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. 5. DECEMBER, 2006
ISSN: 0795 - 6061
The Ilorin Journal of Health, Physical Education and Recreation provides the
opportunity for physical and health educators and those in related areas to share
their findings, observations and comments on health, physical education and
recreation-related issues in human development
Preparation of Manuscripts
Authors should submit three (3) copies of their manuscripts written in
English language and typed double line space on one side with good margins.
Manuscripts should not exceed 10 (ten) pages on A4 size paper, including an
abstract of not more than two hundred (200) words. Diagrams, tables and drafts
should be simple and appear at the appropriate position on the text.
The first page of the paper should show the title, author’s name (s) and address
(es). The next page of the manuscripts should begin with the title, abstract and
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introduction, etc, in that order. All manuscripts must conform to the APA (4 th
edition) format.
An assessment fee of five hundred naira only (N500.00) or ten dollars ($10.00)
must accompany the manuscripts. Al correspondence concerning manuscripts
and editorial matters should be addressed to either the Managing Editor or the
Editor-in-Chief.
Managing Editor
Prof. A. A. Adesoye
Editor-In-Chief
Prof. Olawole O. Obiyemi
Editorial Board
Editor-in-Chief.
-
PROF. OLAWOLE O. OBIYEMI
Managing Editor
-
PROF. A.A. ADESOYE
Assistant Editor
-
O’ LANRE OLAITAN
Board Members
-
PROF. L. EMIOLA
-
PROF. E.A. OGUNSAKIN
-
PROF. S.A. ADEYANJU
Obafemi Awolowo University, Ile-Ife
-
PROF. P.B. IKULAYO
University of Lagos
-
PROF. D.G. OSHADIN
University of Benin, Benin City
-
PROF. D.I. MUSA
Benue State University, Makurdi
DR.A.E. TALABI
-
DR. O. OYERINDE
Consulting Editors
-
PROF. E.B. OKUNROTIFA
Obafemi Awolowo University, Ile-Ife.
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PROF. K. VENKATESWAV
Ahmadu Bello University, Zaria.
PROF. ABEL L. TPROPLA
Technikon Pretoria Republic of South
Africa.
PROF. J. HANS DE RIDDER
Potchefstroomse Universiteit, Republic of South
Africa .
PROF. WALTER DECLIER
Universiteit Antwerpen, Belgium.
PROF. MIKLOS BANHIDI – APACZAI
Csere Janos Faculty, University
Hungary.
of
West
PROF. FRANK H. FU
Department of Physical Education, Hong Kong
Baptist University.
ASSOC. PROF. KUNIYOSHI IDA
Department of Sport Cultural, Osaka
University of Health and Sport Sciences.
DR. CRAIG MAHONEY
School of Sport Studies,
Roehampton Institute London
(University of Surrey).
PROF. RICHARD J. FISHER
Department of Sport Science and Physical
Education, St. Mary’s University College,
Strawberry Hill, United Kingdom.
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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
1.
Sexual Coercion among Married Women of Lagos State Sports Council,
Nigeria.
Obiyemi, O.O. (Prof.) Ogunsanwo, B.A. (Dr.) & Makanjuola, W.B.
2.
Sport Facilities and Equipment Management Practice and Provision in
College of Education Jalingo, Taraba State
Adesoye, Abimbola Abefe (Pfo.) & Ojo, Olusoja Sunday (Mr.)
3.
Causes, Effects and Treatments of Cigarette Smoking Among Adolescents:
An Overview – Olaitan, O. Lanre
4.
Perception and Attitude Towards Unprotected Sex Among Students of
Kwara State College of Education, Ilorin, Nigeria
Isaac O. Osho and Olabode O. Kayode
5.
Correlation of Bureaucratic Features in Achieving Sports Management
Science Objectives in Nigeria
Obiyemi, Wole A.A. (Prof), Ogunsanwo, B.A. (Dr) & Ojo, O.S. (Mr.)
6.
Causes and Implications of Drug Abuse: A Case Study of a Typical
Nigerian Society O.M. Peter – Ajayi (B.Ed).
7.
Workplace Experience and Nurses Attitude towards people living with
HIV/AIDS in Ekiti State, Nigeria.
Olanipekun, Kayode Olushola (M.Ed)
8.
Knowledge of Primary Health Care Services and Health Practices among
Female Nurses Working in Health Institutions in Pankshin Town of Plateau
State
Yakubu Gorah Kajang Ph.D & Bakari Mohammed
4
9.
A Comparison of 20MST and 12 Minutes Run/Walk Test
10.
Sudden Death in Sports: The Scientific Evidences and Principles of Cardiac
Rehabilitation in a Survivor – A Review
Abdulahi Ibrahim Darki
Onigbinde A.T, Adedoyin R.A, Johnson, O.E, Obembe O.A
11.
Effects of Angle Variation on Arm Flexors Muscle Strength
12.
Bi-annual Nigerian University Sports Competition: A Means for Healthful
Living – Umaru Musa
13.
Socio-economic Determinants
Organization: The way Forward
Onigbinde A.T, Talabi, E.A, Adedoyin R.A, Johnson, O.E, Obembe O.A
of
Female
Leadership
in
Sports
Kambayari, Apagu
14.
Keeping Fit through Exercise Programme: A way Forward in Nigerian
Society – Prof. E.B. Okunrotifa
15.
Religious Affiliation and Contraceptive Knowledge and Practice in Biu Local
Government Area of Borno State,
Shallangwa A.M. (B.Ed) and Jaramas M.O. (B.Ed)
16.
The Relationship between Transformational and Transactional DecisionMaking Styles of Sports Administrators and Achievement of Sports
Councils in Nigeria – Dr. Musa Garba Yakasai
17.
Perception of Soccer Fans about Placing in the Production of Processional
Soccer League Matches in Kano Township
Dr. Mohammed Baba Gambari
18.
Sexual Behaviour of the Nigerian Senior Secondary School Female
19.
Use of Psychoactive Substances in Enhancing Sports Performance: An
Overview – Dr. A.O. Abioye
20.
The Influence of some Bureaucratic Procedures on Sports Management
Science in Nigeria
Students – Dr. Mrs. Tehresa N. Ogwu
Adesoye, A.A. (Prof), Ogunsanwo, B.A. (Dr.) & Ibiloye, G.O. (Capt.)
21.
Social Characteristics and Means Monarchical Age of Nigerian Female
Athletes and Non-athletes – Dashe, V. (Mrs).
5
22.
Development Discipline through Athletics
23.
Sports Facilities in the Administration of Intramural Sports programmes –
24.
Psycho-social Factors Influencing Sports Participation among Special
Students in Selected Secondary Schools in Osun State
Dr. Henry Augustine Pufaa
Akin-Taylor, M.A. (Ph.D)
Ibraheem, T.O. & Jimoh, G.K.
25.
Status and Problems of School Health Programme in Priamry Schools in
Bida Local Government Area of Niger State – Sheshi Baba
26.
Stress: Causes, Effect & Management – Oniyangi, S.O.
27.
Implementation of Primary Health Care (PHC) in Asa and Moro Local
Government Areas of Kwara State – Dr. Shehu Raheem Adaramaja
6
IMPLEMENTATION OF PRIMARY HEALTH CARE (PHC) IN ASA AND
MORO LOCAL GOVERNMENT AREAS OF KWARA STATE
BY
SHEHU RAHEEM ADARAMAJA (DR.)
PHYSICAL AND HEALTH EDUCATION DEPARTMENT
UNIVERSITY OF ILORIN.
Abstract
The study examined the implementation of Primary Health Care (PHC)
programme in Asa and Moro Local Government Areas of Kwara State. The
population of the study consisted of the LGA-PHC officials and the people of the
two LGA(s). One hundred respondents each that were randomly selected
questionnaire, validated and tested for reliability. The co-efficient for the
reliability was 0.79r. Student’s t-test was used to analyse the data collected from
the respondents. The results revealed that there were significant differences in
the perception of PHC services, sanitation services and pattern of information
provided on the prevailing health problems in Asa and Moro LGAs. The study also
revealed that there were no significant differences in the provision of water
supply, degree of immunization services and distribution of essential drugs in
PHC programme in the two LGAs. The author recommends among others, that
paternal health care services need to be incorporated with the PHC programme
to ensures hundred per cent success in the Family Planning Services of the PHC
programme. The monthly environmental sanitation in the state should be reintroduced and extended to 10.00am on sanitation days.
7
Introduction
Primary Health Care is expected to provide general health services of
preventive, curative, promote and rehabilitative care to the population as the
entry point of the nation’s health care system. The provision of Primary Health
Care services is largely the responsibility of the Local Government Areas with the
support of the State Ministries of Health (FMOH 1989).
Micheal (1981) and Salami (1998) reported that the World Health
Organization in 1978 articulated the concept of primary health care into broad
health objectives which include the following components:

Health Education concerning prevailing health problems

Promotion of adequate food supply and proper nutrition

Adequate supply of water and basic sanitation

Maternal and child-health care, including family planning

Immunization against infectious diseases

Prevention and control of locally endemic diseases

Provision of essential drugs
Although Primary Health Care delivery is expected to be accessible,
acceptable and affordable to the people in the grassroots throughout the nation,
the attainment of these expectations have been hindered by many factors some
of which include:
8

The implementation of Primary Health Care Programmes nation-wide
indicate that logistic problems are different from one place to another
(Shodeinde, 1992).

Difference in population density Asa LGA has a population of
approximately 78.722, while Moro LGA has a population of 66.213
people (NPC, 1991).

Differences in educational status affect the implementation of Primary
Health Care in Asa and Moro LGAs.

The people of the two (2) LGAs are predominantly farmers and small
scale entrepreneurs. Only a very small proportion are civil servants.
The nature of the peoples occupation will likely affect the operation of
PHC programmes in the two (2) LGAs.

The standard and number of available health facilities and personnel
are grossly inadequate in the two (2) LGAs.

Frequent change in leadership and government policies.

Poor coverage due to transportation problem

Lack of basic statistics
It is hope that these variables would significantly contribute to the success or
failure of PHC programmes in the areas. In the light of the assumed expected
problems, it becomes imperative to undertake a study on the implementation
of PHC in Asa and Moro LGAs of Kwara State.
9
Statement of Problem
The problem of the study was to examine the implementation of PHC
programme in Asa and Moro Local Government Areas. It also assessed the
level of people’s involvement in the programme. The study also investigated
and evaluated the degree of success of the programme and made some
recommendations on how to improve on the programme.
Research Questions
The following research questions are formulated in order to find answers
to the research problems.
i.
How do the people of Asa and Moro LGAs perceived the Primary
Health Care delivery system?
ii.
Do the people of Asa and Moro LGAs enjoy adequate supply of water?
iii.
Do the people of Asa and Moro LGAs participate in and enjoy adequate
sanitation services?
iv.
Do the people of Asa and Moro LGAs have adequate immunization
coverage schedule against the six killer diseases?
v.
Does PHC supply essential drugs regularly and in the right quantity to
these areas.
vi.
Do PHC services in Asa and Moro LGAs include maternal and child
health care and family-planning service?
vii.
Are the people of Asa and Moro LGAs adequately informed about
prevailing health problems in their areas?
10
Hypotheses
The following hypotheses were tested for the study.
i.
There is no significant difference in the way people of Asa and Moro
LGAs perceived PHC delivery system.
ii.
There is no significant difference in the provision of adequate supply of
water in Asa and Moro LGAs.
iii.
There is no significant difference in the level of sanitation services
enjoyed by the people of Asa and Moro LGAs.
iv.
There will be no significant difference in the degree of immunization
services enjoyed by the people of Asa and Moro LGAs.
v.
There will be no significant difference in the provision and distribution
of essential drugs scheme of PHC services in Asa and Moro LGAs.
vi.
There will be no significant difference in the degree of maternal and
child health-care including family planning services, in Asa and Moro
LGAs.
vii.
There will be no significant difference in the pattern of information
provided on the prevailing health problems in Asa and Moro LGAs.
Methodology
The study is a descriptive, survey, designed to examine how PHC is being
implemented in Asa and Moro LGAs. The descriptive survey enables the
researcher to obtain the opinion of a representative sample of the target
population so as to be able to infer the perception of the entire population. The
11
choice of this design is justified because the researcher is interested in the
perceptions of the people in the two LGAs on the implementation of PHC
programmes.
The population for this study consisted of the participants (beneficiaries)
in PHC programmes in Asa and Moro LGAs. In addition to this, the chairmen and
members of the two (2) LGAs Health Teams which include supervisory councilors
for health, LGA-PHC coordinators and their assistants, medical officers,
community health workers, nurses and District health supervisors formed part of
the population.
Stratified sampling technique was used to pick two (2) PHC centres from
the three (3) districts each, that made up the two (2) LGAs (Asa and Moro). A
random sampling of 15 respondents in each PHC centre was made during the
National Programme on Immunization (NPI) visiting days (Mondays and
Wednesdays). In addition to the respondents selected from each PHC centre, ten
(10) members each from the two (2) LGA-PHC teams participated in the study.
In all, a total of 200 respondents completed and returned the questionnaires
forms administered to them.
The instrument used for the study was a structured questionnaire,
validated and tested for reliability. Using split-half method, the co-efficient for
reliability was 0.97r. The researcher, with the aid of two (2) trained research
assistants, administered the instrument on the respondents. Students t-test was
used to analyse the data that emanated from the study.
12
Results
The table below presents the results of the study. All the hypotheses were
tested at 0.05 alpha level of significance.
Main Hypothesis: There is no significant difference in the implementation of
Primary Health Care Services in Asa and Moro Local Government Areas with
respect to:
(a)
Peoples perception of PHC programmes in the areas,
(b)
Adequate supply of water,
(c)
Sanitation services,
(d)
Immunization services,
(e)
Provision and distribution of essential drugs,
(f)
Maternal and child health care services including family planning services,
(g)
Health education on prevailing health problems.
13
Table 1:
Means, standard deviations, standards errors and t-values
of Respondents on the Implementation of PHC services in
Asa and Moro LGAs.
Assessment
tools
L.G.A Not
Means Standard Standard Dr
of
deviation error
cases
Calculated Critical Remark
t-value
value
Perception of
HPC
Programmes
Adequate
Supply
of
water
Sanitation
Asa
Moro
100
100
26.37
23.81
2.68
2.18
0.26
0.21
198 7.40
1.96
Asa
Moro
100
100
8.35
8.25
1.04
0.85
0.10
0.08
198 0.45
1.96
Asa
100
8.22
8.84
0.08
Services
Moro
100
7.83
8.82
0.08
198 3.34
1.96
Immunization
services
Provision and
distribution
of essential
drugs
Maternal and
child health
care
including
family
planning
service
Health
Education on
prevailing
health
problems
Asa
Moro
Asa
Moro
100
100
100
100
9.02
9.13
11.22
11.17
0.87
0.81
0.78
0.66
0.08
0.08
0.07
0.06
198 0.92
1.96
198 0.48
1.96
Asa
100
6.26
1.05
0.10
Moro
100
6.05
1.04
0.10
198 1.42
1.96
Asa
Moro
100
100
10.99
11.30
1.04
1.08
0.10
0.10
198 2.06
1.96
* Adopted from Shehu, (2001): M.Ed. Health Education Thesis
A critical examination of the table above showed that significant difference
existed in how the respondents in the two LGAs perceived PHC services.
Statistically, the calculated t-value of 7.40 was greater than the table value of
1.96 at 198 degree of freedom. The null hypothesis (H0) was rejected at 0.05
alpha level of significance.
14
Significant difference was also found in the sanitation services in Asa and
Moro LGAs. This was inferred from the calculated t-value of 3.34 which was
found to be greater than the critical value of 1.96 at 198 degree of freedom. The
null hypothesis (H0) was rejected at 0.05 alpha level of significance.
The table further showed that water supply in the two LGAs was not
significantly different from each other. This was depicted from the calculated tvalue of 0.45 which was found to be less than the critical value of 1.96 at 198
degree of freedom. The null hypothesis was accepted at 0.05 alpha level of
significance.
An examination of the table showed that the immunization services
enjoyed by the people of Asa LGA was not significantly different from that of
Moro LGA. This implies that towns and villages in both Asa and Moro LGAs were
adequately covered by the immunization services of PHC programme against the
six (6) killer diseases; Tetanus, Poliomyelitis, Measles, Whooping Cough,
Diphtheria and Tuberculosis. This was inferred from the calculated t-value of
0.92 which was found to be less than the table value of 1.96 at 198 degree of
freedom. The null hypothesis (H0) was accepted at 0.05 alpha level of
significance.
The table also showed that there was no significant difference in the
provision and distribution of essential drugs in Asa and Moro LGAs. The
respondents were of the opinion that drugs revolving scheme of the PHC service
were properly managed in their areas. This was deduced from the calculated t-
15
value of 0.48 which was found to be less than the table value of 1.96 at 198
degree of freedom. The null hypothesis (H0) was accepted at 0.05 alpha level of
significance.
Finally, the table showed that the maternal and child health care,
including family planning services in Asa LGA, was not significantly different from
that of Moro LGA. The respondents were of the opinion that maternal and child
health care, including family planning service, were available in all the health
centres in the two areas under study. Statistically, the calculated t-value of 1.42
was less than the table value of 1.96 at 198 degree of freedom. The null
hypothesis (H0) was accepted at 0.05 alpha level of significance.
Discussion of Findings
The mark difference in the perception of PHC service by the respondents
in Asa and Moro LGAs was that the people of Asa LGA were well informed of the
activities of PHC, hence, they perceived the programme positively. This is
because they responded positively to questions on availability and maintenance
of PHC facilities in the area. They were also aware of immunization days and
various vaccines given to them in the PHC centres in the local government. Their
counterpart in Moro LGA saw it on the negative side because they were not well
informed. This finding was supported by Shodeine (1993) who reported that for
PHC services to be effectively understood by the community members, they need
to be adequately informed of the concept, need, problems and prospects of the
programme.
16
The finding that significant difference existed in the level of sanitation
service enjoyed by the people of Asa and Moro LGAs, could be attributed to the
untiring efforts of Health superintendents and sanitation inspectors in Asa LGA
who went from house to house to inspect refuse and sewage disposal as a
measure to ensure environmental hygiene in the area (Shehu, 2001). With this
policy, residents in Asa LG enjoyed better sanitation services; their surroundings
were kept clean and tidy. Their counterpart in Moro LGA failed to observe
sanitation exercise.
The pattern of information provided to the respondents on the prevailing
health problems in Asa and Moro LGAs were significantly different from one
another. Respondents in Asa LGA concurred that they were well informed of the
prevailing health problems in their area than their counterparts in Moro LGA. This
finding is similar to that of Salami (1998) who reported that Moro and its
environs were faced with different health problems ranging from diseases to
poor health facilities as a result of ignorance.
The people of the two (2) LGAs enjoyed adequate supply of water. The
finding that adequate water supply in Asa LGA was not significantly different
from that of Moro LGA is consistent with that of Salami (1998), who reported
that the urge to provide drinkable water to the people in the area under study
emanated from the discovery of guinea worm infections in Kankan and AlapaKoro village in Asa LGA. Lanwa and Oloru villages in Moro LGAs. Local
Government Administration is duty-bound to provide drinkable water for the
17
people (Kubeinje, 2004). To this effect, Asa and Moro LGAs provide wells,
boreholes and in some places pipe-born water were provided in most of the
towns and villages in the two (2) LGAs.
The finding that there is no significant difference in the degree of
immunization service provided to the people of Asa and Moro LGAs is not
surprising, because all the towns and villages in both Asa and Moro LGAs were
adequately covered by the immunization services against the six (6) killer
diseases
(Tetanus,
Poliomyelitis,
Measles,
Tuberculosis,
Diphtheria
and
Whooping Cough). Immunization is provided to mothers and their children in the
LGAs throughout the country free of charge (Asa and Moro LGAs have been
adequately covered by this programme).
The finding that there is no significant difference in the distribution of
essential drugs through the PHC programme in the two (2) LGAs is similar to the
view of Bodunde (2002), who said that the essential drugs revolving scheme of
PHC is bound to succeed in every LGAs if properly managed.
Maternal and child health care, including family planning services were
available in all primary health care centres in Asa and Moro LGAs. The finding
that there was no significant difference in the degree of maternal and child
health care service, including family planning in Asa and Moro LGAs, is consistent
with the view of Kila (1994), who said for the society to grow (population and
health wise) the health of the mother and children should be given the highest
esteem. This has greatly decreased the maternal and infant mortality rate in the
areas.
18
Conclusion
It could be concluded from the above discussion that, significant
difference existed in the way the respondents in Asa and Moro LGAs perceived
Primary Health Care Services, participated and enjoyed sanitation services, and
the pattern of information provided to people on the prevailing health problems
in the areas. People of Asa and Moro LGAs enjoyed adequate water supply,
immunization services, family planning and provision of essential drugs scheme
of the PHC services.
Recommendations
Based on the findings of this study, the researcher makes the following
recommendations:
(a)
Government should make the media houses and the information unit
of the State Ministry of Health (SMOH) and Local Government Health
Authority (LGHA) effective, be alert to their responsibilities and ensure
that rural communities are adequately informed of the prevailing
health problems in their domains and how to prevent them. This would
assist in reducing the high rate of infant and maternal mortality rate in
the society.
(b)
Paternal health care services need to be incorporated into the PHC
programme to ensure hundred per cent successes in the family
planning services of PHC programme.
19
(c)
The last Saturday of every month environmental sanitation should be
reintroduced in the State.
The period of the exercise should be
extended from 7-9am to 7-10.00am.
(d)
Government should create enabling conditions for the effective
implementation of PHC programmes to the people. The programme
should be free of cost, logistics and other attendant difficulties
associated
with
full
enjoyment
by the people.
20
of
the
programme
References
Federal Ministry of Health (1989). National Health Policy. Federal Republic of
Nigeria 2:3.
Kila, A. (1994). Integration of Service Delivery, Lagos: Academy Press Ltd. pp.
23-29.
Kubeyinde, K. (2004).Health Care and the Rural Areas. “Daily Trust”. Kaduna
October, 2004:3.
Michael, J.Y. (1991). Delivery Primary Health Care Nurse Practitioners at Work:
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National Population Commission (1991).
Data. Federal Republic of Nigeria.
Census Projection and Demographic
Ransome-Kuti, O; Sorungbe, A.O.; Oyegbite, K.S. and Bamisaiye A. (1988).
Strengthening Primary Health Care at Local Government Levels. The
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Salami, A. (1993). Primary Health Care. An unpublished monograph, Offa Local
Government Secretariat, Kwara State, Nigeria Pp. 1-5.
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and Moro LGAs of Kwara State. Unpublished M. Ed. Health Education
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Ilorin, Nigeria.
Shodeinde, O.A. (1992). Primary Health Care in Nigeria: Our Children can now
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21