ABSTRACT
The study was carried out on the
information needs and resource utilization by people living with Human Immune
Deficiency Virus/Acquired Immune Deficiency Syndrome in ESUT Teaching Hospital
Parklane Enugu. Health is of utmost important in every human facet, that is the
reason why every hand should be on deck to promote it. Chapter one of this
research work is concerned with a brief discussion of what HIV/AIDS is,
problems facing people living with HIV/AIDS (PLWHA), information needs and
resource utilization was focused on. Chapter two deals with review of related
literature, the review was focused on HIV/AIDS. Information needs of people
living with HIV/AIDS, information used by people living with HIV/AIDS, the
extent to which information resources encourage and support the people living
with HIV/AIDS, to take positive action to deal with HIV/AIDS, the benefits
driven from the used information resources, barriers to access and utilization
of information, resources and strategies to overcome the barriers. Chapter
three shows the method of carrying out the research. Questionnaire will be used
for data collection. Chapter four is the analysis and presentation of data
collection and discussion of findings while chapter five deals with the summary
of findings, recommendation, conclusion and suggestions for further studies.
TABLE
OF CONTENTS
Title page - - - - - - - - i
Approval Page - - - - - - - ii
Dedication - - - - - - - - iii
Acknowledgement - - - - - - - iv
Table of contents - - - - - - - v
Abstract - - - - - - - - viii
Introduction 1
CHAPTER
ONE
INTRODUCTION
1.1 Background to the study - - - 3
1.2 Statement of the study - - - - 9
1.3 Purpose of the study - - - - 18
1.4 Scope of the study - - - - - 19
1.5 Significant of the study - - - - 20
1.6. Research Questions - - - - - 22
1.7 Operation Definition of Research Concepts 23
CHAPTER TWO
REVIEW
OF LITERATURE
2.1 Introduction
- - - - - - - 25
2.2 Conceptual Framework- - - - - 26
2.2.1
HIV/AIDS - - - - - - - 26
2.2.2
Information needs of people living with HIV/AIDS
33
2.2.3 Information used by people living
with HIV/AIDS 36
2.2.4 The extent to which information
resources
encourage and support the people living with
HIV/AIDS to take positive action - - - 39
2.2.5 The
benefits derived from the use of information
resources by PLWHA
- - - - - 43
2.2.6 The bearers to access and utilization of
information resources by the PLWHA - - 45
2.2.7 Strategies to overcome the barriers of access
and
utilization
of information by people living with HIV/AIDS 49
2.3
Theoretical Framework 56
2.3.1
Health Belief Model (HBM) 56
2.3.2
Information Seeking Behavior Theory
(ISBT) 59
2.4 Empirical Studies - - - - - 62
2.5 Summary of the reviews - - - - - 68
CHAPTER THREE
METHODOLOGY
3.1 Introduction - - - - - - 71
3.2 Research design - - - - - - 71
3.3 Area of study - - - - - - - 72
3.4 Population of the study- - - - - 72
3.5 Sample - - - - - - - 73
3.6 Sampling
Technique - - - - - 74
3.7 Instrumentation - - - - - 76
3.8 Validation
of instrument - - - - 77
3.9 Method
of data collection - - - 78
3.10 Method
of Data analysis - - - - 79
CHAPTER
FOUR
4.0 Data Presentation, Analysis and Interpretation
80
4.1 Introduction 80
4.2 Discussion of findings 81
CHAPTER FIVE
Summary, conclusion and recommendation
5.1 Introduction - - - - - - - 85
5.2 Summary - - - - - - - 85
5.3 Conclusion - - - - - - - 88
5.4 Recommendations - - - - - - 89
5.5 Suggestion for further studies - - - 91
References - - - - - - - 92
Appendix I- - - - - - - 95
Appendix II - - - - - - - 97
Abbreviation/meaning - - - - -
INTRODUCTION
One
of the most devastating scourges of our time is the problem of Human
Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS).
Undoubtedly HIV/AIDS present a major challenge to human development in Nigeria.
Besides poverty, no problem has given Nigeria a more daunting challenge than
the present battle with HIV/AIDS. According to Omoniyi (2013), HIV/AIDS can
only be transferred through exchange of body fluid such as blood, semen and
vaginal secretions. This means that HIV/AIDS cannot be contracted through causal contract with infected person
either at work, school or at home. Also Chagbe (2012) opined that the health of
the people is the greatest natural resource of a nation upon which their happiness
and power as a nation depends.
Moreover,
health is of utmost important in every human fact. That is the reason why every
hand should be on deck to promote it. For it is when people are healthy that
they can work and any nation who’s workforce comprises of sick persons is
finished. According to Moonie (2013) is of the opinion that most individuals
that are affected by the virus are vulnerable to chains of other diseases and
the cost of medication eats deep into their savings. Also, some families who
have lost their bread winners to this disease are faced with untold hardship such
as non payment of school fees, house rents and the consequences of being seat
out of school and thrown out by landlords.
In addition, the information needs
needed to fight against HIV/AIDS include: Health education, the control of
sexual transmitted disease, the establishment and management of surveillance
programmes, prevent mother to child transmission, provide and manage
antiretroviral therapy programmes, human resources development and government
involvement. These information needs will help to combat HIV/AIDS.
CHAPTER ONE
INTRODUCTION
1.1 Background to the study
Managing
information is an important part of coping with illness and includes
communicative and cognitive activities seeking, avoiding, providing,
appraising, and interpreting information. It is complex in that people’s
information needs and behavior vary over the course of their illness and along
with the availability and quality of information. In recent years, considerable
research has been done on how people living with Human Immunodeficiency
Virus/Acquired Immune Deficiency Syndrome (PLWHIV/AIDS) manage information. However,
understanding of the role of information in the HIV/AIDS in ESUT Teaching
Hospital, Park lane is still limited, because of the difficulties of reaching
different groups of PLWHA.
This
study has been designed to reach many segments of the diverse HIV/AIDS
community and broaden under standing of how information can better assist
PLWHA.
Information
can be regarded as a resource that can liberate man. Osuala (2001) refers to
information as facts and opinions provided and received during the course of
life. A person using such facts generate more information some of which is
communicate to others during discussion, by letters, symbols, etc. Aniogbolu,
(2008) noted that most information users need information for problem solving,
current awareness and recreational purpose. According to Aniogbolu (2008), the
importance of information utilization by man to his development is becoming
more meaningful to him as his information accumulation ability’s is taking a
new dimension with the development of highly sophisticated information
technology (Aniogbolu, Anyaobi & Olise, 2010).
Information
needs is often understood as vague awareness of something missing and
culminating in locating information that contributes to understanding and
meaning (Kuhlthau, 2009). Belkin, Brooks and Oddy. (2008) in their part saw
information needs as a gap in individual’s knowledge in sense making situations.
Accessibility to the right information is necessary for the general well being
of the individual, institution or organization.
One
of the most devastating sources of our time is HIV/AIDS; undoubtedly HIV/AIDS
presents a major challenge to human development in Nigeria. Ojoawo, (2006) apart
from poverty, no problem has given Nigeria a more daunting challenge than the
present battle with HIV/AIDS. AIDS in indeed devastating Nigerian communities
and poses a real threat to poverty reduction effort and the achievement of the
United Nation Millennium Development Goals, (UNMDG). Indeed HIV/AIDS presents a
serious challenge to Human Development in Nigeria because the exact cause of
and spread of the epidemic is still very difficult to calculate.
In
Nigeria, the first case of AIDS was diagnosed in 1986. The infection rate has
however, grown exponentially. Since then, by June 1999, the Federal Ministry of
Health, (FMOH) in Nigeria had recorded 26,276 AIDS cases. Due to fear of
stigmatization several cases are not reported through the hospitals, which mean
the reported cases were gross under estimations of the rate of occurrence of the
epidemic. The National AIDS/STDS Control Progremmes (NASCP) of FMOH estimated
that the calculated number of AIDS cases would have reached 590,000 by the end
of 1999 (Ojoawo, 2006).
Currently
Nigeria has become the first country in Africa to cross the critical epidemiological
threshold of 5%. In fact, it has since been projected that by the 2009 in the
absence of major changes in sexual behavior and other control measures, the
number of people living with HIV would reach 5 million, of the 40 million people
identified to be living with the disease, 3.5 million is the estimated number
for Nigerian. This amounts to 10% of the 40 million people infected worldwide
(UNAIDS/WHO/UNICEF, 2002). In a country like Nigeria, with limited public
capacity and resources to combat the problem, the prevalence rate is 80 high
that the HIV virus is infecting more than 30 people a day, and the disease is
growing faster that the authorities’ response to it. The prevalence report in
Nigeria revealed that there is no community in Nigeria with zero prevalence
(FMOH, 2009).
Ukwuoma
(2008) noted that in 2003 and 2008 National Antenatal HIV Seroprevalence survey
in Enugu State recorded the prevalence rate in both 2003 and 2008 as 4.9% and
5.1% respectively.
People
living with HIV/AIDS need information to survive. As a matter of fact,
information is vital in the daily life of the people living with HIV/AIDS.
It
is a medium of social transformation and communication and an avenue for them
(people living with HIV/AIDS) to get involved in government programmes and
policies about HIV/AIDS. Therefore, good access to information becomes a must
for PLWHA. It is therefore, necessary to consider the information needs of
people living with HIV/AIDS as well as their information resources. This study
sought to investigate the information needs and resource utilization by PLWHA.
Using ESUT Teaching Hospital Park lane, Enugu as study setting.
ESUT
Teaching Hospital Park lane, Enugu is situated at GRA Enugu North Local
Government. It is a reference center for comprehensive treatment and support of
people living with HIV/AIDS.
1.2 Statement of the problem
The
cause of the disease HIV/AIDS, allover the world, relates to individual social
behavior such as casual sex, intra venous drugs use (FMOH, 2008). In Nigeria
however, the leading driving force of the spread of the HIV infection includes
low level of education, high level of ignorance, cultural practices that
encourage multiple sexual partner such as polygamy and concubine, poverty and
lack of access to appropriate reproductive health survives and information
particularly the illiterate and young people. The practice of traditional
surgery such as bloodletting procedures with unsterilized instrument on
infertile women, and non observance of infection control procedures by
traditional birth attendants who are heavily patronized in Nigeria, may all be
responsible for spread of HIV/AIDS in Nigeria.
Other
factors blamed for the spread of the epidemic are the other cultural practices
that expose people to unsterilized sharp objects used for body scarification
and circumcision, the subordinate role of women and their attendant
vulnerability which prevents them from negotiating safe sex, ignorance, stigma
and discrimination, poverty, illiteracy and the non chalant attitude of some
individuals.
In
spite of various efforts at both domestic and international levels, Nigeria’s
situation seems not to translate to any reliable cheering news about HIV/AIDS
epidemic. It is becoming more of a developmental problem than just a health
problem. The problem constitutes a major challenge to sustainable human
development in Nigeria, which must be a concern for all.
Lack
of information resources, lack of awareness
of the existence of information
resources by the people living with HIV/AIDS, Non-utilization of the available
resources by the people living with HIV/AIDS, High level of illiteracy among
people living with HIV/AIDS, lack of skilled man power to appropriately
organize that available resources in ESUT Teaching Hospital Library for easy
accessibility and retrieval by people living with HIV/AIDS are the major
problems faced by the PLWHA in ESUT Teaching Hospital Park lane, Enugu.
This
study focuses on the information needs and resource utilization by people
living with HIV/AIDS (PLWHA). The case study is ESUT Teaching Hospital Park lane,
Enugu. The following are the problems facing PLWHA
a. Emptiness:
Most people living with HIV/AIDS feel they are empty vessels immediately they
have been diagnosed as being HIV positive. The feeling that they have nothing
to offer to the society also makes them feel empty and useless. They
consequently develop an inferiority complex which worsens their condition. They
become helpless.
b. Absence of Counseling:
Most people living with HIV/AIDS who know their status were not given pre-test
counseling and as such were not prepared psychologically. This affects the
psychological well being of the people living with HIV/AIDS (PLWHA), thereby
leading to depression. Counseling is important to people living with HIV/AIDS.
With counseling, which is supposed to be on-going process, PLWHA gain and
demonstrate courage. Lack of counseling services in our hospitals is greatly affecting
PLWHA. Even hospitals that have trained counselors do not offer appropriate
counseling services and are not committed to work.
c.
Lack
of Family Support: Experience has shown that some family members
abandon and sometimes isolate PLWHA on the grounds that they have tested
positive to HIV. This is largely due to lack of awareness in our families such
attitudes lead to suspicious among PLWHA. This eventually leads to untimely
death in most PLWHA. Hence PLWHA to believe that it is better to die than to
live. There is also little or no family support to give hope to PLWHA in most
homes.
d. Stigma:
This is one of the most subtle and debilitating challenges faced by PLWHA. It
inhibits open, honest communication between them and others. Stigma makes the disclosure
of the disease by PLWHA within the family difficult. Without disclosure,
prevention and care are almost impossible, families and communities are deeply
intertwined in the African context and should therefore be supported in
preventing stigmatization. This will also promote better self esteem among
PLWHA with respect to their careers. It will also eliminate the vicious cycle
of self-stigmatization. People living with HIV/AIDS face stigma in the home, in
the health care setting, in the religious sector, while the mass media can as
well unintentionally promote stigma, though they have potential to shape the
attitude, values and perception of a large member of people.
e.
Human
Rights Violation: Existing human rights instruments
confirm that discrimination against PLWHA or those thought to be infected is a
violation of their human rights. This is a great challenge facing PLWHA.
f.
Discrimination:
The acts of stigma constitute discrimination based on presumed or actual HIV
positive status constitute discrimination based on presumed or actual HIV
positive status and violates human rights due to the stigma associated with the
rights of PLWHA. This situation intensifies the negative impact of the
epidemic. At the individual level, for example, it causes undue anxiety and
distress which by themselves contribute to ill-health. At the level of family
and community, it causes people to feel ashamed and to conceal their link with
the epidemic, as well as withdraw from participation in more positive social
functions. At the level of society, discrimination against PLWHA reinforces the
mistaken belief that such action is acceptable and that those infected with
HIV/AIDS should be ostracized and blamed. This is a great challenge to PLWHA.
Around
the world too there have been numerous instances of HIV/AIDS related cases of
discrimination. People with HIV or those believed to have HIV/AIDS have been:
-
Segregated in schools and hospitals, and
placed under cruel and degrading conductions. Cases of degrading treatment have
often been reported in prisons where inmates are often without basic needs,
including access to medical care.
-
Refused employment
-
Denied the right to marry
-
Reflected by community
-
Killed because of their sero positive
status.
-
Required when returning to their home
country to present themselves for an HIV test. Individuals have being denied
the right to return to their country on suspicion of being HIV positive. Others
have been denied visa and entry permissions.
In
conclusion therefore, continuous advocacy campaigns are needed in response to
the challenges faced by PLWHA and to bring about social change. All hand must
be on desk to tackle the challenges facing PLWHA. To win the war against
HIV/AIDS, PLWHA must be used as agents of change in the society.
1.3 Objectives of the study
The
main purpose of this study is to depict a comprehensive picture of information
need and resource utilization by people living with HIV/AIDS in ESUT Teaching
Hospital Park lane, Enugu. The specific purposes of the study are as follows:
a. To
determine the areas in which people living with HIV/AIDS needs information ESUT
teaching Hospital.
b. To
find out the information resource used by people living with HIV/AIDS in ESUT
Teaching Hospital Park lane, Enugu.
c.
To determine the extent to which
information resources encourage and support the people living with HIV/AIDS to
take positive actions to deal with HIV/AIDS in ESUT Teaching Hospital Park lane,
Enugu.
d. To
determine the benefits derived from the use of information resources by the
PLWHA in ESUT Teaching Hospital Park lane, Enugu.
e.
To find out the barriers to access and utilization
of information resources by PLWHA in ESUT Teaching Hospital Park lane, Enugu.
1.4 Scope of the study
This
study is limited to ESUT Teaching Hospital Park lane, Enugu, it investigates
the information needs and resources utilization by people living with HIV/AIDS.
The research wants to measure the following variables: the areas in which
people living with HIV/AIDS need information, the extent to which information
resources encourage and support the people living with HIV/AIDS, to take
positive actions to deal with the HIV/AIDS, the information resources used by
PLWHA, the benefits derived from the use of information resources by the PLWHA,
and the barriers to access and utilization of information resources by PLWHA.
1.5 Significance of the study
The
significance of this study will be appreciated for the following reasons:
It
will accentuate public education and dissemination of information to reduce the
stigmatization of persons assumed to be at risk of HIV/AIDS.
This
study will also be important because it will provide psychological and social
support to people living with HIV/AIDS. They should never be abandoned or
treated as social outcasts.
The
study is important because it will explore the necessary of the political action,
that is social workers, individuals, community to participate with other groups
to lobby at the state and federal level on behalf of PLWHA in order to improve
their quality of life, protect their civil rights or liberty and to advocates
for increased funding for appropriate education, prevention, intervention,
treatment services and research.
The
study will also serve as database for policy makers in the area of HIV/AIDS.
The
findings of the study will help the government improve the scope and efficiency
of its information systems and services where necessary to encourage maximum
utilization by PLWHA.
It
will serve as an information base for future scholars in the area.
Finally,
it is hoped that the study will help policy makers, health care providers,
health workers, information providers, library and information professionals,
and other stakeholders in health sectors to respond positively to the
information needs of PLWHA by identifying such needs and exploring avenues to
improving will help the PLWHA to be aware of what is available for them, and
perhaps make effective use of the available information resources for enhance
health condition.
1.6 Research Questions
The
following research questions guided the study:
a.
To determine the areas in which people
living with HIV/AIDS needs information ESUT teaching Hospital?
b. To
find out the information resource used by people living with HIV/AIDS in ESUT
Teaching Hospital Park lane, Enugu?
c.
To what extent do people living with
HIV/AIDS seek and share information and what type of resources do they use in
sharing and seeking information in ESUT Teaching Hospital Park lane, Enugu?
d. What
impact has HIV information had on the lives of PLWHA and on basic demography in
ESUT Teaching Hospital Park lane, Enugu?
e.
What are the barriers to getting HIV
information by PLWHA in ESUT Teaching Hospital Park lane, Enugu?
1.7 Operational definition of research
concepts
The
following research concepts are defined according to the way and manner the
researcher used in this research work.
i.
Information Need: It is defined as an
individual or groups desire to locate and obtain information to satisfy a
conscious or unconscious need.
ii.
Resource utilization: This is the proper
use of available information and library resources by people living with
HIV/AIDS in respect to their health status.
iii.
HIV: This means Human Immune deficiency
Virus.
iv.
AIDS: Stands for Acquired Immune
Deficiency Syndrome.
v.
PLWHA: Stand for People Living with
HIV/AIDS.
HISTORICAL BACKGROUND TO THE STUDY
The
university was established as a non residential multi-campus institution. On
establishment, the university which was conceived on a presidential model after
Harvard University made impressive landmarks and stamped its name as the first
University of Technology and first state University of Nigeria.
In
1991, following the creation of Enugu State from old Anambra State the new
government change name from ASUTECH to ESUT.
Until
2005 when it was relocated to Parklane Enugu and named ESUT college of Medical/Teaching
Hospital.
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