SOCIO-DEMOGRAPHIC DETERMINANTS OF UTILIZATION OF CHILDHEALTH SERVICES BY CHILD BEARING MOTHERS IN UDENU LGA OF ENUGU STATE

Abstracts

The study investigated the socio-demographic determinants of utilization of child healthservices  by child  bearing  mothers  (CBMs)  in  Udenu  LGA of Enugu  State.  To achieve the purpose of the study, ten specific objectives with their corresponding research questions were posed and five null hypotheses were postulated and tested at 0.05 level of significance. The population for the study consisted of 8001 while a sample size of 377 of CBMs was drawn from the population using Yaro Yamen formula. The instrument for data collection was 36 item structured questionnaires. The instrumentwas validated by five  experts.  Cronbach  alpha  procedure  was  used  to  determine  reliability  of  the instrument  which  yielded  reliability  index  of .60.  Research  questions  were  answered using descriptive  statistics  of frequencies;  percentages  and  phi  correlation  coefficient statistics while the null hypotheses were tested using logistic regression statistics. The major findings of the study were as follows: a large proportion (86%) of CBMs utilized immunization  services;  a large proportion  (68.2  %) of child  bearing  mothers  utilized Exclusive Breast Feeding, and a moderate proportion (59.4%) of CBMs utilized growth monitoring services.   Also a large proportion (64.2%) CBMs utilized  ORT and small proportion  (41%) of CBMs utilized  IMCI services.  Also  the finding  showed  positive relationship  between  age, education,  marital  status,  parity  and  religion  of CBMs  and utilization of child health services (EBF, ORT and IMCI). Moreover there was positive relationship   between   age,   education   and   religion   of   CBMs   and   utilization   of immunization while there was no relationship between marital status and parity and immunization. There was significant relationship between age, education, marital status and  parityof  CBMs  and  use  of  growth  monitoring  while  there  was  no  relationship between religion and growth monitoring. From the findings it was concluded that age, education,  marital  status, parity and religion  can  be used to predict  use of Exclusive Breast Feeding while age, education, marital status, parity and religion cannot be used to predict the use of oral rehydration therapy. It was therefore recommended enlightenment campaign for CBMs on the need to utilize child health services in order to prevent and treat properly childhood disease that can cause handicapping condition and death

CHAPTER ONE

Background to the Study

Introduction

1

Utilization  of  child  health  services  has  been  a  great  challenge  in  developing countries and remains criticalin realizing the desired Millennium Development Goal (MDG4) which stresses reduction in child morbidity and mortality.Worldwide, there are

27 million children who do not receive routine immunization and failure to receive these vaccine preventable diseases (VPD) cause more than 2 million deaths and disability every year (UNICEF, 2012).Every year eleven million children die beforetheir fifth birthday and most of them during their first year of life and 98 per cent of these deaths are in developing countries where there is limited access and use of child health services (World Health Organization, 2004).Tsave, Moto,Newtshi, Vhera, Ralesego, Nyathi and Susuman (2013) noted that under five mortality rate is highest in sub-Saharan Africa.

Nigerian situation for children isworse because a baby born in Nigeria is 30 times more likely to die before age five than one born in industrialized country (United Nation International Children Emergency Fund(UNICEF, 2001). UNICEF further observed that one in seven Nigerianchildrendies  before their first birthday. Child mortality rates are exceedingly high and Nigeria ranks 15th  highest in the world among countries with high under-five mortality with more than one million children dying annually from preventable and treatable diseases (Federal Ministry of Health, 2001).

Nigeria is one of the least successful African countries in achieving improvement in child survival in the past four decades in spite of advances in child health care services such as universal immunization, oralrehydrationtherapy, growth monitoring andintegrated management of childhood illness (WHO, 2009). In response to the challenges of high morbidity and mortality rate among children, Enugu State Government initiated a policy on free maternal and child health care in 2007 (Enugu State, Ministry of Health,2007). This  policy  is  aimed  at  reducing  the  high  maternal  and  child  mortality.  However, Nigerian Demographic and Health Survey (2008) reported some improvement in infant and under five mortality rate but these rates still fall short of the world standard.

Children all over the world are seen and considered as God’s gift to humanity. Children are human beings between the stages of birth and puberty (Ikechebelu, Udigwe, Ezechukwu  and Ndinechi, 2008).   United  Nation, (2001) defined  a child  as a person below the age of 18 years. Age of majority is the threshold of adulthood as it is conceptualized in law. The legal definition of child refers to a minor, otherwise known as a person younger than the age of majority. It is the chronological moment when minors cease to legally be considered children andassume control over their persons, actions and decisions therebyterminating the legal control and legal responsibilities of their parents or guardians over and for them (Iruloh, Ernest-Ehibudu, &Orluwene, 2014). In this study a child is anybody within the age of five years.Children constitute the large group in the country and  at this developmental  stage,they  are vulnerable  and  subject  to infectious disease hence the need for adequate utilization  of child health services to cushion the effect of these diseases on them. The health of children should be the concern of every individual, family, community and the nation because the future of the nation depends on them.UNICEF (2005) stated that investing in the health of children is not only human rights but sound economic decision and a sure way for a country to set its course towards a better  future. The  health  of children  is vital  to  individuals,  family and community because  they  are  vulnerable  and  subject  to  diseases  which  made  them  to  be  major consumer health services.

Health services are an act of help intended to promote and maintain the health status  of the  individual,  family  and  community  (Iragunima,  2010).  Park  (2010)  also opined that health services are actions or activities undertaken by health professionals for the purpose of prevention, cure and rehabilitation of individual, family and community. Ability of the health  professionals  to give qualitative  and effective  health  services  to children of under five will go a long way in reduction of high morbidityand  mortality among children.

Child  health  services  are the promotive,  preventive,  curative  and  rehabilitative health care for children (Alakija, 2000). Nelson (2002) asserted that child health services is  the  totality  of  medical  and  non  medical  management  of children  to  protect    and promote their healthin such a manner that will permit themto come into adulthood at their optimal stage of development   both physically, mentally and socially so that they can compete with life struggle at the most effective level. In the context of this study, child

health services are the totality of preventive, curative and rehabilitative services rendered to children in order to maintain and promote their physical, social and mental wellbeing. The  first  five  years  of  life  is  extremely  crucial  in  the  physical  and  intellectual development  of children  and  can  determine  their  potential  to  learn  and  thrive  for  a lifetime  (United  Nation  International  Emergency  Fund  (UNICEF),  2002).  Childhood disease can retard this development.In Nigeria the vaccine preventable diseases that cause high morbidity and mortality among children aretuberculosis, Diptheria,tetanus, pertusis,hepatitis  Bvirus, haemophilus  influenza  type B,poliomyelitis,  yellow feverand measles.Apart from vaccine preventable diseases, there are other life threateningdiseases that contribute to morbidity and mortality in children such as malaria, diarrhea and acute respiratory tract infection.Child health service is organized to take care of these childhood diseases, improve health, prevent diseasesand promote growth, development and survival of children. Enugu State Ministry of Health Strategy for health (2008-2013) identified the components of Child health services as growthimmunization,  exclusive breast feeding, growth monitoring, and oral rehydration therapy for treatment of diarrhoeal diseases and integrated  management  of childhood  illnesses.Lucas  and Gilles  (2006)  stated  that  the components of child health services are immunization, exclusive breast-feeding, growth monitoring, EBF/nutrition supplementation, oral rehydration therapy for treatment of diarrhoea diseases and treatment of health condition using IMCI. The study will adopt components  of  child  health  services  byEnugu  State  Ministry  of  Health  Strategy  for Health.

Immunization is one of the most cost effective and easy methods of preventing childhood diseases. The vaccination of children  against killer but preventable diseases such as tuberculosis, diphtheria, whopping cough, tetanus, hepatitis B virus, haemophilus influenza type B, poliomyelitis and measles has been the corner stone of child health services. Immunization is part of National Health Policy and was implemented on priority basis. Kadri, Singh, Mahanan   and Trived (2010) defined immunization  as intentional introduction  of  weakened  micro-organism  in  small  dose  into  the  body  to  stimulate sensitive, reaction   that brings about immunity against invasion of such micro-organism in large amount.  It is a method of stimulating resistance in the human body to specific disease  using micro-organism  that have been modified or killed  (Blackman,  2009).To accomplish  this  immunization  vaccines  are  used  such  as BCGwhich  protects  against

tuerclosis , oral polio vaccine against poliomyelitis, penta valent vaccine for diphtheria, tetanus,  whooping  cough, hepatitis  B virus  and haemophilus  influenza type  B. Other vaccines are measles for measles virus infection, yellow fever vaccines for yellow fever virus  and  pneumococcal  conjugate  vaccine  for  protection  against  pneumonia.  In  the present study, immunization is the process of introducing vaccines to children in order to protect them against vaccine preventable diseases. Immunization is an effective public health intervention for reduction of childhood mortality and the expected coverage rate in Nigeria is 90 per cent (Brown & Oluwatosin, 2012). The authors further stated that in Nigeria the coverage is below the target and (37.9%) of children were fully immunized. Immunization of children should be completed before their first birth day and should be combined with exclusive breast feeding for six months to ensure adequate growth and development of children.

Exclusive breast  feeding is another component  of child health services. WHO, (2004) reported  that promoting breast feeding is a step to improvement of infant and young child’s nutrition. WHO further defined exclusive breastfeeding as giving no other food and liquid including water order than breast milk to the infants for six months of age. Oniyango, Oyerinde and Olawore (2014) refers to exclusive breastfeeding as being able to feed the baby on the mother’s breast milk alone from the moment the child is born till 6 months of age, seeing the child grow and gain weight appropriately while the mother remains healthy and happy. In the context of this study exclusive breast feeding is the giving of breast milk only to babies without any other fluid from birth to the period of six months. WHO (2001)   noted that as the child grows and becomes more active, breast feeding is not sufficient to meet full nutritional requirements hence the need for complementary feeding which should start at six months. Observing the feeding pattern of children is part of growth monitoring of children.

Growth monitoring is a component of child health services. George (1993) defined growth  monitoring  as regularly measuring  the weight and height of children.  Growth monitoring is an operational strategy of enabling mothers to visualize the growth or lack of growth and to receive specific guidance in ways in which she, her family and the community at large can act to assure health and continued regular growth of her child (Alade, 2001)..  Feleke, Adole and Bezabih  (2017) stated  that growth  monitoring  and promotion  is  a  prevention   strategy  comprised   of  growth   monitoring   linked   with

promotion that serve as the activity in an integrated  child and nutrition program. The authors  further  stated  that  utilization  of  growth  monitoring  services  has  remained inadequate and very low. During the process of monitoring growth of children in the clinic especially if the mother has been defaults, it will clearly show in the growth chart. In this study, growth monitoring is the process of assessing the height and weight of children to ensure their regular growth. The growth chart also teaches the mother on how to prepare oral rehydration therapy in the home.

.          Oral Rehydration Therapy is one of the key strategies in IMCI in the management of diarrhoea diseases. Oral rehydration therapy is a type of fluid replacement used as treatment for dehydration which involves drinking water mixed with sugar and salt, while continuing to eat (Akinsola, 2006). Rehydration project (2014) views ORT as giving of fluid by mouth to prevent and or correct dehydration that results from diarrhoea. In this study ORT is the use of home remedy in the form of salt sugar solution to rehydrate a child with dehydration that results from diarrhoea. A child who is well immunized and exclusively breast feed hardly developschildhood diseases though one cannot completely rule out the occurrence of ill health in children. The ability of woman of childbearing age to identify and recognize the signs of illness, provide adequate and quality care, seek medical help early in sickness goes a long way to save and keep the child alive (Sarode,

2007).

Another  component  of  child  health  services  is  treatment  of  Minor  Ailments.. Cleason and Waldman, (2000) opined that treatment of or management of minor ailment is a medical treatment made available for children. The authors suggested that children brought into the clinic following acute illnesses should be treated as quickly as possible.In response  to  thesechallenges  UNICEFand  WHO developed  Integrated  Management  of Childhood  Illness  (IMCI)  strategy  for  prompt  and  adequate  treatment  of  childhood illnesses.     The  components  of  IMCI  are  to  improve  health  system  for  effective management of childhood illnesses, improve family and community practice and improve the health workers skill in the use of IMCI (Adesokan, 2010). One of the key concepts in improving family and community practice is educating child bearing mothers on how to utilize home remedy for treatment of infection and diarrhoea disease.

Child bearing mothers (CBMs) refer to women aged between 15 -49years (WHO,

2012). Samuel (2010) stated that child bearing mothers refer to women aged 15- 45years.

In the present study, child bearing mothers are mothers who are within the age of 15-49 year.    The  most  important  roles  of child  bearing  mothers  is bearing  and  rearing  of children and taking care of sick members of the family. For them to perform these roles they must be healthy. Childbearing mothers are more at risk than others,may be because these women are either carrying a pregnancy or nursing a child. The stress and strain of pregnancy may limit adequate utilization of child health services.

Utilization of services is a factor in accomplishment of CHS objectives. Utilization of child health services refers towillingness of the user of the services to avail themselves of these services (Abanobi, 2005). Abanobi further stated that utilization of child health services is the willingness ofthe target population to make use of the services to protect and promote optimal health and wellbeing of children. Emmanuel- Elsvan, Dekker, Jan- Geertzen and Joost (2005) refers to utilization of health services as the process of seeking professional  health  care  and  submitting  oneself  to  the  application  of  regular  health services with the   purpose of preventing health problems. In the context of this study, utilization refers to the use of CHS by child bearing mothersfor the purpose of promoting and improving the health of children.

Child  health  services  can  be  low,  moderately  or  highly  utilized.  However utilization  of  CHS  can  be  influenced  by  socio-  demographic  correlates.  Socio-  is connected  with society or the study of society. Demography refers to the challenging number of births, deaths and disease in a community over a period of time. Weeks, (1999) opined that demography is concerned with everything that influences or can be influenced by population size distribution, processes, structures or characteristics.

Socio-demography refers to certain characteristics or features possessed by a given population  which  makes  them  behave  in  a particular  way  (Raphael,  2008).  Raphael further described socio-demography as pertaining to or characterized by a combination of sociological and demographical characteristics such as age, education, occupation, marital status and parity. In the present study socio-demography refers to the attributes of child bearingmothers  such  as  age,  education,  marital  status,  religious  affiliation  and  parity which may make or mar them to avail themselves of CHS.

Socio-demographic  factors  of  age,  level  of education,  marital  status,  religious affiliation  and  parity  as  they  influences  utilization  of  CHS  were  explored.Socio  is connected  with  society or the study of society.    Demography  refers  to  the  changing

number of birth, deaths and disease in a community over a period of time.  Weeks (1999) opined that demography is concerned with everything that influences or can be influenced by   population   size,   distribution,   processes   structures   or   characteristics.      Socio- demographic refers to certain characteristics or features possessed by an individual or a given  population  which  makes  them  to  behave  in  a particular  way  (Raphael,  2004). Abanobi  (2006)  described  socio-demographics  as  pertaining  to  or characterized  by a combination of sociological and demographical characteristics such as age, level of education, marital status, religious affiliation and parity which influences a certain population.   Ask.com (2013) defined socio-demographic as an element of a group in a society such as age, education marital status, religion and parity.   In this study, socio- demography refers to attributes of CBMs such as age, level of education, marital status, religious affiliation and parity which makes or mars them to avail themselves of CHS in Udenu Local Government Area of Enugu State.   These socio-demographic variables of age, level  of education  marital  status,  religious  affiliation  and parity  as it  influences utilization of CH were explored in this study.

Maternal age has been shown to have relationship with CHS utilization.  Tsave, at al (2013) revealed that there are high rates of childhood immunization services among mothers aged 35-49 and multivariate analysis also revealed that mothers aged 40-44 are more likely to immunize their children than young mothers. They further revealed that CBMs aged 35-44 are significantly correlated with the use of immunization.This implies that mothers aged 35 to 44 make use of immunization services more than mothers in other age groups.

Utilization of child health services varies with level of education. The mother’s education has been reported as a key factor in reducing infant and child mortality. The higher a mother’s level of education, the more likely it is that she will marry later, play greater   role   in   decision   making   and   exercise   her   reproductive   rights   (Nigeria Demographic and Health Survey(NDHS), 2004). The NDHS report further revealed that the proportion of WCBA that uses oral rehydration therapy progressively rises with the levels of education.

In addition to level of education, marital status may influenceutilization of child health  services.  Ngirabega,  Leonard,  Munyashangore,  Dramaix-Wilmet,  (2010)opined that single, widowed or divorced mothers may have limited utilization of child health

servicesmore than those living with their husband.Oniyango, Oyerinde and Olawore (2014)revealed  that married,  singles and divorced CBM have significant  influence on their exclusive breastfeeding utilization.

Parity isanother socio-demographic factor that relates to child health services utilization. Tsave at al (2013) reported that women with six or more children are less likely to use child health services (immunization  services) compared  to those with 1-

2children.  In  a  similar  study  by  Ngirabega,  Leonard,  Mumyanshogore  and  Damaix- Wilmet  (2010) parity has significant  relationship  with  ever-use of growth  monitoring chart. Fagbule, Olaosebikan and Parakoyi (2003) reported that multiparous women were less aware of growth chart than woman with party 2-4. One cannot make use of what she has no idea.

Another socio-demographic factor that varies with child health services utilization isreligious  affiliation.  Oniyangi,  Oyerinde  and Olawore  (2014) reported  that  religious affiliation of child bearing mothers cannot be correlated with child health services utilization. However, Essan (1999) stated that religious (Christian) mothers do not have enough time to breastfeed their infant although religion is not against exclusive breast feeding.In  the present study, socio- demographic  variables of age, level  of education, marital status, religion and parity as it influence the utilization of child health services will be explored in Udenu Local Government Area (LGA) of Enugu State.

Udenu  LGA is  one of seventeenLGAs  of Enugu  State  and  is mainly of rural locations. Observation from the researcher reveals that there are few health facilities in UdenuLGA for child health services. The few available ones are not properly utilized due todistance.The  health  facilities  are  poorly  equipped  with  very  few  health  workers. Majority of CBM in Udenu LGA are not well educated and lack  decision making ability to seek child health services for their children leading to high incidence of childhood diseases and handicapping conditions with its attendant physical, economic and psychological burden on parents.

The study was anchored  on modelof Health Seeking Behaviour  (HSB), Health Belief model (HBM) and Diffusion of Innovation theory (DIT). Health SeekingBehaviour Model(HSBM)developed  by  Anderson  and  Newman  (1973)proposed  that  the  use  of health services is a function of three sets of factors such as income, availability and access characteristics  of the health  services and need characteristics.Health  belief model is a

psychological model propounded by Rosenstock and Becker (1974). This model has its focus on the relationship with health behaviour, beliefs, practices and utilization of health services. This was useful because child bearing mothers who feels the health of their children are being threatened by a negative health condition will take a health action (use child  health  services)  that  lead  to  successful  recommended  health  action  for  their children. Diffusion Innovation Theory provides explanation on new ideas and practices spread within a society or from one society to another (Rogers & Shomaker, 2003). Based on this theory, the pattern that women of child bearing age will follow in adopting new ideas in the community depend on some processes such as innovators, early adaptor, early majority and later majority. Diffusion innovation theory (DIT) is relevant to utilization of child health services because if new idea such as exclusive breast feeding is introduced few mothers (early adopter) will subscribe to the idea and if CBMs accrue some health gains from it, they will disseminate this news to friends who will join in utilizing the child health service.

Literature  shows  that  only 17  per  cent  of children  under  five  have  access  to modern health facilities (NDHS, 2004). Preventive and promotive child health services which include immunization, exclusive breast feeding, growth monitoring and promotion as well as management of simple ailment are poorly utilized below WHO stipulation. The health system has been plagued by problems of service quality such as unfriendly staff, unavailability of drugs and long waiting periods in the health facility, high parity and low level of maternal education (WHO, 2009).  All these factors could be impediment to the utilization of child health services which helps in the reduction of child morbidity and mortality rate.

It seems that there is no study on sociograhic determinants of child health services in Udenu  LGA of Enugu State.   Determining this certainly will be a positive step to improvement in utilization of child health care services among child bearing mothers in Udenu  LGAs of Enugu  State. Thus the study of socio- demographic  determinants  of utilization of child health services becomes necessary.

Statement of the Problem

There has been an increasing demand for health care services for children in order to reduce childhood morbidity and mortality through immunization, exclusive breast feeding, growth  monitoring, oral rehydration  therapy and treatment  of minor ailment.

Irrespective of these services, the cooperation ofchildren’smothers is critical in realizing the desired goals of child health service.Child health in Nigeria is discouraging and is described among the worst in Africa. It is tragic that one in seven Nigerian children die before her fifth birthday. Child mortality rate is exceedingly high and Nigeria ranks 15th highest in the World among countries with high under- five mortality (UNICEF, 2008).

In spite of advances in universal immunization, oral rehydrationtherapy,  growth monitoring and promotion in Nigeria, Enugu state inclusive is one of the least successful in achieving improvement in child survival (NDHS, 2004).This is due to low utilization of  child  health  services  by  CBMs.  According  to  some  authors,  lack  of  education, underage,  marital  differences,  too  many  children  in  the  family,  distance,  inadequate number of health personnel and poor quality of care have been implicated.

.          Regrettably irrespective of laudable programmes such as integrated management of  childhood  illness,  millennium  development  goal,  free  maternal  and  child  health services which stresses reduction in childhood morbidity and mortality through proper utilization  of child health services in Enugu  State, condition of childrenremains  poor. Observation by the researcher has shown that many mothers do not utilize the available child health services; rather they resort to local treatment like use of palm kernel oil, scarification  and  use of other  herbs in  the prevention  and  management  of childhood ailments. In addition there is lack of drugs, equipments, good referral system in the few available health facilities thus leading to low utilization of child health services. These problems are worrisome  and indicate negative  implications for child  health servicedelivery; hence the need to study socio- demographic determinants of utilization of child health services becomes necessary.

Purpose of the Study

The purpose of the study is to investigate the socio- demographic correlates of utilization of child health services by CBMs in Udenu Local Government Area of Enugu State. Specifically the study will attempt to find out:

1.the   extent   of  utilization   of  immunization   services   by  CBMs   in   Udenu   Local

Government Area of Enugu State

2.the extent of utilization of exclusive breast feeding services byCBMs in Udenu Local

Government Area of Enugu State

3.the  extent  of  utilization  of  growth  monitoring  services  byCBMsin  Udenu  Local

Government Area of Enugu

4.the  extent  of  utilization  of  Oral  Rehydration  Therapy  by  CBMs  in  Udenu  Local

Government Area of Enugu

5.the  extent  of  utilization  of  integrated  management  of  childhood  illness  services byCBMs in Udenu Local Government Area of Enugu

6. the relationship  between  some socio-demographic  variables(age,  education,  marital status, parity and religion) and utilization of immunization services among CBMs in Udenu, L.G.A of Enugu State?

7. the relationship between some socio-demographic  variables( Age, education, marital status, parity and religion) and utilization  exclusive breast  feeding services  among CBMs in Udenu, L.G.A of Enugu State?

8. the relationship  between  some socio-demographic  variables(Age,  education,  marital status,  parity  and  religion)    and  utilization  of growth  monitoring  services  among CBMs in Udenu, L.G.A of Enugu State?

9. the relationship between some socio-demographic  variables (Age, education, marital status, parity and religion) and utilization of  oral rehydration therapy services among CBMs in Udenu, L.G.A of Enugu State?

10. the relationship between some socio-demographic variables(Age, education, marital status , parity and religion)   and utilization of integrated management of childhood illness services among CBMs in Udenu, L.G.A of Enugu State?

Research Questions

The following research questions will guide the study

1.  What is the extent of utilization ofimmunization servicesamong CBMsin Udenu LGA

of Enugu State?

2.  What is the extent of utilization of exclusive breast feeding services among CBMsin

Udenu LGA of Enugu State?

3.  What is the extent of utilization of growth monitoring services among CBMsin Udenu

LGA of Enugu State?

4.  What is the extent of utilization of oral rehydration services among CBMs in Udenu

LGA of Enugu State?

5.  What  is  the  extent  of  utilization  of  integrated  management  of  childhood  illness services among CBMs in Udenu LGA of Enugu State?

6.  What is the relationship between some socio-demographic variables (Age, education, marital  status,  parity  and  religion)  andutilization  of immunization  services  among CBMsin Udenu, LGA of Enugu State?

7.  What is the relationship between some socio-demographic variables (Age, education, marital status, parity and religion) and utilization of exclusive breast feeding services among CBMsin Udenu, LGA of Enugu State?

8.  What is the relationship between some socio-demographic variables (Age, education, marital  status,  parity  and  religion)  and  utilization  of  growth  monitoring  services among CBMs in Udenu, LGA of Enugu State?

9.  What is the relationship between some socio-demographic variables (Age, education, marital status, parity and religion) and utilization of oral rehydration therapy services among CBMs in Udenu, LGA of Enugu State?

10. What is the relationship between some socio-demographic variables (Age, education, marital  status,  parity  and  religion)and  utilization  of  integrated   management  of childhood illness services among CBMs in Udenu, L.G.A of Enugu State?

Hypotheses

The following null hypotheses are postulated to guide the study. Each of the null hypotheses  will  be  tested  at  0.05  level  of significance  and  at  appropriate  degree  of freedom.

1.  There  is no  significant  relationship  between    socio-demographic  variables  (age  -, education,  marital  status,  parity  and  religion)     and  utilization  of  immunization services among CBMs in Udenu L G A

2.  There  is  no  significant  relationship  between  socio-demographic   variables  (age, education,  marital  status,  parity  and  religion)  and  utilization  of  exclusive  breast feeding  services among CBMs in Udenu L G A

3.  There  is  no  significant  relationship  between  socio-demographic   variables  (age, education, marital status, parity and religion)   and utilization of growth monitoring services among CBMs in Udenu LG A.

4.  There  is  no  significant  relationship  between  socio-demographic   variables  (age, education,  marital  status,  parity  and  religion)    and  utilization  of oral  rehydration therapy  services among CBMs in Udenu LGA

5.  There  is  no  significant  relationship  between  socio-demographic   variables  (age, education, marital status, parity and religion) and utilization of integrated management of childhood illness among CBMs in Udenu LGA.

Significance of the Study

The present study provided information on socio- demographic correlates of utilization of child health services in Udenu LGA of Enugu State. It is expected that the information  obtained  may be  useful  to  health  educators,  health  care  providers,  State Ministry of Health and child bearing mothers.

The  study  generated  data  on  the  extent  of  utilization  of  child  immunization services among CBMs. The result will be beneficial to health workers and health educators.It was beneficial to health workers who will know the extent the basic child health care services (immunization) are being utilized in health facilities thereby giving room for improvement in health services.   The data generated  will be useful to health educators  and  health  workers  whowill  utilize  the  result  to  educate  child  bearing motherson  the benefits of full immunization  coverage before the child first birth day. CBM will make use of the knowledge obtained for proper utilization of immunization services.

The study generated data on the extent of utilization of exclusive breast feeding services.  The result will be useful to health workers who will use the result to find out the proportion of CBMs who do not practice EBF thereby helping them in intensifying health talk in health facilities on the benefits of EBF to both the child and mother so as to enhance high utilization rate.

Result  of  the  study  generated  data  on  the  extent  of  utilization  of  growth monitoring services by CBMs. The finding will be useful to health educators and health workers who will use it to identify the proportion of mothers who did not bring their children to child welfare for monthly weighing and growth promotion during the first five years of life for the purpose of counseling them on the importance of monitoring their child’s growth and development so as to enhance high utilization rate.

The finding generated data on the extent of utilization of oral rehydration therapy by CBMs. The result willbe useful to health workers who will use the result to find out the percentages  of CBMs who do not utilize ORS/SS during the episode of diarrhoea thereby  intensifying  health  talk  for  those  that  under  utilize  it.  Result  of  the  study generated data on the extent of utilization of IMCI services. The result will be useful to nurses and health educators who will use it to find out the proportion of mothers who do not use the health facilities or do not seek care on time for their children during ill health for the purpose of health educating mothers on the dangers inherent in delay in seeking care and using wrong places during ill health for the purpose reducing high morbidity and mortality resulting fromsuch actions thereby increasing the percentageof mothers who use child health services.

The study generated data on the relationship between age and utilization of child health services. The result will be useful to health  workers who will use the result to identify the  age group that  utilize  child  health  services  more  than the others  thereby helping in intensifying health education for those age group that under utilize CHS.

The study generated data on level of education as it relates to utilization of child health services. Health educators will also use the result to educate CBMs and community members  on  the need  for girl  child  education  which  will empower them  in decision making and positive health care seeking behaviour because better educated mothers tend to have increased ability to utilize child health services.

The study equally generated data on marital status as it relates to utilization of CHS. The result will be useful to the health educators who will use it to identify the group of mothers that is more likely to under utilize CHS so as to enable them plan enlightenmentcampaign to curb any problems arisingfrom such group that will limit their utilization of CHS.

The study also generated data on parity of CBMs as it influences utilization of CHS.The finding will be useful to health workers who will use itto educate CBM who has high parity and its influence on utilization of CHS so as to enable them treat children from such mother as atrisk group thereby giving them adequate attention and care.

The study also generated data on religious affiliationas it influences utilization of child health services. This will be useful to clergies and religious groups who will use it to propagate the positive effect of child health services. The study is significant because

diffusion of innovation theory, health belief model and health seeking behavior model have been developed to facilitate utilization of child health services.

Scope of the Study The study was limited to child bearing mothers in Udenu LGA.  The    study    was focused on socio- demographic determinants of utilization of child health services. Socio- demographic  factors  of  age,  level  of  education,  marital  status,  parity  and  religious affiliation   were   explored.   These   variables   were   studied   to   determine   if   any relationshipexist between them and utilization of CHS.

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