HEALTH SEEKING BEHAVIOUR TOWARDS HYPERTENSION AMONG TRADERS IN UBANI MARKET IN UMUAHIA NORTH LOCAL GOVERNMENT AREA OF ABIA STATE.

ABSTRACT

This study aimed to determine health seeking behaviour towards hypertension among traders in Ubani market in Umuahia North Local Government Area of Abia State. A systematic random sampling technique was used to select308 traders, their age ranges between 20-60 years. A well-structured and validated questionnaire was used to collect information on the demographic and socio-economic characteristics, level of awareness about hypertension, knowledge scores about hypertension, level of knowledge of respondents on hypertension, respondent general health seeking behaviour, respondents health seeking behaviour towards hypertension, respondents’ perception on health facilities’ efficiency in treatment/management of hypertension, health seeking behaviour status of the respondents towards hypertension, perception of respondents towards risk of getting hypertension (susceptibility), perception of respondents towards severity of hypertension, perception towards benefits/barriers of preventive behaviour towards hypertension, anthropometric measurement of the respondents, socio-demographic predictors of health seeking behaviour of respondents towards hypertension, socio-demographic predictors of perception susceptibility of respondents towards hypertension, socio-demographic predictors of perception severity of respondents towards hypertension and socio-demographic predictors of perception benefits/barrier of respondents towards hypertension. There were eight (8) knowledge questions asked and each correctly answered question was given 12.5 marks thereby making it a total of 100 marks. The knowledge scores were further graded as follows; <40 = poor knowledge, 40-59 = average knowledge and 60-100 = good knowledge. IBM SPSS statistics (version 20) was used to analyze the data. Descriptive statistics (mean, frequency and percentage) were used to determine their socio-economic characteristics and awareness of hypertension,anthropometric status was assessed using World Health Organization (WHO). Most (46.8%) of them had only secondary education and a little above half (52.9%) of them make an earning less than ₦10,000. Majority (60.1%) had high health seeking behaviour status while only few (13.3%) had low health seeking behaviour status. Also, a little above average (52.6%) hadgood knowledge about hypertension status whereas only (36.7%) had poor knowledge. Majority (79.2%) had high susceptibility towards hypertension, while only few (20.8%) had low susceptibility towards hypertension. The result further reveals that majority (94.8%) of the respondent had low severity towards hypertension, while a little proportion (5.2%) had high severity towards hypertension, also majority (48.4%) had normal Body Mass Index (BMI); whereas most (35.1%) were at risk of obesity.Correlation was significant at 0.01 and 0.05 levels. There was no significant relationship between body mass index and knowledge, health seeking behaviour and perception. Regression analysis was used to analyze Socio-demographic predictors of health seeking behaviour, perception susceptibility, perception severity and perception benefits/barrier of respondents towards hypertension. This study revealed a good knowledge of hypertension and poor perception (severity) of traders towards hypertension. Public education inform of seminars/conferences and organizing a regular periodic screening for traders and community members will go a long way to help in tackling the issue.

TABLE OF CONTENTS

LIST OF TABLES

Table 4.1         Socio-demographic characteristics of traders                                                45

Table 4.2         Level of awareness about hypertension among traders                                    47

Table 4.3         Knowledge scores about hypertension                                                           49

Table 4.4         General health seeking behaviour of the respondents                                                51

Table 4.5         Respondents Health seeking behaviour towards Hypertension              53

Table 4.6         Respondents’ perception on health facilities’ efficiency in                                                             treatment/management of hypertension                                                   55

Table 4.7         Health Seeking Behaviour status of the respondents towards hypertension  57

 Table 4.8 a     Perception of respondents towards severity of hypertension                           58

Table 4.8 b      Perception towards benefits/barriers of preventive behaviour toward hypertension                                                                                                                                  60

Table 4.9         Perception towards benefits/barriers of preventive behaviour towards                              hypertension                                                                                                   61

Table 4.10       Body mass index (BMI) and waist-hip ratio of the respondents                 64

Table 4.11       Relationship between knowledge, health seeking behaviour, Perception and                  anthropometry of respondents                                                                                    66

Table 4.12       Socio-demographic predictors of health seeking behavior, perception                               susceptibility, and perception severity and perception benefits/barrier of                         respondents towards hypertension                                                               68

CHAPTER 1

INTRODUCTION

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, that it is the most common cause of cardiovascular disease on the continent. World Health Organization (WHO, 2007). WHO (2003) reported that hypertension is a major factor in the high mortality of adults in sub-Saharan Africa. It remains a major global public health challenge that has been identified as the leading risk factor for cardiovascular morbidity and mortality as well as all-cause mortality (WHO, 2004). 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, for this reason, hypertension is often called a ‘silent killer’ (Hoel and Howard, 1997). The burden of Non-Communicable Diseases (NCD) is rising rapidly nationally and globally constituting a major challenge to development (WHO, 2007). An increasing number of studies suggest that NCD will soon be the most important cause of morbidity and mortality in developing countries. (Manton, 1988). At the beginning of the 20th century, cardiovascular disease (CVD) was responsible for fewer than 10% of all deaths worldwide. Today, that figure is about 30%, with ~80% of the burden now occurring in developing countries. So prevalent is hypertension in Sub-Saharan Africa today that hypertensive heart disease might in fact be the most common form of CVD in Africa (Cruickshank, et al., 2001).

Health Seeking Behavior can be defined as personal actions to promote optimal wellness, recovery, and rehabilitation (Iyalomhe et al., 2010). It 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 et al., 2010). 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. 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 (Erinosho, 1998). Various factors such as ethnicity, class, gender and other aspects of peoples’ backgrounds (including family factors) seem to have a strong influence on health care-seeking behaviour (Bucquet and Curtis, 1986). With regards to hypertension, failure to achieve blood pressure (BP) goals – the target of treatment - may be attributable to the poverty of patients’ knowledge, perception, attitudes and life-style practices (Mari, et al., 2006; Iyalomhe, 2007; Ong et al., 2007, Petrella et al., 2007).

Thus, studies from multiple countries have documented the utilization of multiple sources of health care and factors that influence these choices. Traditional health practitioners and their role in health care systems are acknowledged world-wide (Mbwanba et al., 2007). Utilization of traditional medicine is apparently on the increase globally and is being given recognition by health insurance providers in developed countries (Ritchie, 2007). In Nigeria, herbal medicine appears to be strongly considered by hypertensive patients as one of the viable alternative for a cure for hypertension (Oke and Bamidele, 2004).

1.1  STATEMENT OF PROBLEM

Overtime, hypertension happens to be a scourge to humanity, because its prevention and control has not received due attention in many developing and developed countries as a result of the fact that it is often regarded as a normal disease that can occur at old age, which is also one of the most risk factors for cardiovascular and coronary heart disease. Awareness, treatment and control of hypertension are extremely low in these countries as health care resources are used by other priorities including, fever, tuberculosis and malaria (Petrella et al., 2007). Therefore, it remains a major Global Public Health challenge that has been identified as the leading risk factor for cardiovascular morbidity and mortality (WHO, 2002). Annually, it causes 7.1 million (one-third) of global preventable premature deaths. The overall global prevalence among adults was estimated to be 26.6% in men and 26.1% in women (Kearney et al., 2005).  Wide gaps still exist in the knowledge, attitude, practice and perception of people especially traders on the health status and health seeking behavior regarding hypertension (Petrella et al., 2007). The fact that health seeking behavior is not known in most widely used medical textbooks, however shows that many health seeking behavior studies are not presented in a manner that will deliver an effective route forward (Menendez, 2005). And because of these problems mentioned, it is worth carrying out this project research in order to identify the health seeking behavior of traders towards hypertension.

1.2  OBJECTIVES OF THE STUDY

1.2.1 General objective of the study

The General Objective of the study is to determine the Health Seeking Behavior towards hypertension among traders in Ubani Market in Umuahia North Local Government Area of Abia State.

1.2.2 Specific objectives of the study

The specific objectives of this study are to:

      i.         Determine the socio-demographic characteristics of the traders.

     ii.         Assess their level of awareness and knowledge about hypertension.

   iii.         Determine the health seeking behavior of traders towards hypertension.

   iv.         Assess the perception of traders towards hypertension using the Health Belief Model.

     v.         Determine the Anthropometric status of the traders using Body Mass Index and Waist Circumference Indicators.

   vi.         Identify the relationship between the Socio-demographic characteristics, knowledge, perception and anthropometric status of the traders with their Health Seeking behavior.

1.3  SIGNIFICANCE OF THE STUDY

Findings from this study will help traders know the necessity of regular blood monitoring exercise and also provide a good knowledge and better perception about hypertension among traders as hypertension is known as ‘silent killer’ displays no symptoms and is often detected for the first time when it has already damaged one of the target organs like the heart, brain or the kidneys leading to complications like stroke, heart disease, kidney failure.

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