THE EFFICACY OF HEALTH EDUCATION COMMUNICATION TOOLS AND STRATEGIES IN THE ERADICATION OF COMMUNICABLE DISEASES IN OVIA NORTH LOCAL GOVERNMENT AREA

ABSTRACT
Poliomyelitis has over the years been proven to be one of the most contagious and dreaded childhood diseases. The effect of this disease ranges from general health discomfort due to physical deformation of legs, paralysis and early infant mortality. The adverse effects of Polio on children propelled intensive campaigns on the acceptance of Polio vaccine in order to mitigate the hazardous health impact of the Polio virus on children. This was done by breaking down the campaign channels into components such as the Health education communication for poliovirus intervention. Therefore, the study sets out to assess the communication tools and strategies of the Health education communication as a channel for polio intervention and to strengthen the acceptance of polio vaccine in the study locations through the deployment of effective change communication platforms. The objectives of this study are; to investigate the knowledge and perceptions of polio disease in the study locations; to explore the factors militating against the acceptance of polio vaccine in the study locations; identify and analyze the communication approach of the Health education communication for polio intervention in the study locations and devise ways that Polio can be more effectively communicated for a lasting and sustainable result. The theoretical framework used for this study is the Health Belief Model by Becker (1974) from the work of Rosenstock (1966). The theory states that the perceived level of susceptibility, severity, benefits and barriers are factors that influence an individual‟s likelihood of adopting a new health practice. The study employed both quantitative and qualitative research methods of Questionnaire, Focus Group Discussion and Key Informant Interview. Findings of this study revealed that Health education communication (HEC) in Ovia North LGA utilize multiple communication platforms such as home visits, compound discussion, distribution of leaflets and messages via cassette and phone. The study established that despite the efforts of HEC and the viable communication methods they deploy to create awareness on Polio and the importance of the vaccine, there is still considerable refusal or non-compliance of Polio vaccine in the communities and the residents are aware and concerned. It was discovered that the people in the communities do not accept the vaccine because it is free while they pay huge sums of money to be treated in hospitals. Interestingly, others still believe it is an evil attack not a health problem. The study recommends that HEC should engage educational institutions, especially secondary schools, to create health clubs for awareness on health issues like polio. Also, HEC should carry out a study and interact with community people to agree on the time for awareness and vaccination rounds.

CHAPTER ONE
GENERAL INTRODUCTION
1.0 Background to the study
Poliovirus is a disease that has been ravaging the health of children within zero to five years over a long period of time. This is due to the damage it inflicts on the nervous system which results in paralysis and sometimes, death of a victim. Globally, this disease has been declared deadly and different measures to curb the spread of the disease and administer the required vaccine became important and paramount.

Diseases affecting the society such as Malaria, Tuberculosis, HIV/AIDS, Cholera and Poliovirus among others have caused millions of deaths of adults and children. Attention of countries in the world has turned to eradicating the Poliovirus disease and safe-guarding the society for healthy living. Bill and Melinda Gates Foundation (2011) recorded that, since 1988 the World Health Assembly established the goal of eradicating Polio as one of the infectious and fatal diseases that paralyzed about 350,000 children annually through different Polio eradication initiatives globally. Mass vaccination campaigns which led to the cut-down of Polio cases by 99% was achieved by the coming together of some organizations that formed a large public health initiative. It consist of WHO, UNICEF, CDC, USAID, Bill and Melinda Gates Foundation, NonGovernmental Organizations and more.

Nigeria National Immunization Coverage Survey (2010) reported that, the Nigerian Expanded Programme on Immunization (EPI) was initiated in 1979 to address Polio crisis. Some progress was made with the Universal Child Immunization in the 1980s, followed by a significant decline in the 1990s. In an effort to enhance the effectiveness of the programme and to meet the global challenges of immunization, the EPI was restructured and renamed National Programme on Immunization (NPI) in 1997. Following the Federal Government Health Sector Reform, NPI was merged with the National Primary Health Care Development Agency (NPHCDA) in May 2007. The mandate of the NPHCDA is to protect children from vaccine preventable diseases through the provision of vaccines. This led to the immunization coverage survey done in practically all Nigerian states to ascertain immunization performance level. Evidence from the immunization survey indicates that variations exist in routine immunization performance across the country‟s zones with the South West and South East zones showing higher performance and the North

West and North East showing low-performance. The Independent Monitoring Board of the Global Polio Eradication Initiative Report (2016) shows that there are high risk local government areas such as Oredo, Ovia North and Chikun in Edo State and Wamako, Sokoto North and Sokoto South in Sokoto State with highest prevalence of non-compliance.

Poliovirus disease is an extremely infectious disease caused by a virus that attacks the nervous system. Children younger than 5 years old are more likely to be infected by the virus than any other group. There are three types of Polio infection: Sub-clinical, Non-paralytic and Paralytic. Sub-clinical and Non-paralytic do not affect the brain and spinal cord (central nervous system) but Sub-clinical patients may not experience any symptoms while Non-paralytic produces only mild symptoms and does not result in paralysis. However, Paralytic is the rarest and most serious form of polio, which produces full paralysis in the patient. Poliovirus is often transmitted from person-to-person through faecal matter. Areas with limited access to running water or flush toilets are prone to contact the virus. The virus that causes polio is so contagious that anyone living with an infected person will likely become infected also. More so, it is transmitted through drinking contaminated water and eating contaminated food that contains the virus (Healthline Newsletter on Polio 2016). In the same vein, Ogden (2011) stated that the disease has the capacity to disfigure and paralyze its victim after an attack by the virus. It has the tendency to survive for two months outside the body and is transmitted in an area with open sewers and drains in filthy areas with poor sanitation. It can be spread undetected and reach the brain and spinal cord resulting in paralysis or death.

Communication of polio is critical in ensuring that children are fully immunized and simultaneous immunity is attained and maintained across large areas with high risk of the disease. The process uses communication strategies such as interpersonal communication, social mobilization and media campaigns among others. The communication tools and strategies try to engender outreach to the population, raise awareness concerning the virus and create demand for vaccine, preventing misinformation and doubts in Nigeria but there are communities with the problem of non-compliance. Interventions are intensified and funded in the country yet there is household non-compliance or resistance of vaccine and missed children. These communication tools and strategies have recorded success but there is a need to fast-track activities in order to fight noncompliance in some rural communities.

The Polio Network (2012) submits that Health education communication (HEC) was created by UNICEF in 2012. It was saddled with the responsibility of communicating issues around Polio, the need for and administering the vaccine. They communicate to families and communities about the importance of taking the oral polio vaccine to prevent polio infection. To extend human resource capacity in high risk states, about 7000 volunteers have been hired and they constitute the Health education communication across the country. This emergency system requires the support of volunteers in different communities to intensify communication activities on Polio eradication intervention until the goal is reached. Health education communication (HEC) sets out to ensure a poliovirus free society and nation through dissemination of information on modes of contracting and transmission of Poliovirus, prevention of the disease and other vaccine preventable diseases. They identify and characterize chronically missed children and non-compliant parents through a community-friendly approach to prevent the transmission of Poliovirus.

It further stated that, core of the volunteers' work is interpersonal counseling on pre-natal and ante-natal visits to the hospital by women, immunization and promotion of key households practices such as hygiene, treatment of diarrhea, prevention of malaria, and breastfeeding form. Volunteers from their respective settlements, preferably female volunteers, are trained to work as "change agents" in the community and are responsible for house-to-house mobilization for polio and routine immunization.

1.2 Statement of the Research Problem
The performance of polio vaccination has been improving even though Nigeria remains endemic among 3 other countries in the world (Nigeria, Pakistan and Afghanistan). In 2012, Nigeria reported 122 cases of wild poliovirus (WPV), representing 95% of the total reported cases in Africa and 54.5% of the cases reported globally. Nigeria recorded in 2013 58% reduction in the number of cases compared to 2012. Overall, there has also been a 50% reduction in the number of infected Local Government Areas in 2013 compared to 2012. In 2015, Nigeria had no record of polio outbreak but evidence from the immunization survey indicates that some Northern states have shown low-performance in administering vaccine. The Independent Monitoring Board of the Global Polio Eradication Initiative Report (2016) revealed high risk Local Government Areas such as Oredo, Ovia North and Chikun in Edo State among others with highest prevalence of non-compliance.

Various campaigns have however been done and are still ongoing by Government and NonGovernmental Organizations trying to create awareness on Polio crisis and the need for the vaccine. More so, records show resistance or non-compliance in some parts of Northern Nigeria. There exist practices and beliefs that pose threat to the fight against Poliovirus. Beliefs such as infertility caused by oral polio vaccine, children falling sick after receiving vaccine while some feel their children are not sick therefore, they do not need the vaccine. Practice such as eating germ-infested food, drinking unhygienic water and living in an unclean environment aid the spread of the virus.

The negligence of some parents on the issue of complete vaccination of their children or wards is a factor that needs immediate attention. Some children receive some doses but it would not be effective because they do not consistently receive all the doses that they should. Some settlements are left out and children missed during routine immunization days because of the lackadaisical attitude of some vaccinators. This has brought about the need to look into the polio communication approach used by organizations to influence people toward the acceptance of polio vaccine especially in rural communities in northern Nigeria.

1.3 Aim and Objectives of the Study
The aim of the study is to examine the impact of health education communication in the eradication of communicable disease (poliovirus).

The specific objectives are:

i. To investigate the knowledge and perceptions of poliovirus disease in the study locations.

ii. To identify and analyze the communication tools and strategies of the Volunteer Community Mobilizer Network for poliovirus intervention in the study locations.

iii. To explore the factors militating against acceptance of poliovirus vaccine in the study locations.

iv. To suggest ways that Polio eradication can be more effectively communicated for a lasting and sustainable result.

1.4 Research Questions
i. What are the perceptions and knowledge of people on poliovirus disease in the study locations?

ii. What is the communication tools and strategies deployed by Volunteer Community Mobilizer

Network for poliovirus intervention in the study locations?

iii. What are the factors hindering the acceptance of poliovirus vaccine in the study locations?

iv. How can polio eradication be more effectively communicated to communities for a sustainable change?

1.5 Justification for the Study
Investing in the health of people remains a high priority for government throughout the world. However, most developing countries like Nigeria have experiences which have shown that effective health intervention requires an attitudinal change. The study brings to bare some practices that contribute to the resistance of polio and possible ways that such practices could be addressed. Thus, solving health problems requires that people understand their environment and are motivated to adopt or change certain attitudes. At the early stage of Polio vaccination controversy in northern Nigeria (Edo), WHO declared the vaccine safe and emphasized that it was not going to administer medicine without consent of the people. This stresses the importance of local acceptance of the campaign among beneficiaries of the polio vaccination initiative. This study is significant because it benefits polio communicators and Organizations to realize that effective communication; changing attitude, practices and beliefs will enhance the acceptance of polio vaccine leading the nation to a polio free country. Also, it will contribute to the spread of knowledge and help others carry out further research in the academia.

1.6 Scope of the Study
There are different organizations across the nation committed to the fight against Polio through their various programmes among which is Health education communication. This study focuses on Health education communication (HEC) in Ovia North Local Government Area of Edo State. Among the areas covered by HEC within Ovia North Local Government Area, the study is limited to settlements within Muchia and Chikaji wards. This study tends to look at the perceptions of people on poliovirus disease and the communication approach used by HEC in Ovia North Local Government Area to ascertain its strength and weaknesses with a view to suggesting ways on how polio eradication can be more effectively communicated for a sustainable result.

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Item Type: Project Material  |  Attribute: 50 pages  |  Chapters: 1-5
Format: MS Word  |  Price: N3,000  |  Delivery: Within 30Mins.
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