ABSTRACT
This study was undertaken to examine the
roles of health agencies in the promotion of health in selected communities in
Esan West local government area. The
study was limited to Esan West Local Government Area of Edo state.
Questionnaires were designed to elicit information, which served as the basis
for the assessment of the various research questions of the study. The population
of the study comprised women attending antenatal care in Esan West Local Government Area of Edo State. The sample for
the study included 100 subjects (or respondents). The simple random sampling
technique was used to select the sample for the study from five healthcare
centres in Esan West Local Government Area. The study found that: There are no
regular health campaigns in most of the communities visited for the study,
although general health campaigns were rare, Child immunization is regular in
these communities. There are no adequate facilities in the community health
centres. Children are taught in schools health and hygiene practices; the
impact of teachers in enlightening residents on proper health habits is
minimal. The only form of health education relieved by the people comes from
antenatal care centres. The role of NGOs in financing health programs in these
communities as well as the provision of vaccines is unhidden. Following the
findings above, the study recommends among others that there should be regular
health campaigns in communities; the government should ensure there are
adequate facilities in community health centres and Antenatal care service
should be made available and accessible in every community; the school as a
primary health agency should ensure that children are though in schools health
hygiene practices.
TABLE OF CONTENTS
Title Page- - - - - - - - i
Certification- - - - - - - - iii
Dedication- - - - - - - - iv
Acknowledgement- - - - - - - v
Abstract- - - - - - - - viii
CHAPTER ONE: INTRODUCTION
Background to
the Study- - - - - - 1
Statement of
problem- - - - - - - 7
Purpose of the
Study- - - - - - - 8
Research
Questions- - - - - - - 8
Scope of the
Study- - - - - - - 9
Limitation of the
Study - - - - - 9
Significance of
the Study - - - - - 9
Definition of
Terms- - - - - - - 10
CHAPTER TWO: REVIEW OF RELATED LITERATURE
Concept of health
and health agency- - - - - 12
Health promotion- - - - - - - 13
Factors affecting
community health- - - - - 15
Role of health
agencies in institutions of learning- - - 17
Established health
agencies - - - - - 25
Roles of international
health agencies- - - - 29
Use of antenatal
care by pregnant women- - - - 34
Summary of
literature review- - - - - 36
CHAPTER THREE: METHODOLOGY
Research Design
of the study - - - - - 38
Population of
the study- - - - - - 38
Sample and
Sampling Technique- - - - - 39
Research
Instrument- - - - - - - 39
Validity - - - - - - - - 39
Reliability- - - - - - - - 40
Administration
of instrument - - - - - 40
Method of Data
analysis - - - - - - 40
CHAPTER FOUR: DATA ANALYSIS AND DISCUSSION
OF FINDINGS
Discussion of
Findings - - - - - - 46
CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS
Summary - -- - - - - - 49
Conclusion- - - - - - - - 50
Recommendations
- - - - - - - 51
REFERENCES- - - - - - - 52
Appendix- - - - - - - - 55
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Over the past 20 years, the number
of international actors involved in disease outbreaks and health emergency
responses has dramatically increased (Laverack, 2017). In the aftermath of the
2010 earthquake in Haiti, for example, several hundred international
non-governmental organizations were mobilized alongside the United Nations, the
government and the private sector, greatly increasing the complexity of the
situation. The global outbreak of the Covid-19 pandemic is the most recent in
the global events of health concerns. These concerns have continued to place a
higher demand on various agencies to provide some kind of support in the quest
to promote community and ultimately global health (Robinson, 2022).
The growing number of such events
has placed pressure on the availability of funding opportunities and, at the
same time, there has been a realization that the goal of involving communities,
though not as successful as expected yet, continues to play a crucial role in
the successful confrontation of community health concerns (Park, Reber, &
Chon, 2016). The transmission of communicable diseases between countries
is also a growing issue in which one country cannot be separated from another
because connections between people span national, geographic and cultural
borders. For example, the rapid spread of the Ebola virus in West Africa was
exasperated by the cross-border movement of people and by an already fragile
healthcare system not designed to contain a disease outbreak
An outbreak can refer to an
increase, often sudden, in the number of cases of a disease above the endemic
level in the population within a restricted geographical area or may extend
over a much broader area and may last for a prolonged period (Watt, Williams,
& Sheiham, 2014). A health emergency occurs when the consequences have
the potential to overwhelm the capabilities of the health system to contain the
problem. Disease outbreaks and health emergencies are closely connected and the
term “disease outbreaks” has been used in this commentary to cover both
contexts (WordPress, 2016).
Health promotion has a key role to play in disease outbreaks
because it can offer well-established approaches that can be utilized as part
of a response. These are essentially bottom-up approaches that actively involve
communities as the way forward and integrate local expertise and civil society
networks for the delivery of activities. The role of health promotion includes
data collection, communication, community capacity-building and engagement, and
rumour and resistance management.
In the post-outbreak response, health promotion also has a
valuable role in addressing stigma, working with survivors and providing social
support to families and communities. Community engagement is an especially
important but underestimated activity that is a crucial step to help others
address the risks that are caused by an outbreak (Damian & Gallo, 2020).
Communication is also an important approach encompassing health communication
and communication for development which are used to promote positive health
behaviors. Hygiene promotion campaigns, for example, prevent person-to-person
disease transmission by targeting individuals to hand-wash with soap. However,
the emphasis on individual responsibility must avoid leading to accusations of
‘victim-blaming’, making people feel guilty about their state of health even
though certain risk factors are outside of their control, for example not
having proper quarantine facilities to prevent cross-infection. The guiding
principle is to facilitate people to make informed choices to collectively
modify their behaviour by identifying their needs and then by taking actions to
resolve them, such as self-quarantine and disinfection to avoid infection. The
critical point is that disease outbreaks can only be fully addressed by helping
people to empower themselves rather than simply trying to change their
behaviour. The difference is whether or not the approach gives the health
promoter the authority to control the situation, for example through setting
the agenda. If it does, it is less likely to be empowering. If it facilitates a
process of needs assessment, planning and capacity-building toward collective
action, it has a much better chance of success. The advantage of empowerment is
that it strengthens the whole, the individual, the family group, and the
community. Empowerment increases autonomy, and personal skills, and gives
people the control they need to achieve healthier lives.
Health promotion has an important role in the post-outbreak period
as it increases awareness about available facilities and promotes the use of
services such as vaccination, counselling and welfare initiatives. Health
promotion can help to build social support networks for the survivors of an
outbreak and to counter stigma and isolation. Several medical complications
have been reported in survivors, for example in those of Ebola and Zika
diseases, including eye and neurological problems such as microcephaly and
Guillain-Barré syndrome. Health promotion support includes counselling
survivors, mobilizing communities to assist with rehabilitation services for
people with disabilities, social support through self-help groups and
networking with patients dealing with long-term psychosocial complications
(International Conference on Health Promotion, 2016)
The responsibility for maintaining and improving public health
lies with all sectors of society. Society's efforts have been carried out
through a combination of personal health care (sometimes called "medical
care") and public health systems. Through the activities of both private
and governmental healthcare providers, organizations, and institutions, the
personal healthcare system provides primarily curative services, such as
treating illnesses and injuries, to individuals with relatively little
attention to prevention. The financing of these services comes from the
out-of-pocket payments of patients, private health insurance, and government.
However, to enhance and maintain the public's health, preventive programs and
activities are needed. The public health system focuses on prevention through
population-based health promotion public services and interventions which
protect entire populations from illness, disease, and injury. The primary
providers of these public health services are government public health agencies
(Perkins, 2010).
Public health agencies in communities are responsible for
protecting, assessing, and assuring individual, community, and environmental
health. These agencies build partnerships and often provide or coordinate
direct services to ensure that there is access to adequate health services in a
community. Public health agencies have particularly played this role in efforts
to reduce the toll from illness, injury, and environmental and other risks.
They have also directly taken on the challenges of addressing the healthcare
service needs of the most vulnerable and at-risk individuals and groups. Public
health agencies meet obligations to their communities in many different ways:
by fostering a wide range of policy-guided community initiatives to promote
health and improve health conditions; through the collection, monitoring, and
dissemination of information about health status and disease occurrence;
through the direct provision of service in the community and the home; and
community education. Another role public health agencies play is to regulate
sources of risk and promote health and safety practices, such as by licensing
restaurants and health facilities and regulating water and air quality.
Public health tasks are carried out primarily by governmental
health and environmental protection agencies at local, state, and national
levels. Some non-governmental organizations and private individuals perform
public health activities in cooperation with or at the request of government
agencies. Frequently, the government agency provides either financial or
technical assistance. Because the government functions as a representative of
the people and needs to be responsive to them, the ultimate responsibility for
public health activities must lie with government agencies. Non-governmental
organizations carry out many useful activities. However, only government
agencies derive their authority from the entire community, locality, and nation
and are therefore accountable to the entire public. Public health agencies,
even while being cost-conscious, are in principle not constrained by profit
motives or by agendas other than that of the public's health (American Public
Health Association, APHA, 2015).
1.2 Statement of Problem
There is no denying the fact that
our healthcare index is very poor and that the majority of our people are
suffering. Today, Esan West Local Government Area has been rated as one of the
local governments with high maternal morbidity and infant mortality rates in
Edo state. This is because public hospitals and health centres are grossly
under-equipped while private hospitals provide high-cost health and medical
services, to the detriment of the poor. Also, self-medication is on the
increase just as the market for quackery has blossomed in the community
(Aganaba 2018).
Ojo, (2014), identifying with the
above, stated that the factors contributing to the dwindling effect of
community health administration in any rural area, including inadequate funding
of health care delivery services by the local government, the rising cost of
treatment, poor integration of private health sector, low public enlightenment
and lack of community involvement and participation. With these problems,
already plaguing communities in Esan West Local Government Area, and continuous
outbreaks of diseases (i.e. Lassa fever) there is an urgent need for community
health promotion that focuses on living disease-free lives rather than curing
diseases. And there is a need to re-examine the functions of established health
agencies in accomplishing this task.
1.3 Purpose of the Study
The purpose of carrying out this
study is to examine the roles of health agencies in the promotion of health in
selected communities in Esan West local government area. The study specifically
aims at;
· Assessing
the roles of primary health agencies in promoting community health
·
Examining the roles of educational
institutions as health agencies
· Roles
of non-governmental organizations in the promotion of community health
1.4 Research Questions
1. What
are the roles of health agencies in the promotion of health in communities?
2. What
are the roles of primary health agencies in the promotion of community health?
3. What
are the roles of the school as an agency for health promotion?
4.What
are the roles of non-governmental organizations in the promotion of community
health?
1.5 Scope/Delimitation of the Study
This project work is meant to
examine the roles of health agencies in the promotion of health in selected
communities in Esan West local government area, and thus the findings are
restricted to Esan West Local Government Area of Edo state.
1.6 Limitations of the Study
In carrying out this research, several challenges are envisaged by
the researcher such as:
·
Failure, of respondents, to return all
administered questionnaire
·
Irregular completion of the questionnaires
which may lead to rejection
·
Respondents may not understand the purpose
of the study and thus may not take the exercise seriously.
1.7 Significance of the Study
The findings of this study would
help to educate members of the public, particularly in Esan West LGA, on the
roles of health agencies in promoting health in their communities, thereby
making it easy for members of society to offer their cooperative, efforts
in the joint responsibility (between the agencies and community members) of
promoting community health. It will help remind the government and public
health workers of their health obligation to members of society. That is
the responsibility of promoting the health of its citizens. It will help as a
reference source for researchers who, in the future, may want to carry out
studies in this area.
1.8 Operational Definition of Terms
Primary Health Care: This
is an essential health care made universally accessible to individuals and
families in the community
Community Mobilization: This
is a process of encouraging and arousing the interest of members of a given
community to be actively involved in identifying their problems and planning
for solutions to them, to ensure self-reliance and initiative.
Community diagnosis: This
is the process of finding out the needs (problems) of a particular community
with the assistance of members of the community.
Advocacy: Advocacy
in primary health care simply means the process of creating awareness of
certain health programs
Health: This
is defined as a state of complete physical, social and mental well-being of an
individual and not mainly the absence of disease or infirmities.
Community: Is
defined as a specific group of people living in a defined geographical area,
who share a common culture, values and norms and are arranged in a social
structure according to relationships over time.
Management: This
is the organization and coordination of the activities of an enterprise
following certain policies in the achievement of
defined objectives.
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