ABSTRACT
Health seeking behaviours are important determinants of health and health outcomes especially in Nigeria, where different avenues exist for seeking and receiving health care. This study was carried out to evaluate the health seeking behaviour towards hypertension among adult traders in Ahia-Ohuru market Aba, Abia state. The sample size for this study were 342 adult traders in Ahia-Ohuru market, Aba, Abia State, which were selected with the aid of balloting. A structured questionnaire was used to get the data which was used for this study, while the data was analyzed using descriptive statistics of frequency and percentage. The association between the variables was done using chi-square analysis. The result on personal data of the adult traders revealed that majority (72.3%) of the adult traders resided in urban areas of the city, 55.7% were females, and 93.9% were Christians. The result on health seeking behaviour showed that more of the adults (28.9%) visited private health facilities when they were ill as against 2.0% who visited traditional or herbal health centers when they were ill, and 2.9% who visited faith healers. The result on blood pressure showed that 39.4% of the adults had normal blood pressure, 30.8% were pre-hypertensive, 18.9% have stage 1 hypertension while few (10.9%) had stage 2 hypertension. The result when further disaggregated by sex revealed that more males; 21.2% and 11.1%, were suffering from stage 1 and stage 2 hypertension as against the female 17.0% and 10.8%, respectively. The result on the association between health seeking behaviour of the adult and their blood pressure revealed that there was a positive association between health seeking behaviour using private health facility, self-medication with herbal drugs, and self-medication with pharmaceutical drugs and faith healers, with blood pressure of the adults. Also, the result on the association between personal data and blood pressure of the adults revealed that there was a positive association between age, educational level, occupation, income level and salt consumption with blood pressure of the adults. The study therefore concludes that, educational level, income level and occupation are probable factors which may inadvertently contribute to hypertension.
TABLE OF CONTENTS
TITLE PAGE i
CERTIFICATION ii
DEDICATION iii
ACKNOWLEDGMENTS iv
TABLE OF CONTENTS v
LIST OF TABLES vii
ABSTRACT viii
CHAPTER 1
INTRODUCTION
1.1 Statement of Problem 3
1.2 Objectives of the Study 5
1.3 Significance of the Study 5
CHAPTER 2
LITERATURE REVIEW
2.1 Hypertension 7
2.1.1 Causes of Hypertension 8
2.1.2 Risk factors associated with High Blood Pressure 12
2.2 Health Seeking Behaviour 14
2.2.1 Determinants of Health-Seeking Behaviour 16
2.2.2 Forms of Health Care 22
2.3 Traders 30
CHAPTER 3
MATERIALS AND METHODS
3.1 Study Design 31
3.2 Area of Study 31
3.3 Population of the Study 32
3.4 Sampling and Sampling Technique 32
3.4.1 Sample Size 32
3.4.2 Sampling Procedure 33
3.5 Preliminary Activities 34
3.5.1 Preliminary visit 34
3.5.2 Training of research assistants 34
3.5.3 Informed consents 34
3.6 Data Collection 35
3.6.1 Questionnaire Administration 35
3.6.2 Interview 35
3.6.3 Blood Pressure measurement 35
3.7 Data Analysis 36
3.8 Statistical Analysis 37
CHAPTER FOUR
RESULTS AND DISCUSSION
4.1 Personal Data and the Socio-Economic Status of the Adult Traders 38
4.2 Health Seeking Behaviour Towards Hypertension Among the Adults 42
4.3 Blood Pressure of the Adult Traders 48
4.4 Association Between Health Seeking Behaviour of the Adult Traders
and their Blood Pressure Measurement 48
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
5.1 Conclusion 52
5.2 Recommendations 52
REFERENCES 54
Appendixes 66
LIST OF TABLES
3.1 Guidelines for interpreting blood pressure measurements 36
4.1a Personal data and the socio-economic status of the adult traders 40
4.1b Personal data and the socio-economic status of the adult traders 41
4.2a Health seeking behaviour towards hypertension among adult traders 44
4.2b Health seeking behaviour towards hypertension among adult traders 45
4.3 Blood pressure measurements of the adult traders 47
4.4 Association between health seeking behaviour and blood pressure of adult traders 50
4.5 Association between personal data and blood pressure of the adult traders 51
CHAPTER 1
INTRODUCTION
The American Heart Association (AHA) defined hypertension as blood pressure that is consistently higher than 130 over 80 millimeters of mercury (mmHg) (Arnett et al., 2019). Hypertension (also known as high blood pressure) is one of the most common non- communicable diseases affecting adults all over the world. It is now being widely reported in Africa and is the most common cause of cardiovascular disease on the continent. It is also a major factor in the high mortality of adults in sub-Saharan Africa (World Health Organization (WHO), 2005). Hypertension and its complications are estimated to cause 9.4 million deaths every year (Lim et al., 2012).
Adeloye and Basquill (2014) reported that the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. By itself, hypertension has no early recognizable symptoms and, as a result, patients with hypertension often come to medical attention late when they already have developed complications such as strokes, heart attacks, heart failure and kidney failure, all of which are major causes of death in the adult population (Perkovic et al., 2007). For this reason, hypertension is often called a 'silent killer' (Murtagh and Rosenblatt, 2010). The burden of non-communicable diseases (NCD) is rising rapidly nationally and globally constituting a major challenge to development (WHO, 2007).
Health-seeking behaviour has been defined as a sequence of remedial actions that individuals undertake to rectify perceived ill-health (Ahmed et al., 2000). Health-seeking behaviour is a part and parcel of a family or community identity being the result of an evolving mix of personal, experiential and socio cultural factors. It varies for the same individuals or communities (Iyalomhe and Iyalomhe, 2010).
The concept of studying health seeking behaviours has evolved with time. Today, it has become a tool for understanding how people engage with the health care systems in their respective socio-cultural, economic and demographic circumstances. All these behaviours can be classified at various institutional levels: family, community, health care services and the state (Boutain and Spigner, 2008).
Multiple channels of health care exist in most countries. Although homeopathic and other forms of alternative medicine (for example herbal medicine) are utilized in some industrialized countries, the major channels of health care in the developed countries are cosmopolitan, western-style health care institutions like clinics, general and specialist hospitals (Harding and Taylor, 2002). This is in contrast to the situation in Nigeria and in other developing countries where the channels of care which are utilized are more varied, consisting of indigenous healers, spiritual churches, pharmacies, patent medicine vendors (PMVs) and hospitals (Brieger et al., 2004).
The market traders, who are hypertensive, prefer going to a herbalist for treatment, neglect their health condition, barely check their blood pressure status, while some do not even take the advice given to them by health care professional either because of their belief, level of knowledge and even nature of work. While others neglect checking their blood pressure status until they develop complications such as stroke, cardiovascular disease, or even kidney failure. Various factors such as ethnicity, class, gender and other aspects of people's backgrounds (including family factors) seem to have a strong influence on health care-seeking behaviour (Iyalomhe and Iyalomhe, 2010).
In particular, health-seeking behaviour can be described with data collected from previous research report, such as the time difference between the onset of an illness and getting in contact with a healthcare professional, type of healthcare provider market traders sought help from, how compliant market traders are with the recommended treatment, reasons for choice of healthcare professional and reasons for not seeking help from healthcare professionals (Onwujekwe et al., 2011).
This study aims to assess the health seeking behaviour towards hypertension among adult traders in Ahia-Ohuru market, Aba, Abia State.
1.1 STATEMENT OF PROBLEM
Hypertension is a significant and growing public health problem in developing countries, such as Nigeria (Cruickshank et al., 2001). This is because its prevention and control has not been given proper attention as a result of the fact that it is often regarded as a normal disease that can occur to the elderly and aged people. Nigeria, currently with a population of over 160 million, is the most populous in Africa (World Bank Nigeria, 2013), and the prevalence of hypertension in the country hugely contributes to the overall burden in Africa (WHO, 2005). In 2008, WHO estimated hypertension prevalence of 42.8% in Nigeria. This is believed to be due to an increasing adult population, rapid urbanization and uptake of western lifestyles, including high consumption of processed foods (with high salts and fats), tobacco and alcohol products (Mezue, 2013).
Research findings show that high blood pressure is diagnosed in many people as an incidental finding when admitted for unrelated ailments (Perkovic et al., 2007). This obviously has resulted in high morbidities and mortalities from hypertension in Nigeria (De-Graft Aikins et al., 2010).
Knowledge, attitude, practice and other factors like non-availability of health facilities, lack of drugs, and lack of money to pay for treatment cost has led to traders’ poor health seeking behaviour towards hypertension, which has led to complications of hypertension and even death (Katung, 2001). Awareness, treatment and control of hypertension are extremely low in this country as health care resources are overwhelmed by other priorities including HIV/AIDS, tuberculosis and malaria.
The paucity of research in that area, and the fact that health seeking behaviour studies is not known in most widely used medical textbooks, however shows that health seeking behaviour studies are not presented in a manner that will deliver an effective route forward. Due to these problems or challenges identified, this research is worth carrying out to discover the Health Seeking Behaviour towards Hypertension among adult traders.
1.2 OBJECTIVES OF THE STUDY
The general objective of this study is to assess the health seeking behaviour towards hypertension among adult traders in Ahia-Ohuru Market, Aba, Abia state. The specific objectives include to:
1. Assess the personal data and the socio-economic status of the adult traders in Ahia-Ohuru market.
2. Explore health seeking behaviour towards hypertension among adult traders in Ahia-ohuru market.
3. Determine the factors affecting the health seeking behaviour of adult traders in Ahia-ohuru market.
4. Measure the blood pressure of the adult traders in Ahia-ohuru market.
5. Determine the association between health seeking behaviour of adult traders in Ahia-ohuru market and their blood pressure measurements.
1.3 SIGNIFICANCE OF THE STUDY
Findings from this study will help provide a good knowledge about hypertension "a silent killer"; which shows no symptoms, but detected for the first time when it has already damaged one of the target organs like the heart, brain or kidney leading to complications like stroke, cardiovascular disease, kidney failure etc. It will also help provide a good knowledge on the different Health seeking behaviour of traders towards hypertension as well as the factors that influence their health seeking behaviour.
Furthermore, findings from this research also, will be of benefit to the market traders as it will enlighten them on the need for regular blood pressure check up, so that they will not realize they have hypertension when admitted for unrelated ailment or when they are already suffering the complications of hypertension. Results and findings from this research will not only contribute to existing academic literature but can also be used by the government, researchers, policy makers, and other relevant stakeholders to develop and implement strategies to manage and combat hypertension in the lives of the people living in the study area.
Nutritionist and dietitians will benefit from the findings of this study as it will provide more information on the lifestyle, health seeking behaviour, and blood pressure status of traders in the chosen area, which will aid them in giving nutritional advice to the respondents.
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