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Using a socio-demographic approach to examine community health services and HIV/AIDS awareness in Southeastern Nigeria
Investigating community health services and HIV/AIDS awareness in the African countries is now a priority. Owing to socioeconomic factors, the Africans continue to starve and neglect health conditions. Poor resources and low education levels make it extremely difficult to raise awareness about life-threatening diseases and available health services. This research prospectus will particularly discuss about the Southeastern region of Nigeria. A social transformation is highly desired. Government aids will prove futile if social stigmas are not given up and community participation is pursued. Women health is important and a HIV positive female tends to transmit the disease to the offspring that results in premature death. Men and commercial sex workers should be made aware about using condoms, and sex education must be made compulsory in schools.
Raising awareness about public health isn’t limited to HIV/AIDS. It is an approach towards maintaining an overall good health for the entire community. Women, children and physically challenged sections are always neglected and suffer from infectious diseases. HIV and Malaria are rampant in Southeastern Nigeria. Due to a thriving patriarchal society, women end up marrying an infected patient. Regular health checkups and tests should be made mandatory.
The three common causes of HIV/AIDS in Nigerian states are discussed below:
According to Avert (2014), heterosexual activities contribute to approximately 80 percent of HIV cases in Nigeria. Women are at a greater risk of falling prey to this infectious disease. In 2011, almost 1.7 million women were noted to be HIV positive. About 3 percent of HIV positive patients belonged to the age group of 15-24. Lack of information and education about sexual health fails to tolerate the wrath of rising levels of sexually transmitted diseases. Minimal use of condoms also contributes towards the alarming rise of HIV/AIDS among women. It is gender inequality that has been recognized as the key cause of the HIV epidemic among Nigerian women. Blood transfusions through unsafe blood banks have been identified as the second largest reason behind spreading of HIV. Technology innovations required for screening HIV is lacking in these centers. Mother-to-child transmission is the other main cause, and approximately 69,400 children were found to be HIV infected in 2011. Sex workers and drug users are at a high risk of acquiring this infection (as cited in Avert, 2014).
This prospectus focuses mainly on three states belonging to the region of Southeastern Nigeria: Enugu, Anambra and Abia. The rationale behind choosing these states is discussed below. Brief references have been made to the Cross River State and Sub-Saharan Africa. Theoretical research will be conducted using a socio-demographic approach. Challenges and opportunities are vividly discussed in order to analyze the availability of health services for the minority section.
Are gender inequality and economic disparities the significant contributors toward the rising cases of HIV/AIDS in Southeastern Nigeria?
Will sex education and campaigns raise awareness about HIV/AIDS?
Nature of the study
The study will encompass a detailed theoretical and data analysis in order to examine community health services and HIV/AIDS awareness in Southeastern Nigeria. The range and extent of such analysis is given below.
The Enugu state of Southeastern Nigeria is the most vulnerable region. The biggest difference exists across the socioeconomic status. Low income families do not have access to quality healthcare and opt for medical providers of doubtful quality. Herbalists are used by the middle and higher income families. Regardless of all the investments that have been made to improve the quality of public healthcare in Enugu, the social stratification continues to segregate the public from accessing quality health facilities. Poor people that include a substantial proportion of the rural areas have questionable healthcare systems that provoke them to spend on useless services. This leads to economic loss and ultimately, an increased economic burden of ill health. The low income families lack awareness about the seriousness of various diseases or, they cannot afford the various available services. In order to improve the worsening situation in rural areas, experts suggested several measures like utilization and financing of healthcare services, providing subsidies to healthcare and constriction of affordable public hospitals. Programmes should be envisioned to increase financial risk protection of healthcare systems. Research shows that mortality rate lowers between 1.1% and 6.9% for each 10% hike in public spending (as cited in Onwujekwe et al., 2011).
According to Entonu and Agwale (2007), commercial sex workers in Enugu have been already diagnosed with HIV and a 13-year-old sexually active teenager represented the first case of HIV in Nigeria. Sex workers are known for spreading this infection to various parts of the country. Youths in Enugu aged between 20-29 years have reported the maximum number of HIV cases. According to the national HIV survey conducted by the Federal Ministry of Health, the adult HIV occurrence has risen from 1.8% in 1991, to 4.5% in 1996, 5.8% in 2001 and 5.0% in 2003. National data showed a prevalence of 5.0% among 27,708 women and 12% of such cases are from the Southeastern coastal region of the Cross River State. Nigeria is recorded to have about 70% of low-income population and literacy level is as low as 55%. Cases of HIV are associated with much other illness that makes patients vulnerable to the virus. Kaposi's sarcoma and herpes zoster are commonly associated with HIV infection. Patients with Kaposi’s sarcoma had 60% cases of HIV, while patients with herpes zoster had 69.2% of HIV cases. Even patients with cervix cancer are prone to HIV. Though the secondary school teachers in Southeastern Nigeria are knowledgeable about HIV/AIDS, but they refrain from passing such information to the students owing to social and cultural restrictions. Introduction of sex education is urgently required and is acknowledged to be an efficient measure to stop unwanted pregnancies and sexually transmitted diseases (as cited in Entonu and Agwale, 2007).
The rise of HIV/AIDS is also linked with malnutrition. HIV progresses faster in pregnant women with anemia. An iron- and foliate-deficient diet and hookworm infections result in anemia.HIV infection during pregnancy is associated with increased risk of anemia-related maternal death in Nigeria. Sub-Saharan Africa is the worst affected region with 25.4 million people living with HIV. Sub-Saharan women of reproductive age make up almost 57% of living HIV patients and accounts for 80% of HIV-infected women in the world (Uneke et al., 2007).
Given that the faulty community health services have been identified, I would now discuss the ongoing attempts that can solve HIV/AIDS issues in communities of Southeastern Nigeria.
There are several federal and state level campaigns that strive towards ensuring quality community health services and raise awareness about HIV/AIDS in Southeastern Nigeria. Christian Aid in Nigeria is working on several projects sponsored by institutional and other key donors. It has incorporated a project to strengthen community health and response to HIV. It utilizes an integrated approach and delivers service through trained community-based agents. This project began in 2010 and has managed to reach a million people. There is Voice to the People (V2P) programme in Anambra that involves the state and local governments in decision-making process and entitles the public to demand their rights and services from the government. This programme is lead by Christian Aid and services are delivered by partnership of state-level and national organizations. This programme will run across 12 local government areas of Anambra. It will reach over 2.4 million people and assist in capacity building (Christian Aid, 2015).
According to Okeibunor et al. (2013), Nigerian states have a significant population comprising the nomads. This section of the Southeastern Nigerian population has least access to health services as compared to the general population. The Community-Directed Intervention (CDI) strategy is ideally used to offer equal treatment for everyone. By incorporating CDI, the communities can themselves direct the planning and implementation of intervention. Until now, CDI has worked in more than 19 African countries. In this process, the community takes charge of specific health issues through a series of community meetings. This approach can be utilized for targeting issues of HIV/AIDS among the nomads in Enugu (as cited in Okeibunor et al., 2013). According to Sheik-Mohamed and Velema (1999), nomads have less access to formal education; thus, hampering community upliftment.
Now the analysis will be made about the Abia state government’s initiatives in preventing cases of HIV/AIDS. According to the 1991 Nigerian Population Census, the Abia State had a total population of 1,913,917 that consisted of 933,039 males and 980, 878 females. Approximately, 70% of the population lived in major urban hubs, while the rest resided in rural areas with fragile healthcare services (as cited in UNDP, 2005). Ogbonna (2013) noted that the Abia State government targets to achieve zero percent transmission of HIV from mother to child. The results are aimed to be achieved by the end of 2015. Franklin Orji, director of Public Health Services, announced the availability of health facilities equipped with HIV/AIDS amenities for pregnant women. The number of PMTCT providing services would go up from 43 to 342 centers in Abia. Low availability of PMTCT facilities for women resulted in 23 percent rise of infected pregnant women, and over 5,000 infected infants. The state government is also making efforts to impart education about HIV/AIDS to the traditional birth attendants (as cited in Ogbonna, 2013).
The federal government has granted N8 billion for the fight against HIV/AIDS in Taraba and Abia. This would be channelized thorough the National Agency for Control of AIDS/SURE-P HIV Implementation programme. The funds are targeted towards offering Anti-Retroviral Therapy (ART) treatment to an estimated 50,000 eligible adults and children, and for Prevention of Mother to Child Transmission (PMCT) care to 10,000 pregnant women in the two states. Transfer of power from the federal to state government is to ensure active involvement of local governments in fight against HIV/AIDS (as cited in Leadership, 2015).
Possible types and sources of information or data
Data or information will be mainly collected from government sources/websites and documents. International journals are the key sources for this research work. International media reports and academic texts will also form a substantial part for theoretically supporting this work. NGO campaigns are also sourced here to declare practical resolution to the problems of community health services in Southeastern Nigeria.
Anticipated results and possible limitations
A socio-demographic approach utilized in this paper revealed that, it is the economically poor families in the age group of 15-29 to be under the massive threat of acquiring HIV. Though there are several new policies at the national and state-levels, but community involvement needs to be boosted in order to bring about social transformation in Southeastern Nigeria. Sex education is extremely important and should be implemented superseding all orthodox cultural norms among African countries. People with HIV should be treated fairly and awareness about the causes of AIDS must be enhanced. Despite rigorous international campaigning, half of the population in developing countries is under the false notion that casual contacts with the affected person transfers HIV infection. This leads to stigmatization and stops the infected person from choosing the available treatments. Gender inequality is another concern and women are rarely aware about the implications of their negligence upon the next generation. Community leaders should bring up these issues with the state government and relief measures should be made by targeting the socio-demographic profiles. This would confirm equity among everyone.
There are few limitations of this research paper and these can be used for further investigation. The focus of this paper is on Enugu, Abia and Anambra. Studying the socio-demographic factors of other states in Southeastern Nigeria can help develop a complete overview of fighting measures adopted against the rise of HIV/AIDS.
Avert. (2014). Global epidemic: Sub-Saharan Africa. Retrieved from: http://www.avert.org/hiv-aids-nigeria.htm.
Christian Aid. (2015). Christian Aid in Nigeria. Retrieved from: http://www.christianaid.org.uk/whatwedo/africa/nigeria.aspx?Page=3.
Entonu, P.E. and Agwale, S.M. (2011). A review of the epidemiology, prevention and treatment
of human immunodeficiency virus infection in Nigeria. Brazilian Journal of Infectious Diseases. Vol. 11(6). Retrieved from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702007000600011.
Leadership. (2015, February 24). FG Spends 8bn To Fight HIV/AIDS In Taraba, Abia. Retrieved
Ogbonna, A. (2013, August 2). Nigeria: Abia scale up PMTCT services. Health Newborn
Network. Retrieved from: http://www.healthynewbornnetwork.org/press-release/nigeria-abia-scale-pmtct-services.
Onwujekwe et al. (2011, November 2011). Constraints to universal coverage: inequities in health
service use and expenditures for different health conditions and providers. International Journal for Equity in Health. Retrieved from: http://www.equityhealthj.com/content/10/1/50.
Okeibunor, et al. (2013, April 8). Prospects of using community directed intervention strategy in
delivering health services among Fulani Nomads in Enugu State, Nigeria. International Journal of Equity Health. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3648442/#B1.
Sheik-Mohamed, A. Velema, JP. (1999). Where health care has no access: the nomadic
populations of sub-Saharan Africa. Tropical Medicine & International Health. Vol. 4(10).
Uneke et al. (2007). Prevalence and Public-health Significance of HIV Infection and Anaemia
among Pregnant Women Attending Antenatal Clinics in South-eastern Nigeria. Journal of Health, Population and Nutrition. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2754029/.
UNDP. (January, 2005). Abia state economic empowerment and development strategy. Retrieved
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