COMPARATIVE STUDY ON HEALTH EDUCATION INTERVENTION ON MALARIA PREVENTION IN COMMUNITIES
Abstract
Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment, by teaching women to respond promptly when their children have fever, can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition, treatment and prevention among caregivers of children under five in Awka North in Anambra Nigeria. The study was a community based intervention study conducted in three stages: A preintervention stage, where 150 caregivers, were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The postintervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage.
Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6%) had adequate knowledge concerning malaria causation, transmission, prevention and treatment. Twenty eight (56%) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P = .012). Thirty-four (68%) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P < .001), knowledge (P < .001), malaria prevention practice (P = .001), first line treatment option (P = .031) and the type of treatment given to the children with fever (P = .048). Health education impacted positively caregivers’ knowledge of malaria and their willingness
CHAPTER ONE
INTRODUCTION
1.1. Background to the Study
Nigeria is a nation fill with vegetation and water bodies; this is usually pronounced in the eastern and the southern part of the country. This is usually good for the people living in such environment in terms of agriculture and good weather condition; even with these advantages there are more disadvantages to this gift of nature.
Some of the disadvantages include diseases presented by most of the water bodies especially the stagnant ones. But for the purpose of this study we shall focus on malaria as one of the advantages faced by the inhabitants of this environment.
From the statistics of world health organization (WHO); it reads that malaria is mostly found throughout the tropical and sub-tropical regions of the world and this ugly disease has causes more than three hundred (300) to about five hundred (500) million acute illness. The study went further to state that more than one million deaths from this population are noticed annually.
The study states that about 30 to 40 percent of the world population is that are living in most of the poorest countries are liable to be infected with malaria parasite. The malaria parasite spread more far more than four times living with most deadly diseases like Acquired Immune Deficiency Syndrome (AIDS), Leprosy, measles, tuberculosis, whooping cough etc. combined together today.
It is general noticed that most young mother of under three to five in the six geo-political zones in Nigeria have neglected this issue of malaria parasite and the preventive methods as recommended by the world health organisation (WHO).
Most health organisations have been trying to control the effect of this malaria parasites; the national malaria situation survey relating to the preventive health behaviour in malaria shows that there have been a poor use of mosquito net among parents of under five in the six geo-political zones in Nigeria; the study shows that a percentage below 10% was recorded for the parents of under-five that uses mosquito nets.
The survey went on to show that some of the preventive measures that were reportedly adopted included the use of the following: Windows- 16.5%, door nets –15.6%, insecticide and aerosol –33.8%, mosquito repellents about 22.7% and herbs were about 23.0%.
Malaria is the most occurring parasitic endemic disease in Africa, although it is preventable, treatable and curable, but yet it is one of the major health problems in Nigeria. The malaria effect and signs in the country is getting worse despite numerous interventions that have been used for the prevention. The blockage to the success of some the interventions are observed to be socio-cultural, economic and political in nature. Malaria is stated to be the most alarming cause of death and deformity in children under five in the country. In Nigeria today, modern medicine tends to interpret health in terms of medical interventions, and discuss more on the importance of medical technologies. It is mostly ideal to promote the concept and qualities of health as a result of the interaction of human beings and their surrounding environment. Behavioural change communication aimed at making sure that individuals, families, communities and health workers are taking preventive measures to prevent disease, improve on their knowledge of malaria and use of antimalarial drugs accordingly. There should be more efforts to facilitate a smooth transition into the use of Arthemisin based combination theraphy (ACTs). Intensive BBC and capacity development should be directed towards the user of the malaria drugs and all cadres of health providers through under listed means.
Today if we decide to compare Africa with the rest of the world we will see to it that African have a greater burden of the issue of malaria; in Africa and other south of Sahara, it is noticed that malaria infections caused by plasmodium falciparum is most severe and posed danger to the lives of the people in that environment.
In Nigeria today poor infrastructures like good hospital tends to increase the campaign against malaria. We have only noticed few benefits from the history on the fight against malaria in most part of Nigeria.
Series of programme have been implemented to see to the complete eradication of malaria parasite one of these programme is the Roll Back Malaria; this strategy in its own way played an important role in the complete detection and eradication of malaria parasite though rapid treatment, multiple prevention, good action, flexible and dynamic global movement. In Nigeria there should be need for the involvement of community health worker as they will help in the completion and ease of service to fight against mosquito infection in most of the communities in Nigeria. Community health workers help in delivery of health services in general, and preventive health measures, in particular.
The involvement of community workers helps mediate socioeconomic differences within communities, the overall health improvements achievable through community-based interventions by the federal government of Nigeria, the world health organisation and the community workers tends to be on the increase.
The study tend to put Yola South into consideration to elicit information on the understanding of both behavioural and non-behavioural factors that are crucial for the design of appropriate interventions for tackling malaria. This study also aims to assess the effect of health education intervention on malaria prevention in communities in Yola South.
1.2 Statement of Problem
In the world today the mortality rate from the malaria is running into millions; this disease is becoming a huge burden for people in Africa and other under developed countries; because of this, the economic development of this region is growing at a lower rate.
In Nigeria today according to the National Malaria Control Programme; malaria parasite is responsible for more than sixty percent outpatient that visits; there have also been recorded that at least 24% of children dies on yearly bases from malaria. The federal government of Nigeria has recorded about more than 130 million naira annually according to (Pharmanews, 2003) in terms of treatment costs, cost for prevention and loss of man-hours put into malaria programme.
As at April in the year 2000, the international community and most of the African nations met at a summit in Abuja, Nigeria, the essence of the meeting was to see how to reduce the mortality rate among the African peoples by malaria. Recently the federal government of Nigeria has introduced health education programme and community workers with effort to reduce the burden place on the people of Adamawa state by malaria. The federal government of Nigeria through the WHO has come up with strategy that will run from 2016 to 2030 to see how to reduce the effect of malaria to at least 90%, they also plan to reduce mortality rate from malaria to at least 90%. Some time ago the aim of malaria prevention seems like a waste of time and resources but with these new strategies by the federal government of Nigeria by the introduction of health education programme and with the help of community workers, the new strategy might be successful. This study is therefore interested in the comparative investigation of the previous method used by the federal government of Nigeria in the fight against malaria and the introduction of health education and community workers using Yola South as a case study.
1.3 Purpose of the Study
The aim of the study a comparative study on health education intervention on malaria prevention in communities in Nigeria is stated below:
1. To examine the role of health education intervention on the control of malaria
2. To determine the effect of community workers on the control and prevention of malaria in Yola South.
3. To discuss the roles of community workers in socio economic development of Yola South.
4. To determine the effect of malaria parasite on human health
5. To determine the difference between the Roll Back Malaria (RBM) programme and the introduction of health education and community workers.
6. To discuss the help of the federal government through the world health organisation (WHO) in the prevention and control of malaria.
1.4 SIGNIFICANCE OF STUDY
The study will be of immense benefit to both researchers, students, the communities of Yola South and the nation as a whole as it will discuss the various ways of malaria prevention, the study will also the need for the services of community workers in the prevention of malaria in the community, the study will also discuss the effect of malaria on human health. Finally the study will discuss the difference between the Roll Back Malaria (RBM) programme and the introduction of health education and community workers.
1.5 RESEARCH QUESTION
In order to achieve the above stated objectives the study came up with the following questions:
1. What is the role of health education intervention on the control of malaria?
2. What is the effect of community workers on the control and prevention of malaria Yola South?
3. What is the effect of malaria parasite on human health?
4. Is there any difference between the Roll Back Malaria (RBM) programme and the introduction of health education and community workers?
5. What are the roles of community workers in socio economic development of Yola South?
6. What are the roles of the federal government of Nigeria and the world health organisation (WHO) in the prevention and control of malaria?
1.6 SCOPE OF STUDY
The study will be limited to health education intervention in communities of Yola South.