ABSTRACT
The study assessed the utilization of orthodox and traditional medicine in health-care management among rural farm households in South-South, Nigeria. The specific objectives were to: ascertain the health-care needs of farm households; determine the level of utilization of orthodox and traditional medicine, and examine the annual expenditure on orthodox and traditional medicine in health-care management among farm households, among others. A sample of 360 farm households was randomly selected through a multi-stage sampling technique. Primary data were collected through the use of structured questionnaire. Data were analyzed using descriptive statistics. Z-test and ANOVA were used to test the hypotheses. The result shows a prevalence of twelve illnesses in the study area with a grand mean score of (1.94). Respondents had low level of utilization for orthodox medicine and high level of utilization for traditional medicine with grand mean scores of (2.44) and (2.57). The respondents’ annual mean expenditure on orthodox medicine was N14, 331.30 compared to N5, 962.78 for traditional medicine. The Z-test showed a significant difference between the level of utilization of orthodox (2.444) and traditional (2.573) medicine with a Z- value of -3.271 at 5% level. Therefore, the null hypothesis was rejected. The Z-test also found a significant difference between the expenditure on orthodox and traditional medicine with a Z-value of 8.750. Therefore, the null hypothesis was rejected. Furthermore, the Z-test result found a significant difference between the farmers perception of the efficacy of orthodox and traditional medicine with a Z-value of 3.204 at 5% level. Therefore, the null hypothesis was rejected. The Z-test also showed a significant difference in respondents rating between the perceived factors affecting respondents’ utilization of orthodox and traditional medicine with a Z-value of 3.201 at 5% level, therefore, the null hypothesis was rejected. Moreover, ANOVA test showed significant difference in the levels of utilization of orthodox medicine across the three states with F-value of 6.654 at 5% level. Therefore the null hypothesis was rejected. Similarly, ANOVA test also showed significant differences in the level of utilization of traditional medicine across the three states with F-value of 16.105 at 5% level, therefore, the null hypothesis was rejected. Furthermore, the ANOVA test result also showed that significant differences existed in expenditure on orthodox medicine across the three states with an F-value of 6.161 at 5% level. Thus, the null hypothesis was rejected. Moreover, ANOVA test result also showed that significant differences existed in expenditure on traditional medicine across the three states with an F-value of 13.614 at 5% level, therefore, the null hypothesis was rejected. The study concluded that both orthodox and traditional medicines were utilized by farm households in South-South, Nigeria, but that the farmers were more favourably disposed to using traditional medicine than orthodox. It was recommended that Traditional medicine resource centres be established for people to start studying traditional medicine as a profession and policies be made to integrate traditional medicine into the mainstream of medical science, and that traditional medicine practitioners be empowered to function like the western medicine professionals.
TABLE OF
CONTENTS
Title
Page i
Declaration ii
Certification iii
Dedication iv
Acknowledgements v
Table
of Contents vi
List
of Tables xi
List
of Figures xiii
Abstract xiv
CHAPTER 1: INTRODUCTION 1
1.1 Background of the Study 1
1.2 Statement of Problem 7
1.3 Research Questions 12
1.4 Objectives of the Study 12
1.5 Hypotheses of the Study 13
1.6 Justification for the Study 14
1.7 Scope of the Study 15
1.8 Definition of Terms 15
CHAPTER 2: LITERATURE REVIEW 17
2.1 Conceptual Review 19
2.1.1 The Nigerian health system. 19
2.1.2 Global pattern of medical pluralism 20
2.1.3 Orthodox medical practice in Nigeria. 23
2.1.4 Orthodox health-care delivery system in
Nigeria 24
2.1.4.1 Types of orthodox health-care services 28
2.1.5 Traditional medicine in Nigeria. 28
2.1.5.1 Concept of traditional medicine 30
2.1.5.2 History of traditional medicine 32
2.1.5.3 Traditional medicine development in Nigeria 33
2.1.5.4 Forms of traditional medicine practiced in
Nigeria 37
2.1.5.4.1 Bone
setting 37
2.1.5.4.2
Traditional birth attendants 38
2.1.5.4.3 Herbal
medicine 39
2.1.5.4.4
Traditional psychiatrist 39
2.1.5.4.5
Traditional surgeon 40
2.1.5.5 Practitioners of therapeutic occultism. 41
2.1.6 Medicinal plants 42
2.1.6.1 The nature of medicinal plants 43
2.1.6.2 Maintenance of medicinal plant resources 43
2.1.6.3 Efficacy of traditional medicine 44
2.1.7 Models of health-care 47
2.1.7.1 The monopolistic health-care model 47
2.1.7.2 The tolerant (co-existence) health-care model 48
2.1.7.3 The parallel (Inclusive) or dual health-care
model 48
2.1.7.4 The integrative health-care model 48
2.1.7.5 The traditional model of health-care 49
2.1.8 Accessibility and utilization of health
services. 51
2.1.8.1 Accessibility 51
2.1.8.2 Utilization 55
2.1.9 Health seeking behaviour: approaches,
problems and prospects in the
developing world. 56
2.2 Empirical Studies on Health 59
2.3 Review of Related Theories. 64
2.3.1 Structural functionalism 64
2.3.2 Modernization theory 65
2.3.3 Gravity model 67
2.3.4 Rationale choice theory 67
2.3.5 Health belief model 69
2.3.6 Theoretical framework 71
2.3.6.1 The behavioural model of health service
utilization 71
2.4 Conceptual Framework 74
CHAPTER 3: METHODOLOGY 79
3.1 Study Area 79
3.2 Population of the Study 83
3.3 Sample and Sampling Procedure 83
3.4 Data Collection 85
3.5 Validity of Instrument 86
3.6 Reliability of Instrument 86
3.7 Measurements of Variables 86
3.8 Data Analysis 88
3.9 Hypotheses Testing 90
3.10 Model Specification 91
CHAPTER 4: RESULTS AND DISCUSSION
4.1 Socio-Economic Characteristics of the
Respondents 95
4.1.1 Age of the respondents 95
4.1.2 Marital status of the respondents 96
4.1.3 Household size of the respondents 97
4.1.4 Gender of the respondents 97
4.1.5 Farm size of the respondents 98
4.1.6 Farming experience of the respondents 99
4.1.7 Respondents' level of education 99
4.1.10 Respondents’ annual farm income 100
4.1.11 Cooperative membership of the respondents 101
4.2 Health-Care Needs of Farming Households
in the Study Area 105
4.3 Level of Utilization of Orthodox and
Traditional Medicine by Farm
Households in the
Study Area 109
4.3.1 Level of utilization of orthodox medicine by
farm households 109
4.3.2 Level of utilization of traditional medicine
by farm households in the
study area 112
4.4 Annual Expenditure Distribution on
Orthodox and Traditional Medicine
in Health-Care
Management among Farm Households in the Study Area 116
4.5 Perception of the Efficacy of Orthodox
and Traditional Medicine in the
Study Area 120
4.5.1 Perception of the efficacy of orthodox
medicine in the study area 120
4.5.2 Perception of the efficacy of traditional medicine in the study area 123
4.6 Factors Affecting Farm Households’
Utilization of Orthodox and
Traditional
Medicine in the Study Area 127
4.6.1 Factors affecting farm households’
utilization of orthodox medicine in
South-South
Nigeria 127
4.6.2 Factors affecting farm households’
utilization of traditional medicine in
South-South
Nigeria 132
4.7 Constraints Associated with the Use of
Orthodox and Traditional
Medicine in the
Study Area 136
4.7.1 Constraints associated with the use of
orthodox medicine by farm
households in
South-South Nigeria 136
4.7.2 Constraints associated with the use of
traditional medicine by farm
households
in South-South Nigeria 140
4.8 Hypotheses Testing 144
4.8.1 Testing hypothesis 1 144
4.8.2 Testing hypothesis 2 145
4.8.3 Testing hypothesis 3 146
4.8.4 Testing hypothesis 4 147
4.8.5 Testing hypothesis 5 148
4.8.6 Testing hypothesis 6 150
4.8.7 Testing hypothesis 7 152
4.8.8 Testing hypothesis 8 154
CHAPTER 5: SUMMARY, CONCLUSION AND RECOMMENDATIONS 157
5.1 Summary 157
5.2 Conclusion 161
5.3 Recommendations 162
References 164
Appendices 181
LIST
OF TABLES
4.1: Distribution
of respondents according to their socio-economic
characteristics 101
4.2: Mean
score responses of the health-care needs of the respondents
in the study area 108
4.3: Mean scores of the respondents on the
level of utilization of orthodox
medicine for
health-care management by farm households in the study
area 111
4.4: Mean
scores of the respondents on the level of utilization of traditional
medicine for health-care
management by farm household in the study
area 115
4.5: Annual
expenditure distribution on orthodox and traditional medicine
in health-care
management among farm households in the study area. 119
4.6: Mean scores of the respondents’ perception
of the efficacy of orthodox
health-care
service 122
4.7: Mean scores of the respondents’ perception
of the efficacy of traditional
health-care
services 126
4.8: Mean
scores of the respondents on factors affecting respondents
utilization of
orthodox health-care 131
4.9: Mean
scores of the respondents on the factors affecting respondents
utilization of
traditional health-care 135
4.10: Mean
scores of the respondents on the constraints associated with the
use of orthodox
medicine by farm households in South-South Nigeria 139
4.11: Mean
scores of the respondents on the constraints associated with the use
of traditional
medicine by farm households in South-South Nigeria 143
4.12: Z-test analysis of difference between the levels of utilization of
orthodox
and traditional medicine by the farm households in the
study area 144
4.13: Z-test
result of difference between the expenditure on orthodox and
traditional medicine in health-care
management among farm households
in South-South, Nigeria 146
4.14: Z-test
result of difference between the farmers’ perception of the efficacy
of orthodox and traditional medicine in the study area 147
4.15: Z-test of difference in respondents’ rating between the perceived
factors
influencing respondents’ utilization of traditional
and orthodox medicine
by rural farm households in the study area 148
4.16: Result
of ANOVA for test of difference in the levels of utilization of
orthodox medicine by the rural farm households
across the three states in
South-South, Nigeria 149
4.17: Result of differences in the levels of
utilization of orthodox medicine by
rural farm households among the three selected states
using Post hoc
multiple comparism test 150
4.18: Result
of Analysis of Variance of difference in the level of utilization of
traditional medicine by the farm households across the
three South-South
States 151
4.19: Result
of differences in the levels of utilization of traditional medicine by
rural farm households among the three selected states using
Post hoc
multiple comparism test 152
4.20: ANOVA
result of difference in the expenditure on orthodox medicine in
health-care management among farm households across
the three states
in the study area 153
4.21: Result of differences in the expenditure on
orthodox medicine by rural
farm households among the three selected states using Post
hoc multiple
comparism test 154
4.22: ANOVA test of difference between the expenditure on
traditional medicine
in health-care management among farm households across
the three states
in South-South Nigeria 155
4.23: Result
of differences in the expenditure on traditional medicine by rural
farm households among the three selected states using Post
hoc multiple comparism test 156
LIST
OF FIGURES
1: A conceptual framework for comparative
assessment of the utilization
of orthodox and
traditional medicine in health-care management among
rural farm
household in South-South, Nigeria 78
2: Map of Nigeria showing South-South
region 82
3: Sampling procedure breakdown figure 84
CHAPTER 1
INTRODUCTION
1.1 BACKGROUND
OF STUDY
The value attached
to good health cannot be overestimated. This is due largely to the fact that
the sustainability and viability of any nation’s socio-economic growth depends
on the vibrancy of her health sector (Orabuchi, 2005). In other words, the
health sector forms the backbone of the growth and development of any economy. The
dictums “Health is Wealth”, “A healthy nation is a wealthy nation”, etc are all
indications of the importance that is universally attached to health (Alubo,
2010). Health, according to World Health Organization (2006), is defined as a
dynamic state of complete physical, mental, spiritual and social wellbeing, and
not merely the absence of disease or infirmity. Health is also defined by
Monique (2011) as the ability to adapt and self- manage oneself in the face of
social, physical and emotional challenges.
Health-care, on
the other hand, is defined as all the goods and services designated to promote
health, including preventive, curative and palliative interventions, whether
directed to individuals or population (Park, 2005). According to Free Dictionary
(2016), health-care is defined as the prevention, treatment, and management of
illness and the preservation of mental and physical wellbeing through services
offered by the medical and allied health professionals. Wikipedia (2012)
defines health-care as the maintenance or improvement of health via the
diagnosis, treatment, and prevention of diseases, illness, injury, and other
physical and mental impairments in human beings. Health-care can majorly be
classified into modern (conventional, orthodox, western or allopathic) and
traditional (indigenous, complementary, alternative or integrative) groups
(Omogbadegun et al, 2013). Health is
the most precious of all things and is the foundation to all happiness. The
health of a population is an essential element in its ability to progress and
develop especially in an agrarian society like ours. The fact that three out of
the eight Millennium Development Goals (MDGs) developed by the United Nations
touched on health indicates that the importance of good health cannot be overemphasized
(Ladele and Bisi-Amosun, 2014). It is, therefore a necessity and a basic need.
To improve the health of the population in the developing world like ours,
health services provided must be capable of addressing and meeting the
health-care needs of the people.
Health-care needs
is any physical, developmental, mental, sensory, behavioural, cognitive or
emotional impairment or limiting conditions that require medical management,
health-care intervention, and or use of specialized programme (Council of Clinical
Affairs, 2008). They are those things human beings need in order to maintain,
restore or provide functional equilibrium to normal species functioning
(Andreas et al., 2006).
Health-care can be
seen both as a consumption good and an investment good (Awoyemi and Sowunmi,
2009). As a consumption good, health-care improves welfare, and as an
investment good, it improves the quality of human capital through the
improvement of productivity and at the same time, increases the number of days
available for productive activities. This is exemplified by the fact that healthier
workers are physically and mentally more energetic and robust. They are more
productive and earn more wages. They are also less likely to be absent from
work because of illness (or illness of a family member). Labour hours and
hourly wages are substantially reduced because of illness and this has a
serious effect on an economy like ours, especially in the rural areas where 70%
of the work force is engaged in manual labour in the farm (Awoyemi and Sowunmi,
2009).
In
order to maintain a stable labour force in the rural farm households, the
health conditions of the households should be properly managed. Management is
described as the art of knowing what you want to do and seeing that it is done
in the best and cheapest way. Health-care management is the profession that
provides leadership and direction to the organizations that deliver personal
health services, and to divisions, departments, units or services within these
organizations (Lombardi and Schermerharn, 2007). Health-care can also be seen
as that management that runs the health-care organization. Health-care
management has to do with facility management.
For
this study, health-care management has to do with the various ways in which the
rural farm households manage their health, or treat themselves whenever they
are sick, or perceive signs of ill-health. Do they use traditional, orthodox or
other methods of health-care to treat themselves? Ill-health remains one of the
threats to rural farm households and invariably to agricultural production in
Nigeria. Asenso-okyere et al. (2011)
posit that ill-health reduces physical strength and work days/hours available
for the farm. Asenso-okyere et al.
(2011) reports that poor health results in a loss of work days or in reduced
workers capacity and this is likely to reduce output. Limited access to food may
occur in a household if individuals are too ill or over-burdened to produce or
earn money to buy food (Keverenge-Ettyang et
al., 2010).
Ill-health has the
following effect on farm households: being absent from work due to morbidity
(and eventual death); precious family time diverted to caring for the sick, and
loss of savings in dealing with the disease and its consequences (Asenso-okyere
et al., 2009). The long term effect of ill-health on farm
households includes; loss of farming knowledge, reduction of land under
cultivation, planting of less labour-intensive crops, reduction of varieties of
crops planted, and reduction in the number of livestock. Ultimately, ill-health
leads to a decline in households’ income which leads to severe deterioration in
households’ livelihood (Asenso-Okyere et
al. 2011b). As pointed out by the World Bank (2010), illness and death from
HIV/AIDS, malaria, tuberculosis and other diseases reduce agricultural productivity
through the loss of labour. Farming households with high medical expenditure
may be deprived of resources to invest in experimentation on improved practices
and adoption of new technology. Poor health reduces farmers’ ability to
innovate, experiment and operationalize changes in agricultural systems
(Asenso-Okyere et al., 2010).
Good
health enhances the ability of the farming households to take risk on the new
crops or farming methods that might pay off with better production and income (International
Food Policy Research Institute, 2006). On the other hand, poor health inflicts
great hardship on farming households such as substantial monetary expenditures,
loss of labour, and sometimes death. As exemplified by the International Labour
Organization (ILO, 2000), the agricultural sector is one of the most hazardous
in terms of occupational hazards. Majority of farmers are usually exposed to
harsh weather conditions, difficult working postures and lengthy hours of work due
to the use of crude implements. Farm households usually have close contacts
with plants, wild and domestic animals, as well as agricultural chemicals such
as inorganic fertilizers, pesticides, etc., which predispose them to infections
and illnesses (Olatunji, et al.,
2013).
The Food and
Agriculture Organization (FAO) (2002) estimates show that approximately three
million people are poisoned, and two hundred people die from pesticide use annually.
In Tanzania, a study reported that 68% of vegetable farmers who used pesticides
were sick after routine pesticides application (Ngowi et al., 2007). Illnesses and diseases have adverse effect on
agriculture and rural development, and this can be seen in the area of labour
loss, farm income loss, as well as asset loss. From the foregoing, it can be
seen that farmer’s health has significant effect on agricultural productivity.
The health status of the adults affect their ability to work, and thus
underpins the welfare of the households including children development (Asenso-Okyere
et al., 2011). Ulimwengu (2009) indicated that healthy farmers were
found to produce more per unit of input, earn more income, and supply more
labour than farmers affected by sickness. It is also a known fact that
production inefficiency increases significantly with the number of days lost to
sickness. It was also found that a one percent improvement in a farmer’s health
condition led to a 31% increase in efficiency (Ajani and Ugwu, 2008).
High
efficiency in agricultural production as a result of good health is a form of development,
and this development is only possible when there is access to health-care
services, and in turn its effective utilization by individuals. According to
Peters et al. (2008), access to
health-care services is a multi-dimensional process involving the quality of
care, geographical accessibility, availability of the right type of care for
those in need, financial accessibility and acceptability of service.
Utilization of health-care, on the other hand, is related to the availability,
quality and cost of services, as well as socio-economic structure, and personal
characteristics of the user (Chakraborty et
al., 2003; Manzoor et al. 2009;
Onah et al. 2009). Availability and
accessibility of health services can make economic development sustainable. In
many cases, when factors such as accessibility, availability and proper
utilization of health-care services are denied, development can be stalled.
Health-care access
and utilization are of major interest to rural development because they are
vital elements of wellbeing and components of human capital (Aghion et al., 2010). Good health is a need for
all and the choice of a particular health-care system responds to the laws of
demand and supply; and demand for health is a derived demand in the sense that
health-care is not demanded for itself but for the advantages that can be
derived from being healthy (Titus et al.,
2015).
Various
countries have enunciated health-care policies directed towards the maintenance
and improvement of the health status of their population, especially those
living in the rural areas. This is borne out of the realization that good
health-care is paramount for the wellbeing of the citizens and subsequently the
socio-economic development of their various societies.
Nigeria has a dual
system of health-care delivery – the officially recognized orthodox system and
the barely tolerated traditional system. Traditional Medicine (TM) has been
defined as the alternative or non-conventional mode of treatment often
involving the use of herbs in a non-orthodox manner, as well as the process of
consulting herbalists, mediums, priests, witch doctors, medicine men and
various local deities when seeking a solution to diverse illnesses (Temitope
and Ibrahim, 2014). Traditional medicine therapy for some ailment will
cost very low or could even be free if the person could collect the medicinal
plants and prepare the medicament himself (Mafimesebi and Oguntade, 2010). According
to World Health Organization (2010) at least 80% of the people in developing
countries depend largely on indigenous practice for the control and treatment
of various diseases affecting both humans and animals, especially in the rural
farming households.
Farming
households comprise of all adult males, females, and children who partake in
the cultivation of land and rearing of households’ livestock (Ojo and Akanji,
1996). The farming households are noted to be operating at low level of
production with labour-intensive production technologies. Rural farm households
who are labour suppliers in small-scale farming in Nigeria do not only lose
valuable hours in treating sicknesses, but also lose income that would have
been generated at the period.
1.2 PROBLEM
STATEMENT
A major problem
confronting Nigeria and other countries in sub-Saharan Africa is how to sustain
our rural health-care delivery services. Increased agricultural productivity in
any country depends on the health condition of the labour force. The agricultural
sector is seen as one of the most hazardous in terms of occupational hazards as
farmers are always and usually exposed to harsh weather conditions, difficult
working postures, longer hours of work as a result of the use of crude
implements. Farmers are always at risk of getting in contact with wild animals,
agricultural chemicals and even inorganic fertilizers. All these predispose
them directly or indirectly to disease infection and illnesses. This calls for
proper health-care delivery system to be in place to address this issue.
Unfortunately, very few low income countries, Nigeria inclusive, have not been
able to meet the basic health-care needs of their citizenry, especially the
rural dwellers. In Nigeria, there has been a growing recognition of the
challenge of rural people health issues and the need for it to be addressed
(Hamid et al., 2005).
Rural dwellers are
subjected to high incidences of morbidity and mortality resulting from the
prevalence of preventable parasitic and non-parasitic infectious diseases.
About 70 percent of the working population is employed in the agricultural
sector, which is a common phenomenon in developing countries like Nigeria,
where access to good health care facilities is non-existent especially in the
rural areas. High loses are recorded in agricultural production due to disease
infections on the rural households. When the farmer or any member of the household
is sick, they cannot go to the farm, so their farm activities are abandoned,
also money that would have been used to purchase farm inputs, improved
implements or hire tractors and labourers is used for treatments which leads to
low productivity (Fanello and Baker, 2010). Women in the farming households
suffering from diseases are less able to take part in farm work, thereby
reducing the household income and savings (Kughur et al., 2015). The households lose valuable working hours to
ill-health and this has serious implications on the rural farm families as it
affects their productivity. This means income loss through the hire of
additional labour to help in farm work, thus affecting the acquisition capacity
and eventually poverty through the sick and caregivers to the households
(Oluyole et al., 2011).
Effiong and Ebong
(2009) estimated that rural farm households with diseases cleared only 40
percent as much land for crop production as similar households without disease.
He further traced a variety of adjustments in households afflicted with diseases,
including increase in labour input by healthy family members per unit of output,
as well as reallocation may also increase the workload of healthy family
members.
Unhealthy farm
households are unable to produce enough agricultural goods to earn a decent
livelihood and this consequently increases their poverty and malnutrition
status which further worsens their health. According to Adesope et al. (2012), the annual income of the
farm households decreases with increase in days of incapacitation because the
more the number of days of incapacitation by farm households, the greater the
loss incurred during treatment and the lesser the annual income. Ill-health constitutes
a great burden on the already depressed farm households through its effect on
the agricultural sector (Oladepo et al.,
2010). The effect of a diseased household on agriculture is felt in two key
farm parameters; first, a reduction in the labour quantity and quality,
initially in terms of productivity when the disease infected person is ill, and
later the supply of households labour will drop with the illness, and
peradventure death of the person. At this point, other household members will
devote production time to caring for the sick person (WHO, 2000). Secondly, the
disposable household income will be affected as most of the income will be
channeled into restoring the health of the sick. During this period, farm households’
financial resources would be diverted to pay for the medical bills at the
expense of agricultural inputs (Kughur et
al., 2015).
The
relationship between health and agriculture is very important because a farm
household with poor health will only attract low returns on investment, and
increase the cost of financing or the cost of production. Good health affects
agriculture by boosting peoples’ capacity to work and thus increasing how much
they can produce. This, however, enhances their capacity to take risk in the
areas of crops and livestock farming methods.
Nigeria
is still tagged with some of the worst health-care statistics in the world;
this makes the country one of the least in virtually all development indexes
(Tormusa and Idom, 2016). The World Health Organization (WHO) currently
positions the Nigerian health system at the 197th place of 200 WHO
countries evaluated. According to a report by the United Nation Development
Commission (UNDP, 2008), life expectancy in Nigeria has declined drastically
from 47 - 43 years. Nigeria accounts for
10% of the world’s maternal mortality rate in child birth whereas it
constitutes only 2% world’s population (WHO, 2015). One in every five Nigerian
children dies before their 5th birthday, while over a million
Nigerian children die from preventable diseases. The immunization records of
Nigeria also show that only 18% of the Nigerian children receive full
immunization by the first birthday (WHO, 2015). Malaria also kills the Nigerian
child more than any other disease. Despite all these indices of poor health
delivery services in the country, the Nigerian government at all levels, budget
less than 5% on health, despite its signatory to the 2000 Abuja Declaration to
increase health budget to 15%. Primary health-care centres are in disarray with
structures adorned with ‘expired drugs and cobwebs’ (Hadi, 2015). All these
has effect on the rural farm households
as the poorly developed health system makes it inaccessible for the farmers who
most times lack the enabling resources for medi-care expenditure. It is as a
result of this that the traditional medicine could be a possible alternative
for the rural farm households.
Traditional
medicine provides a wide range of medical services that orthodox medicine does
not (Amangbey, 2014). It is effective as it is used in treating a lot of
ailments such as malaria, jaundice, stroke, infertility, broken bones, typhoid
fever, boils, piles, HIV/AIDS, as well as mental illness (Gyasi et al., 2011). No wonder the World
Health Organization (WHO, 2002) reported that 70% of the population in
developing world, especially Africa, depends on medicinal plants to meet their
health-care needs. This is also supported by Adefolaju (2014) who estimated
that about 86% of Nigerians still lack access to orthodox medicine and rely
almost exclusively on traditional medicine. Increased attention on the
traditional medicine is justified because it is accessible, easy to prepare and
administer at little or no cost at all. Considering the strategic role of the
rural farm households as a hob on which agricultural and food production
strength of the country revolve on, these household needs to be in good health.
The
inhabitants of the South-South region are not exempted as the region has been
subjected to untold hardship and poverty stress through oil pollution, gas
flaring, environmental degradation and other negative activities that are
inimical to the health of man, in particular, and to the existence and survival
of the rural farm households in the region as a result of oil exploration and
exploitation-related hazards. This has contributed to the high rate of
morbidity and mortality of the people of the region ranging from infant
morbidity and mortality, maternal morbidity and mortality, as well as morbidity
and mortality of other members of the farm households (Abimbola et al. 2012). In addition, disease
incidences are higher in the rural areas because of higher level of illiteracy,
poverty and ignorance (Oladoyinbo et al.,
2013).
Orthodox and
traditional medicines are acceptable methods of treating diseases, even in the
rural areas of South-South, Nigeria. The prohibitive cost of accessing orthodox
medicine appears to be a hindrance to the rural people in the zone in utilizing
orthodox medicare. On the contrary, traditional medicine is not only seen as
part of the culture of the people but is also easily accessible and more
affordable to the rural poor population. However, with the government
intervention in the provision of health-care centres in the rural areas which
is expected to be easily accessible and affordable too, it is expected that
more rural farmers in the zone would be able to utilize orthodox medicare
contrary to what the situation had been hitherto. It is important to note too
that, the type of ailment one suffers in the rural areas also influences whether
the person would seek orthodox or traditional medical attention. From the
scenario above, it is not yet clear whether the rural farm households in
South-South, Nigeria are currently more inclined to the use of orthodox or
traditional medicine in meeting their health-care needs. It is in this regard
that the need to make a comparative assessment of the utilization of orthodox
and traditional medicine among rural farm households in South-South, Nigeria,
becomes worthwhile. The study, therefore, sought to provide answers to the
following research questions:
1.3 RESEARCH
QUESTIONS
The following
research questions guided the study
1. What
are the socio-economic characteristics of the rural farmers in the study area?
2. What
are the health-care needs of rural farm households in the study area?
3. What
are the levels of utilization of orthodox and traditional medicine by rural
farm households in the study area?
4. What
is the annual expenditure distribution on orthodox and traditional medicine
among rural farm households in the study area?
5. What
are the farmers’ perceptions of the efficacy of orthodox and traditional
medicine?
6. What
are the perceived factors affecting respondents’ utilization of orthodox and
traditional medicine in the study area?
7. What
are the constraints associated with the use of orthodox and traditional
medicine by farm households in the study area?
1.4 OBJECTIVES
OF THE STUDY
The broad
objective of the study was the comparative assessment of utilization of
orthodox and traditional medicine in health-care management among farm
households in South-South, Nigeria. The specific objectives were to:
1. describe
the socio-economic characteristics of the rural farmers in the study area;
2. ascertain
the health-care needs of rural farm
households in the study area;
3. determine
the level of utilization of orthodox and traditional medicine by the rural farm
households in the study area;
4. examine
the annual expenditure distribution on orthodox and traditional medicine in
health-care management among rural farm households in the study area;
5. ascertain
the farmers’ perception of the efficacy of orthodox and traditional medicine in
the study area;
6. ascertain
the perceived factors affecting respondents’ utilization of orthodox and traditional
medicine in the study area; and
7. ascertain
the constraints associated with the use of orthodox and traditional medicine in
health-care management by farm households in the study area.
1.5 HYPOTHESES
The following
hypotheses for the study were tested
HO1: there is no
significant difference between the level of utilization of orthodox and
traditional
medicine by the farm households in the study area.
HO2: there is no
significant difference between the expenditure on orthodox and traditional medicine
in health-care management among farm households in the study area.
HO3: there is no
significant difference between the farmers perception of the efficacy of orthodox
and traditional medicine in the study area.
HO4: there is no
significant difference in respondents’ rating between the perceived factors affecting
respondents’ utilization of orthodox and traditional medicine in the study
area.
HO5:
there is no significant difference in the level of utilization of orthodox medicine
by the rural farm households among the three selected states in
South-South, Nigeria.
HO6:
there is no significant difference in the level of utilization of traditional medicine
by the rural farm households among the three selected states in
South-South, Nigeria
HO7:
there is no significant difference in the expenditure on orthodox medicine in
health- care management by rural farm households among the three selected
states in the study area.
HO8: there is no
significant difference in the expenditure on traditional medicine in health-care
management by rural farm households among the three selected states in the study
area.
1.6 JUSTIFICATION OF THE STUDY
This study is justified
on the basis that, it will bring to the fore the perceptions of respondents on the
efficacy or otherwise of orthodox and traditional medicine as sources of health-care
in the South-South region. This, of course, if properly ascertained would
provide a platform for synergy between orthodox and traditional medicine. Another justifiable point worth mentioning is
that the study will determine the level of utilization of orthodox and
traditional medicine, as well as identify the illnesses/diseases that are
prevalent among the farm households in the study area. With this information,
better policy statements can be made in favour of the rural farm families.
This
study is also deemed relevant in the sense that not much research has been
carried out on this subject area especially as it has to do with the South-South
region. As such, the study will unearth various issues such as health seeking
behaviour of the inhabitants of the South-South; establish the factors
responsible for the decision to use traditional medicine in the region rather
than modern medicine, among others. This study is justified by the fact that it
will provide insight into rural health-care usage and the dynamics of rural
health-care needs in the South-South region. Moreover, the research would be
useful to both the Federal and State Ministries of Health, NGOs, and other
international organizations in developing policies that would promote safe,
effective, affordable and accessible health-care. Also, this study is significant
in the view that it would contribute to the body of knowledge regarding
operative mechanisms of both traditional and modern health-care systems. Hence,
it could serve as the basis for further research into related areas.
1.7 SCOPE
OF STUDY
The scope of the
study covered the South-South region of Nigeria only. It was also delimited to
the comparative assessment of the utilization of orthodox and traditional
medicine in health-care management among rural farm households in South-South,
Nigeria. The study equally ascertained the health-care needs, determined the
level of utilization, examined the expenditure distribution, ascertained
farmers’ perception of the efficacy, ascertained the factors influencing
respondents’ utilization, as well as ascertained the constraints associated
with the use of orthodox and traditional medicine by rural farm households in
the study area.
1.8 DEFINITION
OF TERMS
The following
terms have been defined as they relate to the study,
Access: This refers to the
ability of individuals to obtain required services at the right time and place.
Utilization:
This means to put to use.
Health-care utilization: This
means the use of either orthodox or traditional health-care by people.
Health seeking behaviour: This
is how an individual seeks treatment for an illness he or she is already
having.
Efficacy: This
is a measure of a medicine ability to improve one’s health and well-being or
cure one’s disease.
Traditional medicine: This
is defined as the alternative or non-conventional mode of treatment often
involving the use of herbs in a non-orthodox manner, as well as the process of
consulting herbalists, mediums, priests, witch doctors, medicine men and
various deities when seeking a solution to diverse illnesses. This definition
by Temitope et al. (2014) is all
embracing and hence adopted for this study.
Orthodox medicine: Orthodox medicine
is defined as a professional discipline that relies on a body of knowledge,
scientific training and skills aimed at diagnosing, prevention, treatment and
rehabilitation of the physically and mentally sick (Okujagu, 2007).
Illness: This is any
condition that dis-eases a persons’ system and puts some discomfort to the
normal functioning of the body system.
Health-care needs: These
are those things we need in order to maintain, restore or provide functional
equilibrium to normal species functioning. It can also be seen as what one
needs to do to overcome a health challenge.
Health-care management:
For this study, health-care management has to do with the various ways, in
which the rural farm household manages their health, or treat themselves
whenever they are sick, or perceive signs of ill-health. Do they use
traditional, orthodox or other method of health-care to treat themselves.
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