ILORIN JOURNAL OF HEALTH, PHYSICAL EDUCATION
AND RECREATION (IJOPHER)
PUBLISHED BY
THE DEPARTMENT OF PHYSICAL AND HEALTH EDUCATION
UNIVERSITY OF ILORIN
ILORIN, KWARA STATE
NIGERIA
VOL. 4. May 2005
ISSN: 0795-6061
EDITORIAL BOARD
EDITOR-IN-CHIEF
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DR. KOLA OLAFINHAN
MANAGING EDITOR
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DR. A. E. TALABI
ASSISTANT EDITOR
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MR. O. T, IBRAHIM
BOARD MEMBER
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PROF. L. EMIOLA
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PROF. E. A. OGUNSAKIN
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DR. A.A. ADESOYE
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DR. O. OBIYEMI
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DR. O. OYERINDE
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PROF. J. A. ADEDEJI
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PROF. F. AMUCHIE
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PROF. C. O. UDOH
CONSULTING EDITORS
EDITORIAL NOTE
The Ilorin Journal of Health, Physical Education and Recreation
(IJOPHER), is out with a new look and a new mandate. We dare our contributors
to send scholarly articles to our journal and in return we will produce a quality
journal.
TABLE OF CONTENTS
Editorial note
1.
Home-based Approach for Managing the Woman affected by HIV/AIDS:
Implications for Health Education and Promotion.
Ibrahin, A. Njodi & David W. Bwala. & Olaitan, O. ’Lanre
2.
1
Sexual Behaviour and Contraceptive Practices among
Pre-marital Adolescent Students in Ondo Metropolis
J. O. Fawole, C.F Akinnubi (MRS) J.A Adegboyega
3.
Efficacy of Partitioned Pyramidal Structure of Sports Programme for
High Performance in Nigeria - A. I. Kabido
4.
17
Physical Fitness Lifestyle Among Public Servants in Ekiti State, Nigeria
J. A. Adegun
6.
12
Prospects and Problems of Indigenous Soccer Coaches in Nigeria
Toro Abayomi
5.
6
22
Parental practice and Food Preference of Parents and School Children in
Ilorin LGA of Kwara State - Oyerinde, O. O. & Owojaive, Sunday Oni 26
7.
A Comparative Analysis of College Athletes Performance in Two Separate
Muscular Endurance Tests - Ajayi-Vincent O.B
8.
Perceived Consequences of Corporatistic Model of Organisation of Sports
for Sports Development in Nigeria - Mohammed Baba Gambari
9.
32
36
A Comparative Study of Attitudes of Secondary School Teachers Towards
the Teaching of Physical Education in Ilorin East LGA- Bakinde, S. T
40
10.
Socio-cultural Perspectives of Sports Participation - S. O. Babatunde
11.
Dietary Attitude of University of Ilorin Athletes
Dominic, O. L. Mrs,) and Onifade, O.A
43
51
12.
Students’ Perception of Examination Malpractice - Nman Aihaji Habeeb 57
13.
Knowledge of AiDS Among Athletes in Ilorin Metropolis - S.O. Oniyangi
14.
Attribution of Maternal Mortality by Women from High and Low
62
Socio-economic Status in Southern States of Nigeria
Daisy Inyingi Dimkpa
15.
Oral Hygiene Practices and Prevalence of Dental Caries Among School
Children in Oyo State - Olaitan, O. ‘Lanre
16.
74
Attitude of College of Education Lecturers to their Professional Roles
and Duties. B. UAkano & A. T Akinsola
17.
68
79
Sexual Harassment Among Athletes in Higher Institutions in Ilorin
Kwara State - Tajudeen Olanrewaju Ibraheem & Bola, O. Ogunsanwo 84
18.
Disabilities in Children: A Perspective — C. O. Adegbite
90
19.
Bicycling: A Sport that Threatens Manhood — B. O. Asagha
96
20.
Physiological Effects of Havard Bench Steps as Regular Aerobic Exercise
Training Program in the Treatment of insulin-dependent Diabetics.
— Gwani, J.A. & Muhammad M. S, & Chado
21.
101
Relationship Between Lifestyles and Health Problems Suffered by the People
of Kaduna State – Shehu Raheem Adaramaja & comfort O. Adegbite 107
22.
Recruitment of Volunteers as Aids to the Adapted Physical Educators
in Nigeria Schools for the Handicapped - K Lafinhan
23.
Mental Health for Job Demands among Nigerians: The Place of Health
Education and Consultation Programmes — T.I. Izevbigie
24.
115
120
The Interplay of Health Lifestyles in the Control of Osteoposis
- E.O. Agwubike
126
HOME-BASED APPROACH FOR MANAGING THE WOMAN AFFECTED BY
HIV/AIDS: IMPLICATION FOR HEALTH EDUCATION AND PROMOTION
BY
IBRAH1M A. NJODI & DAVID W. BWALA
DEPARTMENT OF PHYSICAL AND HEALTH EDUCATION
UNIVERSITY OF MAIDUGURI;
BORNO STATE-NIGERIA.
&
OLAITAN O. ’LANRE
DEPARTMENT OF PHYSICAL & HEALTH EDUCATION
UNIVERSITY OF ILORIN.
ABSTRACT
In both their private and public lives, women suffer from the effects of many
societal upheavals. Their bodies, intimate relationships and home making chores
are often influenced and gravely affected. Women also suffer the effects of
injustice, poverty, illiteracy and ill health, including HIV/AIDS. It had been widely
reported that HIV/AIDS affects women in many societies. When this happens to
the woman who is both the mother and caregiver. the - lives of many others are
adversely affected and indeed traumatized. This is more so, when the woman as
a caregiver becomes to ill to care for her family, or die of AIDS. The challenges
of providing services, which address the physical. psychological and spiritual
needs of women with HIV infection, must be met. This work examined the
predicaments of the woman with HIV/AIDS and the ways in which her physical
well being can be understood. managed, enhanced and empowered from the
perspective of the health educator.
INTRODUCTION
Women’s health has been widely recognised as a fundamental issue in national
development. Considerable progress in improving the status of women health,
education and employment has been made in many societies in recent times.
Policies and programmes based on gender considerations haqe been developed.
Public awareness of women health has also increased considerably, along with
pressure on government to convert policy statements and legislation into
effective action. More programmes are being mounted to look into ways of
encouraging men to take responsibility for their own and their partner’s sexutd
and reproductive health (WHO,2000).
Despite these advances, overall progress on women health has been
patchy. Globalization and the current economic crises in some regions of the
world has had adverse effects on national health systems which in turn has
affected health services for women. Furthermore, recently made gains in
improving infant, child and maternal survival are being reversed as a result of
social unrest, war, and the epidemic of HIV/AIDS (WHO,2000).
The dramatic increase in HIV/AIDS infection among women, in particular
the p1gb risk of adolescents aged 15 to 25 years, now representing half of
recent HIV victims, s alarming (WHO, 2000). Studies across the world (Carlos;
et. al., 1991; Ezedum, 1999) have shown that infection in young girls is often
related to forced sex and rape. Migration, women/girl trafficking and sexual
exploitation contribute to the spread of the disease among young women Again
the taboos surrounding the disease, such as the stigmatization of the victims
have continued to inflict further violence and isolation of the victims.
Of particular concern are the mother-to-child infection and the dilemma
surrounding breast-feeding by HIV positive mothers. This has serious implication
on the general well being of the child and other members of the family. For
instance, when this happens, not only are children infected with the virus
through vertical transmission from mother-to-child, but the lives of others are
adversely affected when the mother becomes too ill to care for the entire family
or die of AIDS. Susan (1998) pointed out that as health workers, health
educators need to meet the challenge of providing services, which address the
physical, psychological and spiritual needs of people with HIV infection. It would
be reasoned that the most important people to strengthen and support with
health education strategies are the women, who are the home caregivers. This
work examines home-based care, which can enhance the physical and menial
well being of the woman living with HI V/AIDS from the health educator’s
perspective.
Magnitude of the UIV/A1DS Problem
According to UNAIDS estimates, about 14 million women of reproductive
age currently live with HIV/AIDS in the world, giving birth to child with an
elevated risk of HIV infection and death before the age of five years. Adult HIV
prevalence rate seems to have increased or stagnated in many countries
(Adetunji, 2000). More striking is a recent World Bank report, which suggests
that life expectancy at birth in societies with a high HIV prevalence was lower in
2000 than it was in 1975.
Demographic
studies
and
report
about
the
disease
reveal
a
disproportionate number of HI V-positive according to families, cultures, social
groups, age, and resources (Susan, 1998; Adetunji, 2000). l-IIV is known to
thrive most amidst the poor, illiterate, unemployed and socially disadvantaged in
terms of access to health care (Ezedum, 1999; Adetunji, 2000). This has far
reaching implications for public health education. It would seem that
interventions for HIV/AIDS would need to take into consideration the peculiarities
of the people in terms of their demographic characteristics.
Life Expectancy of the HIV Infected Person
One of the most commonly asked questions regarding people infected by
HI V/AIDS is, “How long can a person with HIV infection live? For the health
educator, it is not the length of living that matters, but the quality of existence.
HIV/AIDS must be seen as a chronic rather than a fatal disease. The word fatal
encourages people to think only of death as a hopeless situation or the final
phase of a disease. Conversely chronic means that the disease can be managed.
This distinction must be emphasized and preached by health educators, because
with prompt health care and adoption of healthy lifestyles, adults with HIV
should enjoy some years of quality living.
As we learn more about HIV/AIDS, Susan (1998) noted, we are also
realising that there are many things that we can do to slow down the
progression of the disease. Slowing down the progression of the disease implies
minimising the agonies of pain, stigmatisation and slowing down the perceived
fatality of the disease, What this means, is that death is also being postponed.
Interventions for improving the Quality of Life of the HIV Infected
Woman
Experiences have shown that the quality of living of the HIV infected
person can be improved to make live easy, comfortable, and meaningful (WHO,
1993). This goes to confirm the assertion that people can live with HIV/AIDS on
a pretty sound level. The following low cost home based interventions can be
offered by patient-relatives or health workers to ameliorate the agonies and
inconveniences created by HIV/A1DS: Care giver support, health promotion and
illness prevention, early diagnosis and treatment (Kemp, 1995; Susan, 1998).
1. Caregiver support.
The caregiver is the person who consistently provides the daily needs of
the victim of HIV/AIDS. This person is often the mother but could be any other
relative or even the neighbour. Since home based management of the FIJV
patient revolves around the abilities of the caregivers Kemp (1995) asserted that
it is essential to assist the caregiver to remain healthy and able to provide care
for as long as possible. Caregivers should be encouraged to create supportive
network such as a support group of similar caregivers, involvement of the
religious groups, women’s groups, NGOs and community health workers,
particularly, public health educators. Public health workers should help families to
identify local resources. Caregivers can benefit immensely from people who are
able to come into the home and relieve the caregiver for sometime so that they
can have a break. This can help the HIV-positive mother for whom caring for
herself, often her husband, sick child and the family is very stressful.
2. Health promotion and illness prevention.
HIV infection works by slowly destroying the immune system of the body
thereby making them incapable of fighting infections. Therefore, promoting
health and preventing infections are fundamental in caring for the woman living
with HJV/AIDS. The following could be helpful:
(a)
Nutritional care. People who are malnourished get sick more often and
have more severe episodes of illness than those who are well nourished.
This is true for women living with HJV/AIDS Women with HIV/ATDS are
always fighting the HIV infection, so their bodies are constantly working
overtime. They cannot afford to go without food because they are already
prone to wasting and can be sick often. Nutritional care and support
involve helping people living with HTV/AIDS to optimise their dietary
habits to maintain good nutritional status and meet their special
nutritional needs. Nutritional interventions can help manage symptoms,
promote response to medical treatment and increase the quality of life by
improving daily functioning and nutritional status. Adequate nutrition is
important because it may retard the progression of HIV to AIDS related
diseases (Sharpstone, et. al., 1999, Piwoz & Preble, 2000). Nutritional
care and support can entail nutritional counselling, awareness generation,
provision of food, meal planning, or other interventions. Home based care
offers
strong
opportunities
for
nutrition
counselling.
Community
involvement would be critical to the successful provision of these services
and in many situations requires building capacity of individuals and the
community to manage their own affair to manage their own affairs
Therefore, meeting immediate food and nutrition needs are essential if
HIV/AIDS affected persons are to live with dignity and security
(WHO/FAO,2002),
(b)
Hygiene and sanitation. Hygiene practices and healthy habits help in
reducing individual’s exposure to infectious organisms. People who live in
well-ventilated houses with sanitary and clean water supply are less likely
to become ill. A number of interventions can also reduce the frequency of
infections. Frequent hand washing with soap and water is the best way to
prevent infection, and all family members should be encouraged to adopt
such habits. Covering one’s mouth when coughing or sneezing should be
encouraged. Fresh foods such as fruits and vegetables should be washed,
preferable with little salt solution and all foods should be stored in a cool,
dry place devoid of flies.
(c)
Universal precautions. This refers to protecting oneself from all blood
or body fluids when providing care. HIV is not spread by casual contact or
through
routine
home-care
activities,
especially
when
universal
precautions are consistently used. The best way to prevent contact with
blood or body fluids is to develop a routine way of dealing with common
problems such as diarrhoea, bloody nose, accidental cuts and infected
skin sores. Gloves, even though expensive, can be used to cover hands.
Using other cheap means such as plastic bags (what we generally call
leather bags) is an alternative that could prove helpful. Again, frequent
hand washing with soap and water is a healthy practice that should be
encouraged. Open wounds should be covered, preferably, with a plaster.
Soiled linens and clothes should be soaked in a bleach solution and then
washed. Blood or body fluid spills should be covered with the solution and
then wiped. If sharp razors or needles are used, a container must be
provided to immediately dispose of them.
In addition, attention needs to be paid to care of the skin and
mouth, because they are common in HI V/AIDS cases. Skin care should
include the use of a mild soap for cleansing and the liberal application of a
lotion such as aqueous cream after bathing. Other preventive measures
include good oral hygiene, frequent brushing with a soft toothbrush and
wiping the mouth with a cloth, it is important that women with HIV/AIDS
should have their own toothbrush, which should not be used by other
members of the family.
d. Preventing opportunistic infections. Opportunistic infections refer to
those infections, which take advantage of a weakened immune system in
the body. Most medical guidelines recommended that people should be
given cotrimoxazole three times a week. This is a case for the medical
system, which the health educators can only recommend, rather than
prescribe. Women living with HIV/AIDS should avoid those things and
actions that will precipitate infections that take advantage of the
weakened immune system of the body.
3. Early Diagnosis and Treatment
Early detection and initiation of treatment regime for an illness helps to
prevent the disease from degenerating and escalating into something serious.
Each minor illness is potentially the beginning of a serious infection for people
living with HIV/AIDS. The “common cold” in a woman with HIV/AIDS should not
be considered minor. This woman should be closely monitored for any signs and
symptoms of complications such as an inner ear infection or pneumonia (Carlos,
et. al., 1991). According to Kemp (1995) caregivers should be encouraged to
identify the nearest health centre which is accessible through out the day. They
should be taught to watch for peculiar signs and symptoms. Such signs could be
a change in how the woman normally acts or sleeps, fever, diarrhoea, skin
problems, loss of weight, nose bleeds or bruises, and a pale colour. It should be
noted that diarrhoea is often an ongoing problem of the HI V/AIDS victim. As
such, caregivers should be familiar with it and how to manage it at home,
Caregivers should know;
-
how to make and give sugar-salt solution (ORT) to prevent and treat mild
dehydration,
-
the signs of worsening diarrhoea and dehydration for which a health
centre visit is needed, and
-
that people (victims inclusive) need to eat when they are having
diarrhoea.
Accordingly, caregivers should be educated that bloody diarrhoea is a
possible sign of dysentery, a bacteria infection that would need to be treated
with an antibiotic.
Finally, it should be realised that pain is a real part of living with
HIV/AIDS. Therefore, victims should not be under-medicated for pain. Caregivers
should be encouraged to offer appropriately the prescribed pain-relief medicine
to the victim, especially during an acute illness.
CONCLUSION! RECOMMENDATION
In conclusion, it is sad to note that despite political “noise-making” of
prioritising health care services, especially in developing countries, to which
Nigeria belongs, a reasonable high percentage of Nigerians have continued to
suffer from unnecessary and mostly preventable health problems. HIVV/AIDS is
no doubt unnecessary and preventable. However, unless public health education
in matters of maternal and child health services are strengthened, much could
not be achieved in the prevention and management of HIV/AIDS infection
among women. The way out for us as health educators, is to provide the
enabling environment (home-based approach) to help women of child bearing
age to remain free of HIV/ATDS or its agonising effects, if it is inevitable.
Governments that traditionally spend few public resources on health, education,
arid social services are challenged to meet the demands placed on them to
ensure an appropriate sustainable response. Appropriate interventions to
mitigate the impacts of HI V/AIDS will need to be multidisciplinary in nature and
dynamic, adjusting along with the evolution of disease within the household and
community.
REFERENCES
Adetunji, J. (2000). Trends in Under-5 Mortality Rates and the HTV Epidemic.
Bulletin of the World Health Organization, 78 (10), 1200-1206.
Carlos, et al, (1999). Status of Women’s Health Worldwide, Women’s Health
News and Views, 11 (32), 15.
Ezedum, C. E. (1999). Heterosexual behaviour patterns and STDS/AIDS
Intervention programme among students in Anambra State Secondary
Schools. A Ph.D thesis, University of Nigeria, Nsukka.
Kemp, C. (1995). Terminal illness: A guide to nursing care. Philadelpia: 3. B.
Lippincott.
Piwoz, E. & Preble, E. (2000). HIV/A1DS and nutrition: A review of the Literature
and recommendations for nutritional care and support in Sub-Saharan
Africa. USAID/AED/Commonwealth Regional health Community Secretariat
for East, Central and Southern Africa.
Sharpstone, D. , Murray, C. , Ross, H., et.al. (1999). The influence of nutritional
and metabolic status on progression from asymptomatic HTV infection to
AIDS defining diagnosis. AIDS. 13 (10),. 1221-1226.
Susan, M. (1998). Home-based care for a child affected by HIV/AIDS. MCI!
News, 96-8.
WHO (1993). Guidelines for the clinical management of HJV iitfection in children.
Geneva: The author.
WHO (2000). Women and health: Beijing platform for action-A review of WHO ‘s
activities. Geneva: The author.
WHO/FAO (2002). Living well with HIV/AIDS. A manual on nutritional care and
support for people living with HIV/AIDS. Rome: Food and Agriculture
Organisation.