HEALTH AND FITNESS JOURNAL INTERNATIONAL (HFJI)
Published by
HEALTH AND FITNESS ASSOCIATION OF NIGERIA
(Based in the Department of Physical and Health Education, University of Ilorin)
Vol. No. 2
Dec., 2000.
HEALTH AND FITNESS JOURNAL INTERNATIONAL (HFJI)
GUIDELINES FOR CONTRIBUTORS
The Health and Fitness Journal is a Bi-annual reputable journal established to:
1. Provide a forum for physical educators, health educators, medical practitioners and other health and fitness related professionals, all over the world, the opportunity to report or share their findings, observations and comments on health and fitness related issues.
2. To afford interested individuals to appreciate and learn the close link between health and fitness in human affairs.
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Preparation of manuscripts:
Authors should submit three copies of their manuscripts written in English language and typed double-spaced on one side with good margins. Manuscripts should not exceed 10 pages on A-4 size paper, including an abstract of not than
200 words. Diagrams, tables and charts should be simple and appear at the appropriate positions 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 must conform to the APA (4 th ed) format.
An assessment fee of five hundred naira (N500.00) or ten dollars ($10.00) must accompany the manuscripts. A publication fee of three thousand naira
(N3,000.00) or fifty dollars ($50.00) is usually charged for accepted manuscripts.
All correspondence concerning manuscripts and editorial materials should be addressed to the Managing Editor, Dr. A. E. Talabi, Department of Physical and Health Education, University of Ilorin, Kwara State, Nigeria.
HEALTH AND FITNESS JOURNAL INTERNATIONAL (HFJI)
Editor - in – chief – Professor E.A. Ogunsakin, Department of Physical and Health
Education, University of Ilorin, Ilorin, Kwara State, Nigeria.
Managing Editor - Dr. A.E. Talabi, Department of Physical and Health Education,
University of Ilorin, P.M.B. 1515, Ilorin, Kwara State, Nigeria.
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Advisory Committee
Professor L. Emiola
Professor O. Oshodin
Professor S. Jimoh
-
-
-
University of Ilorin
University of Benin
University of Ilorin
Dr. S. Umoh
Professor A. Adewoye
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-
University of Ilorin
University of Ilorin
HEALTH AND FITNESS JOURNAL INTERNATIONAL (HFJI) EDITORIAL
The concept of this journal is primarily based on the saying that “the right to search for truth implies also a duty. One must not conceal any part of what one has recognized to be true” – Albert Einsten. The salient truth recognized by this author, may be the factors that will determine our future.
We therefore welcome break-through in any area that will contribute to the health and fitness-well being, of our fellow human beings.
We also welcome valuable criticisms that will enable us to meet out set objectives.
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EDITOR IN CHIEF
Prof. Ogunsakin, E.A
VOLUME 1 NO 2 2000
ARTICLES CONTENTS
1. Patterns of Health Services Utilization by Physically
PAGES
Handicapped Students – O.G. Oshodin and C.O. Idehen
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2
3
Age Differences in Blood Pressure Levels in Post-
Primary School Girls – Danladi I.Musa, & Badamosi
Lawal
Reproductive Health and National Development: An
Overview – J.A. Adeyini
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4 Sources and Effects of Water Pollution on Health: The
Nigerian Experience – Audu Andrew Jatau
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22
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An Assessment of Guinea Worm Infection in Kankan
Village of Asa Local Government Area of Kwara State,
Shehu, Raheem Adaramaja
Enzymatic Adaptations, Substrates Utilization and
Storage Following High Intensity Exercise Training. An
Overview M .W.U. Gaya and A. Balami
Basic Health Care Services Patronage in Selected Rural
Areas of Oyo State, Nigeria . Oyerinde O.O.
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37
46
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8 Sexual Fulfilment: A Tool for Mental Health: A Science
Perspective- R.O. Ogunde And A.E. Talabi
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An Overview of the Concept of Child Sexual Abuse:
Perpetrators, Consequences and Prevention –
Olafimihan, Emmanuel Olatunde
A Survey of the Nutritional Status of the Mentally
Retarded Pupils of Torrey Home, Kano, Kano State – K.
Olafimihan
HEALTH AND FITNESS JOURNAL INTERNATIONAL (HFJI) VOL. 1 NO2,
2000
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64
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An Assessment of Guinea Worm Infection in Kankan Village of Asa Local
Government Area of Kwara State.
SHEHU, RAHEEM ADARAMAJA
Department of Physical and Health Education
University of Ilorin.
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ABSTRACT
A large number of people suffer form different illnesses, which they are capable of avoiding, but lack the necessary incentives and organizational support for such health related actions. This research was aimed at assessing the role of primary health care (PHC) in curbing the perennial outbreak of guinea worm infection in Kankan Village of Asa Local Government Area of Kwara State.
The control of guinea worm infections, a water borne helminthic disease, which was identified as a priority health problem, was used as a test case to evaluate the effectiveness of primary health care programme in the area. The knowledge, attitudes and behaviour of the people towards the disease was assessed through a questionnaire.
The population for the study was 120 respondents selected by stratified random sampling technique. Per centages and t-test statistics were used to analyze the data collected. The results showed that there were dramatic changes in health knowledge, beliefs, attitude and behaviour of people, especially in the construction of wells through self-help. The study concluded that given enough assistance and encouragement through PHC programmes, communities can deal with cases of guinea worm infections confronting them effectively, all in an attempt to ensure health for all by the year 2000 and beyond.
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INTRODUCTION
Problems that confront developing countries in areas of health care delivery are many. These problems include poor finance, equipment, shortage of manpower, and the unwillingness of the few health professionals to work in rural areas (Brieger, 1979 and Akpovi, 1980). The conventional model of health care delivery, which emphasize erection of magnificent buildings and provision of sophisticated equipment to serve urban dwellers, is now known to be inadequate. Omishakin (1981) stressed that shortages of supplies like drugs and dressings, etc. and inadequate equipment are formidable constraints in the proper health care delivery in such conventional models. Investing in primary health care delivery system will ensure that basic health care services are made available to the masses to achieve the objective of health for all by the year
2000. As a result, some countries now realize the paramount importance of developing a new approach of extending health care services coverage to those in remote areas at less expensive rates to strengthen the health sector (WHO,
1981). In practice, no government has enough financial resources needed to meet all the health needs of the population (Akpovi, 1981). This is why the new strategy of health care delivery which uses primary health care (PHC) approach is worth considering, for it is a determination to bring health care within the reach of everyone, especially the underprivileged who had been neglected health wise. The spectacular thing about the new innovation is the self-help projects which aim at involving the people to achieve health through their own efforts so
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as to enable them enjoy improved socio-economic activities and increase their productivity.
At present in Nigeria, almost all the budget for providing health service amenities is provided by the state government and local government authorities
(Babalola, 1988). Shehu (1975) observed that, most rural communities do not fully appreciate the services and amenities provided free of charge, and that in some cases such efforts, by the authorities are considered worthless by the people served, because they have not been involved in the development of the programme. A grassroots health development programme (primary health care) was developed with the aim of helping the villagers to synthesize collective wisdom in identifying their problems, work out solutions, mobilize the financial resources required and deploy community PHC workers for self-help programme.
The acceptance of primary health care programme in Kankan village of Asa Local
Government Area of Kwara State has helped in curbing the perennial outbreak of guinea worm infection in the area.
Description of Area of Study
Kankan is a village in Afon district of Asa Local Government Area of Kwara
State. The village has a pollution of 277 people (NPC, 1991). The occupation of the inhabitants is predominantly farming. The village has a Local Government
Education Authority (LGEA School, Kankan) which serves three (3) other communities in the area. The village lacks basic amenities like pipe-borne water, health care facilities, electricity, and good roads. With the intervention of PHC in
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1987, the community can boast of boreholes constructed by UNICEF and wells dug by community members through self-help projects. Most villagers, especially women and children go for modern medical care which is available only at the nearest General Hospital in Afon, Asa Local Government Area Headquarter, a distance of about 12 kilometers. The villagers do neglect minor ailments because of the long distance they have to travel to the hospital. Such ailments often become serious before the sick are rushed to the hospital for care or referral.
The early stages of infection are often neglected or taken care of by the native doctors and through the activities of the quacks. This process of health care is expensive as it takes time and money.
The village head (Mallam Yakubu Salawu Ajadi) reported that before the intervention of PHC in 1987, the sources of water supply to the farming villager’s were stagnant ponds, slow running streams and uncovered water holes.
According to him, most sources of water supply dry up during the dry season
(November to March). This created difficulties for the villages as they waste much time in trekking several kilometers in search of water.
The outbreak of guinea worm infection was first noticed in Kankan in
January, 1987, which called the attention of the government and the United
Nation Children Emergency Fund (Babalola, 1988). Studies indicated the prevalence of the infection in the area was 7.8 per cent in 1977 and 18.6 per cent in 1980. It was as high as 40.5 per cent in 1987 when it finally got the
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support of the federal government and the UNICEF (UNICEF, 1988 and Babalola,
1988).
The guinea worm infection is serious enough to debilitate victims for an average of three (3) months at a stretch during which the sufferer experiences pain and possible deformity. Secondary infection can spread to other body tissues (Brieger, 1979). The appropriate and most permanent solution to guinea worm would be provision of portable water for drinking. However, to depend on treatment of the infection alone is not satisfactory because patients once treated develop new Guinea worm lesions some weeks after the primary treated condition has healed (Belcher, Wurapa and Ward, 1975). In addition, re-infection will occur as long as the drinking water is contaminated.
Statement of the Problem
The problem of the study is to assess the impact of primary health care
(PHC) programme in curbing the menace of guinea worm infections in Kankan village of Asa LGA, Kwara State. The researcher therefore, is motivated to find out the knowledge, attitudes and behaviour of the people before and after the intervention of primary health care programme towards the disease in the area.
Hypotheses
1. There is no significant difference in the knowledge and beliefs of the villagers towards the prevention and control of guinea worm infection in
Kankan village before and after the intervention on PHC programme.
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2. There is no significant difference in the attitude of the villagers towards the prevention and control of guinea-worm infection in Kankan village before and after the intervention of PHC programme.
3. There is no significant difference in the behaviour of the villagers towards self-help projects and government support in eradicating guinea worm infection in Kankan village before and after the intervention of PHC programme.
Methods and Procedure
The research design adopted for this study was a descriptive survey. The method involved investigation which attempted to describe systematically and objectively the characteristics of a given population or an area of interest factually and accurately (Good, 1973). The population consisted of 120 respondents who were selected through stratified sampling techniques, five (5) each from the 24 households that made up Kankan village. Questionnaire was designed to elicit information on the knowledge, attitude, and behaviour of the people towards the control of guinea worm infection in the area. Two separate questionnaires were drawn. The first was to collect information on the knowledge, attitude and behaviour of the people towards the control of guinea worm infection in Kankan village before the intervention of primary health care programme. The second also elicited information on the same variable after the intervention of primary health care programme in the area. The two responses were compared (Before and After).
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Results
The main thrust of this study was to assess the effectiveness of primary health care in curbing the menace of guinea-worm infection in Kankan village.
Only 100 respondents returned the questionnaire forms. The result is as presented below.
Hypothesis 1
There is no significant difference in the knowledge and beliefs of the villagers towards the prevention and control of guinea-worm infection in Kankan village before and after the intervention of PHC programme.
Table I: Statistical Analysis On The Knowledge And Beliefs Towards
Period of
Intervention Of PHC In Kankan Village.
No of Means Standard Standard Degree Calculated Table
Intervention of PHC cases Deviation
(S.D)
D Error
(S.E) of
Freedom
Value Value programme (D.F)
Before
After
100
100
77.58
80.43
4.38 0.4
3.71 0.3
* P = 0.05
98 *4.94 1.96
Table 1: Shows the responses of the respondents on knowledge and beliefs of the villagers towards the prevention and control of guinea worm infection in Kankan villager. The mean before the intervention of PHC programme in the area was 77.58 with a standard Deviation of 4.38 and
Standard Error of 40, while the mean after the intervention of PHC programme was 60.43 with a Standard Deviation of 3.71 and Standard Error of 30.
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The calculated value of 4.94 as against table value of 1.96 with a degree of freedom of 98 was obtained. The calculated value is greater than the table value; the null hypothesis is rejected at 0.05 alpha level. This means that there was a difference in the knowledge and beliefs of the villagers towards the prevention and control of guinea-worm infection in Kankan village before and after the intervention of PHC programme.
Hypothesis 2
There is no significant difference in the attitude of the villagers towards the prevention and control of guinea worm infection in Kankan village before and after the intervention of PHC Programme.
Table II: Statistical Analysis of the Attitudes Towards the
Intervention of PHC Programme In Kankan Village
Period of No of
Intervention cases
Means Standard
Deviation
Standard
D Error
Degree Calculated Table
Freedom Value Value of PHC programme
(S.D) (S.E) (D.F)
Before
After
100
100
23.81
26.37
2.20 .22
2.68 .27
* P = 0.05
98 *7.35
Table II shows the responses of the respondents on the attitude of the villagers towards the prevention and control of guinea worm infection in Kankan village. The mean before the intervention of PHC programme in the area was
1.96
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23.81 with a Standard Deviation of 2.20 and Standard Error of .22, while the mean after the intervention of PHC programme was 26.37 with a Standard
Deviation of 2.68 and Standard Error of .27.
The calculated value of 7.35 as against the table value of 1.96 with a degree of freedom of 98 was obtained. The calculated value is greater than the table value; the null hypothesis is rejected at 0.05 alpha level. This means that there was a difference in the attitude of the villagers towards the prevention and control of guinea-worm infection in Kankan village before and after the intervention of PHC programme.
Hypothesis 3
There is no significant difference in the behaviours of the villagers in selfhelp project and government support in eradicating guinea-worm infection in
Kankan village before and after the intervention of PHC programme.
TABLE III STATISTICAL ANALYSIS ON THE BEHAVIOUR TOWARDS PHC
PROGRAMME INTERVENTION IN KANKAN VILLAGE
Period of
Intervention of PHC programme
Before
No of cases
Means Standard
Deviation
(S.D)
100 7.82 .82
Standard
D Error
(S.E)
.08
Degree of
Freedom
(D.F)
Calculated
Value
Table
Value
After 100 8.22 .84 .08 98 *3.33 1.96
* P = 0.05
Table III shows the responses of the respondents on the behaviour of the villagers in self-help projects and government support in eradicating guinea
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worm-infection in Kankan village before and after the intervention of PHC programme. The mean before the intervention of PHC programme in the area was 7.82 with a standard Deviation of 0.82 and Standard Error of .088, while the mean after the intervention of PHC programme was 8.22 with a Standard
Deviation of .84 and Standard Error of .08.
The calculated value of 3.33 as against the table value of 1.96 with a degree of freedom of 98 was obtained. The calculated value is greater than the table value. The null hypothesis is rejected at 0.05 alpha level. This means that there was a difference in the behaviour of the villagers towards self-help projects and government supports in eradicating guinea worm infection in Kankan village before and after the intervention of PHC programme.
Discussion
At the start of the programme some twelve (12) years ago, Babalola,
(1988) reported that only 12 per cent of the inhabitants indicated that all age groups were at the risk of infection. The same proportion also indicated that guinea worm is contracted by drinking contaminated water. At the time of the study, specifically after the intervention of PHC, 83 per cent of the respondents agreed that everyone was susceptible to the infection. In addition, 96 per cent contended that guinea-worm infection could be contacted by drinking contaminated water. This results show that the changes were significant when compared to Babalola’s data. The realization that they were at risk was used as initiating steps to help them address their mind to control the disease.
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The results also indicated that, people used wrong preventive measures before the intervention of PHC to avoid being infected. Such measures were the use of alum as disinfectant, prayer over water, use of incantations and white chalk in water before drinking. Data collected showed that after the intervention of PHC, 90 per cent of the households in the village now took appropriate preventive measures and reported case (s) of guinea worm infection to the health caretaker in the village. The preventive measures now adopted by the people include drinking water from, the boreholes(s) provided by PHC, boiling drinking water from stream, improved sanitary condition, and participation in self-help projects like construction of wells.
The attitude of the villagers in the area towards communal efforts as a measure for controlling the infection was revealed from the data collected. At the start of the programme only 5 per cent took the right step to control the infection as reported by Babalola, (1988). With the intervention of PHC in 1987, and the efficacy in the implementation of the programme’s component, especially in the provision of adequate water supply through community participation, the villagers now saw the need to participate in communal effort as a measure to control the spread of guinea-worm infection in the area.
Another area of significant change was in their dependence on government to solve their problems. The opinion of the household heads interviewed showed that before the intervention of PHC some twelve (12) years ago, those who wished to wait for government help were over 85 per cent. At the time of this study, the proportion of dependants on government help has decreased to 7 per cent.
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Recommendations
Based on the findings of the study. The following recommendations are made:
To overcome the problem of guinea-worm infection in the area, there is the need to strengthen communal participation in PHC programme in the provision and maintenance of source of water supply in the area.
The majority of the villagers had never been to school, hence, they do not know the modern ways of preventing the occurrence of the disease. The village primary health workers or health caretakers can make enormous success and acceptable impact in the attitude and effect a change in the behaviour of the villagers, by orientating them socially, physically and psychologically towards the right action to improve their health, through health education and adult literacy programme.
Such officers should be encouraged to attend workshops, health campaigns, seminars, and symposia, to up date their knowledge on ways of preventing the spread of guinea worm infection. They should also be mandated to submit situational reports of the disease on a weekly basis to the nearest hospital in Afon (Headquarter of the LGA).
Co-operation from the significant others in the village is paramount. The village head, heads of clans, elders, influential and voluntary groups should be encouraged to participate in the operation of primary health care in curbing the menace of guinea worm infection in the area.
Finally, government should provide the community with more amenities like motorable roads, sources(s) of water supply and a well-equipped and adequately-staffed health centre.
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REFERENCES
Akpovi, S.U. (1980). Physiotherapy and Public Health: The challenges; Journal of
Nigeria Social of Physiotherapy Vol. 6.2 P. 23.
Babalola, O.A. (1988), Health Care Delivery System in Asa Local Government
Area: A Situational Reports. A Monograph Submitted to Asa L.G.A
Secretariat Afon, Kwara State.
Belcher, D.W.; Wurapa, F.K. and Ward, W.B. (1975). Failure of Thiabendazole in the Treatment and Suppression of Guinea Worm Disease. American
Journal of Traditional Medicine and Hygiene. Vol. 24, 3 Pp. 444 – 446.
Brieger, W.R. (1979). Attitudes of Nigerian Medical Students Towards Rural
Practice. Journal of Medical Education Vol. 54, Pg. 428.
Good, V. (1973), Dictionary of Education (3 rd ed) Ottawa. Mc Craw-Hill Book
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National Population Commission, (1991). Census Projection and Demographic
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Omisakin, M.A. (1981). Improving Health Through Health Education and st Preventive Medicine in Developing Countries. Official Report of 1
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Shehu, U. (1975). Health Care in Rural Areas. AFRO Technical Paper, No 10,
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UNICEF, (1988). Community Involvement in primary Health Care. A Study of the
Process of Community Motivation and Continued Participation, Geneva,
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WHO, (1981). Global Strategy for Health for all by the Year 2000: Geneva. WHO
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