FAMILY PLANNING AS AN AGENT OF BIRTH CONTROL IN LAPAI LOCAL AREA OF NIGER STATE

FAMILY PLANNING AS AN AGENT OF BIRTH CONTROL IN LAPAI LOCAL AREA OF NIGER STATE

CHAPTER ONE

INTRODUCTION

1.1     Background of the Study

The practice of birth control or preventing pregnancy is as old as man. Humans from existence have been enjoying the gift of procreation; they have been fruitful and multiplying. This human multiplication or increase has allowed the people to live together in a particular area, city or country forming their population. However, the population of people in a given country should be controlled to avoid over population which can in turn have an adversely effect on the country’s resources and as well boast an increase in maternal mortality. Experts observed that high rate of any given population pose tremendous socio-economic problems for the maintenance of minimal standards of living. Therefore, to avoid a country being overpopulated, it will be necessary to encourage the citizens to have the number of children they can manage. Osakue (2010) might be right when he said that if the nation’s population is left to grow uncontrolled, that the national resources will sooner or later be outstripped by the increasing demand of the growing population. For centuries, humans have relied upon  their  imagination  to  avoid  pregnancy.

All over African continent, plans, projects and programme are designed to provide high quality family planning counselling   to   the   populace.   Many   Nigerians   have resorted to the use of family planning to control fertility, more so some believe it is not necessary to control the number of children a family should have and this has been frustrating the efforts of the Federal Government of Nigeria in formulating birth control and family planning policy   in   the   country.   Experts   observe   that   some Nigerians believe that it should be left for the family to decide the number of children they should have while others were of the opinion that the number of children a family should have depend on the income level of the family.  It  is  assumed  that  a  rich  family  should  have greater  number  of  children  than  the  poor  or  average family but on the contrary, it is the poor family that have the greater number of children with their little income to carter for the family and as a result of that many children are sent to the streets to hawk, some are sent out of their home as house helps where they face some kind of abuses etc.

The provision of family planning is a key means by which two of the Millennium Development Goals (a reduction of under-5 mortality rates by two-thirds and maternal mortality rates by three-quarters by 2015) may be   achieved.   Experts   observed   that   reducing   both unplanned and  higher  risk  pregnancies  is  a  way  of reducing both maternal and infant mortality. They further stated that voluntary family planning has profound health, economic, and social benefits for families and communities, protecting the health of women by reducing unwanted or  high  risk  of  pregnancies,  protecting  the health of children by allowing sufficient time between pregnancies, reducing abortions, supporting women’s rights and opportunities for education, employment and full participation in society and protecting the environment by stabilizing population growth.

Today, the voluntary control of fertility is of paramount importance to modern society. This was probably the fear of Obinna (2011) when he laments on the global perspective countries currently facing the crisis of rapid growth of human survival population that has begun to threaten   human   survival.   Studies   have   shown   that Nigeria as the most populous country in Africa has been among the seventeen most populated countries on earth with an estimation of 160- 170 million people, and also has the highest maternal mortality rates in the world. This has been attributed to the inability of Nigerian women to adequately use family planning and birth control methods to assist them in successfully spacing of their children. They further observed that Nigerian population  exceeds that of Russia and is more than twice the population of Germany and that the Nigerian population has been projected to grow so rapidly that Nigeria may have over 400 million people by the year 2015.

In an attempt to remedy the situation, some researchers reviewed that the Federal Government of Nigeria in 1988 and 2001, adopted the National Population Policy and National Reproductive Health Policy respectively, both of which seek to achieve quality reproductive and sexual health for all Nigerians. The policies were developed to address the unacceptable rate of maternal and infant morbidity and mortality in Nigeria as well as creating awareness on the use of family planning services. The policy also sought to ensure that every man and woman has the opportunity to obtain and use any contraceptives of their choice “at the right place, at the right time, and at the right cost.

Also in 2002, the Federal Government of Nigeria came out with a population policy paper which states that the value of family planning and child spacing on the stability and wellbeing of the family shall be promoted and family services  shall  be  incorporated  in  maternal  and  child health  care.  Since  the  policy  paper  of  2002  did  not succeed, on June 29th 2012, Nigerian President Goodluck Jonathan made headlines that caused controversy on the need for “birth control legislation” in lines of China’s one child policy. Jonathan has recommended that the newly formed National Population Commission should pursue a campaign of “advocacy” and “sensitization” to promote birth control and the idea of child spacing. This is not the first time someone influential has proposed such a policy for Nigeria. Last year, American economist Jeffrey Sachs suggested that “Nigeria should work towards attaining a maximum of three children per family,” an idea that also drew criticism and debate.

The  aim  of  the  formulation  of  population  policy  in Nigeria is to reduce rapid population growth as well as maternal, infant morbidity and mortality.  In Nigeria, family planning and birth control can improve the likelihood of survival of life of the populace at all stages. Commenting on the importance of family planning in Nigeria, Julius Neyerere cited in Centre for Disease Control (1983) said that, It  is  important  for  human  beings  to  put  emphasis  on caring for children and the ability to look after them properly, rather than thinking only about the number of children and the ability to give birth. For it often happens that man’s ability to give birth is greater than their ability to bring up the children. In view of this, the study seek to investigate family planning as an agent of birth control in Lapai Local Government Area of Niger State.

1.2     Statement Of The Problems

Even though Nigeria as country has embraced family planning as an agent of birth control and has integrated it into its primary health care system like the rest of the world, family planning matters are arguably still very thorny and thin-skinned in Africa, particularly in Nigeria. Unfortunately, before the enactment of the policy, issues, particularly, the use of birth control and family planning methods presumably to predict on the right of couples and individuals to decide fully the number and spacing of their children remains a great concern. These controversies have been hindering the success of family planning as an agent of birth control in the country, a lot of Nigerians have been determined to control fertility but could not do so because they have no access to information on modern birth control methods which results in uncontrolled increase in population. The Nigerian population is the highest in Africa at over 200 million, with a growth rate of 2.9 and a Total Fertility Rate of 5.7 (Population Council, 2011; World Bank, 2009, Federal Government  of  Nigeria,  2004;  National  Population  Commission  (NPC)  Nigeria  2009).  The NDHS report of 2018 shows that only 14.6% of currently married women aged 15-49 in Nigeria use any method of contraception (Nigerian Population Commission, 2008). This is in spite of the existence of the national policy on population and sustainable development which encourages voluntary limitation  of births  to  4  children  per woman  as  well  as various  family planning programmes that have been carried out in the country (Federal Government of Nigeria 2004). It is against this problems that this study seek to investigate family planning as an agent of birth control in Lapai Local Government Area of Niger State.

1.3     Objective of the Study

The general objective of the study is to examine family planning as an agent of birth control in Lapai Local Government Area of Niger State.

The specific objectives of the study include:

1. To investigate respondents knowledge of Family Planning
2. To explore the attitude of family towards family planning
3. To identify the rreasons for not using any family planning method
4. To examine the impact of family planning on birth control in Lapai Local Government Area

1.4     Research Questions

1. Do you have a prior knowledge of Family Planning
2. What is the attitude of family towards family planning
3. What are the various the reasons for not using any family planning method
4. What is the impact of family planning on birth control in Lapai Local Government Area

1.5     Significance of the Study

The study on family planning as an agent of birth control is therefore, significant in many aspects. The world’s population is growing at an exponential rate especially in the sub-sahara Africa which if nothing is done will pose a great threat to sustainable development and human existence as a whole, therefore the findings of this study will of great significant to Families, Lapai Local government and other stakeholders as it will enlighten them on the relevance of family planning on birth control in Lapai local government and Nigeria at large.

This study therefore, will greatly help in creating awareness, knowledge  as  well  as  understanding   on  family planning and birth control services in the country.   Findings from this study would enlighten the populace on the need for family planning and birth control in the country aimed at reducing rapid population growth that poses a major hindrance to economic development in the country.

Secondly, the study will contribute to the existing literature on the application of family planning and birth control in the country.  It will also help to enhance the use of family planning as an agent of birth control.

PROBLEMS ENCOUNTERED BY SOCIAL WORKERS IN SOCIAL WORK PRACTICE

PROBLEMS ENCOUNTERED BY SOCIAL WORKERS IN SOCIAL WORK PRACTICE

(CASE STUDY OF BWARI LOCAL GOVERNMENT AREA OF ABUJA)

CHAPTER ONE

INTRODUCTION

1.1       Background of the Study

The evolution of Social work and efforts to promote social development can be seen as closely linked to the primordial tendency of humans to help one another in all past human societies. In traditional, including African societies, the concern for social welfare was reflected in activities within the family, the clan and ethnic group. The urge of man to help man in all societies was demonstrated by the great care accorded to, inter alia, children, orphans, widows, widowers and the invalid as well as the elderly. In such “gemeinschaft” (Tonnies, 1887), social work was more or less a task for everyone instead of individuals and specialized agencies. As such, Social work has always been geared towards improving the quality of life of each and everyone.

Social work as it is known today has relatively recent origins. It emerged at a time when feudalism was disintegrating and capitalism taking its place. The control of the family and the church was fast weakening too. According to Fink (1968:27), these fundamental social changes began occurring between 1834 and 1909 and ushered in the development in Britain of specialized care agencies for certain vulnerable and disadvantaged groups, such as dependent children and people living with physical or mental disabilities. Institutions such as district schools, foster homes, hospitals, infirmaries and special schools were provided for these groups.

At any rate, social work is increasingly becoming globalized, for it is being applied in a variety of settings and numerous agencies and people across the world are benefiting from its services. Among the social work services provided are: “psychiatry, medical, marriage and family counseling; the school; rehabilitation; corrections; public welfare; workplace; drug abuse; and child welfare” (Farley et al, 2006: 13). Social work does not only address needs and problems at the personal or family level but also at the neighborhood, national and international level.

Moreover, with the coming of colonialists in search of raw materials, labour and markets as well as areas for investment there was a need to establish schools, hospitals and basic infrastructural lines so as to ease work in plantations and mines. Laws such as the children and the young person’s ordinance of 1949, probation of offenders’ ordinance of 1947, and Foster Care and Adoption Ordinance of 1955 laid the basic foundation for social work in the pre-independence era.

Samadi, R. (2008); highlighted history of social work in health care system that social workers from the twentieth century have been involved in health care system such as providing services for poor people, worked with the elderly and patients with tuberculosis. In 1977, the World Association of Social Work published standards for the provision of health care services in hospitals and in 1980, the standards for social workers in health centers developed and it replaced hospital standards. Between 1981 and 1982, the National Association of Social Work Board’s new developed standards approved and added to the previous standard of care. These standards include the activities of social workers in the field of kidney patient, disability, treatment and health care and followed by social workers into the health care system and the public and private sectors were engaged. More activities of social workers concentrate on transferring the patient or refer him or her to home and in some cases solve the financial problems. It is against this background that this study examined the problems encountered by social workers in social work practice.

1.2       Statement of the Problem

Social workers posted to work in various areas and but their knowledge and skills are underutilized not intentionally but due to lack of in depth awareness on the roles and functions of social work professionals in such areas. The placement of social workers in rendering their service is good luck to patients and victims of circumstance being attended to with the fact that not all patients require tablets and injections since the majority of patients suffer from social problems. Even those with debilitating medical conditions such as advanced HIV/AIDS, patients with cancer, severe heart conditions and many other cases are in need of social workers, (William, M. 2014).  The National Social Workers’ Association states the primary mission of social workers is to enhance human well-being and help meet the basic needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed and living in poverty. In the course of carrying out this responsibility the social workers are faced with several problems such as lack of skills, lack of finance, lack of time, inadequate number of social workers to attend to the need of the people etc. It is in the light of this that the study seek to identified the problems encountered by social workers in social work practice with particular reference to Bwari Local Government Area of Abuja.

1.3       Objectives of the study

The general objective of this study was to examine the problems encountered by social workers in social work practice with particular reference to Bwari Local Government Area of Abuja.

This study specifically aimed to:

• Identify the awareness of the presence of social worker in the study area
• Examine the roles of social works professionals in Bwari Local government area of Abuja.
• To identify the problems encountered by social workers in the study area

1.4       Research Questions

• Are you aware of the presence of social worker in the study area?
• What are the roles of social workers in Bwari Local government area of Abuja?
• What are the problems encountered by social workers in the study area?

1.5       Significance of the Study

The study aimed at identifying the problems encountered by social workers in social work practice in Nigeria with particular reference to Bwari Area council of Abuja. The identified challenges shall be communicated to the local government authority and the heads of department to make them understand the existing challenges facing social work professionals in the social work practice.

The results of this research study can help in developing strategies on how to eliminate those challenges hence maximize the benefits to clients who require social workers interventions. This study will assist to create awareness to the local government authority on the need to strengthen the social welfare department in  terms of allocating adequate funds as well as increasing the number of social workers into medical practice. Moreover, on job programs might be designed to orient all staff on the roles and functions of social workers in Bwari Local government area of Abuja.

1.6       OPERATIONAL DEFINITION OF TERMS

• Social Work: Social work is a practice-based profession that promotes social change, development, cohesion and the empowerment of people and communities.Social work practice involves the understanding of human development, behavior and the social, economic and cultural institutions and interactions.
• Social Worker: Social workers are professionals who aim to enhance overall well-being and help meet basic and complex needs of communities and people. Social workers work with many different populations and types of people, particularly focusing on those who are vulnerable, oppressed, and living in poverty.
• Administrator– refers to a person in authority or managerial control for organizing work intended to advance the social work profession. Their job involves staff recruitment, placement, monitoring and evaluation of social work practitioners and the quality of their practice (New Dictionary of Social Work, 1995; Dolgoff et al, 2012). In the context of this study supervisors and managers are graded as administrators.
• Agency– refers to a business that makes its facilities available to others for a fee or government parastatals established to aid service delivery in the community (Garthwaith, 2011).
• Behavior– refers here to the actions of a social work administrator or practitioner in relation to the practice environment (Zastrow, 2009).
• Ethical Values and Principles– refers to the broad-spectrum methods mirrored inside the guidelines connected towards the sequence of behaviour to be adhered by practitioners (social workers) in the practising of their profession according to the regulatory body of the country (Dolgoff et al, 2012).
• Practitioner– refers to individuals registered and approved in accordance with the Social Work Act, 1978 (Act 110 of 1978) to practice the social work profession (New Dictionary of Social Work, 1995:60). In the context of this study, it refers to both the social workers, community development workers and administrators.
• Professional Ethics– is a guidance that offers ways of evaluating choices for their unfairness or appropriateness and assists a practitioner into transforming professional values into professional practice activities (Dolgoff et al, 2012).
• Professional Values– are guides that assists the work of a person in his/her professional life, it is the priorities and interpretations of practitioners’ decision making and action in agreement with societal values in the society in which they practice (Dolgoff et al, 2012).
• Reflection– is a method employed by social workers to enhance the understanding and perceptions of the customers’ problems circumstances and to get feedback of the feelings and attitudes of clients through selective repetitions of words and interpretation of their actions (New Dictionary of Social Work, 1995:52).
• Service– is the working component of a social service professional that provides for the clients in a programme (Dolgoff et al, 2012).
• Societal Value– reflects a consensus among a group of people about what is right and good reached through negotiations towards maintaining society’s orderliness (Zastrow, 2009).

ATTITUDE OF PEOPLE TOWARDS EPILEPSY AND IT'S EFFECT ON SOCIETY

ATTITUDE OF PEOPLE TOWARDS EPILEPSY AND IT’S EFFECT ON SOCIETY

ABSTRACT

Introduction – The reaction to epilepsy is shaped by traditional indigenous beliefs. Therefore this study assessed the societal attitude and social support towards people living with Epilepsy in Ogbomoso. Methodology- The study adopted cross sectional descriptive design using 410 respondents selected through multistage sampling technique. Information was collected from the respondents using standardized instrument of Interviewer Administered Questionnaire (IAQ), Attitudinal Scale and Social Support Scale. Data were analysed using descriptive and inferential statistics at 0.05 level of significance. Results – In terms of attitude, 273 (68%) of respondents strongly agreed that PWE would be a burden to the family, 251 (62%) expressed fear during seizures, 215 (53.8%) were of the opinion that PWE should not get manned: 258 (64.5%) would not definitely help someone with seizure,258 (64.5%) would not stay in the room with person with epilepsy. There was a significant association between respondent area of residence and their attitude (X2  = 16.320, P =0.012).  Conclusion  –  It  was  concluded  that  there  was  a  misconception  about epilepsy resulting in negative attitude and poor social support towards People Living with Epilepsy.

CHAPTER ONE

INTRODUCTION

1.1     Background of the Study

Epilepsy is the most common non-infectious neurologic disease in African Countries, including Nigeria (Attotey & Reidpath 2007) and it remains a major medical and social problem (Bagley, 2007). Historically, epilepsy was believed to be a sacred disease, i.e, the result of the invasion of the body by a god. It was thought that only a god could deprive a healthy man of his senses, throw him to ground, convulse him and then rapidly restore him to his former self again  (Reynolds, 1988). The word ‘lunatic’ was first applied to sufferers of epilepsy as gods were thought to occupy heavenly spheres, one of which was the moon. In contrast, mad people were referred to as “maniacs” whose madness was a result of invasion of the body by devils or evil spirits (Osuntokun, 1978). In the Gospel according to Saint Mark Chapter 4, it was a foul spirit that was cast out of the young man with fits. The “Dictator Perpetuus” of the Roman Empire, the great Julius Caesar likely had epilepsy on the basis of documented four attacks that were probably complex partial seizures. Also, it is possible that he had attacks as a child and as a teenager. His son, Caesarion, and his great-great-great grand nephews Caligula and Britannicus also had seizures. The etiology of epilepsy in this Julio-Claudia family is probably linked to inheritance (Hughes, 2010). This historical legacy has continued to influence public attitude to epilepsy making it a dreaded disease. These believes have resulted in patients with epilepsy (PWE) being ostracized, stigmatized and misunderstood. The social implications are serious.

For instance, in Madagascar, Patients with epilepsy are refused burial in the family grave (Osuntokun, 1978). In many Africa countries, people with epilepsy are out-casts (Awaritife & Ebie, 2008) as Africans believe that the disease results from visitation of the devil, effect of witch-craft, the revenge of an aggrieved ancestral spirit or consumption of something harmful in utero (Mkadir, 2009). Suicide or attempted suicide is not uncommon among Nigerians who suffer from epilepsy. The patient with epilepsy is likely to dropout of school, lose his job, find it impossible to marry, lose his wife or her husband, and be tormented to the extent of becoming a Vagrant Vagabond (Awaritife & Ebie, 20008). Given this background, there is a good reason for the increased concern about information on the societal attitude and social support towards people living with epilepsy.  A better understanding of societal attitudes to mental illness and its treatment is an important prerequisite to the realization of successful community based programme (Mkadir, 2009) in order for nurses in the community based health facilities to protect the rights of those living with epilepsy and to sensitively develop services that will address their needs. It is vital to gain a more accurate knowledge of the societal attitudes and social support towards individual with epilepsy across a specific region and population group. There are three common approaches used to reproduce negative attitudes in the communities. These are education, contact and protest (Corrigan, 2012) which are major roles of nurses in the communities. Nurses seek to provide facts about mental illness in order to get rid of community held myths through health education. Contact (home visitation by public health nurses) aims to provide a human face on mental illness and hopes that treatment works. Protest (advocacy) aims to hold back biased messages and challenges commonly held toward mental illness. In some situations, education and contact have been found to be an effective strategy used to reduce mental health stigma among individuals (charyton, Elliot, Lu, & Moore, 2009).

1.2       Statement of Problem

Epilepsy is one of the global health issues affecting more than 65 million people  worldwide, out of which 80% of those affected reside in developing countries (WHO, 2011) more than 50% of this figure are children below the age of 16years  (Thurman & Efy, 2011). In Nigeria, the estimated prevalence of epilepsy varies from 8 to 13 per thousand people (Kabir, Iliyasu, Abubakar & Farinyaro, 2012). Misconceptions have led to social isolation for the individual with epilepsy and in many cases, for his or her family also (Dekker, 2009). It is therefore no great surprise that the myths and prejudice that have surrounded epilepsy have resulted in the stigmatization of people with the disorder (Vercarolis, 2009). Stigma is often a daily companion and can negatively affect an individual quality of life (QOL). It is a major contributor to the burden associated with epilepsy. Reducing the stigma of epilepsy is therefore a key to reducing its impact and improving quality of life. Effective educational programme needs to be developed and implemented to reduce the stigma of epilepsy. In African countries, the disorder is enrobed in superstitions, discrimination and stigma. Persons with epilepsy are at risk of developing a variety of psychological problems including depression, anxiety and psychosis – The socio-cultural attitudes continue to have a negative impact on management of epilepsy. Religious and socio-cultural beliefs influence the nature of treatment and care received by people with epilepsy. There is need to carryout an investigation of attitude of people towards epilepsy and it’s effect on society.

1.3     Research Questions

The study answered the following questions

1.   What are the societal beliefs of the respondent regarding the causes, symptoms and treatment of epilepsy?

2.   What are the societal attitudes towards the persons living with epilepsy in urban and rural communities of Ogbomoso?

3. What are the levels of social support towards the persons living with epilepsy in urban and rural communities of Ogbomoso?

4.   What are the socio-demographic factors responsible for different societal attitudes and levels of social support towards the persons with epilepsy in urban and rural communities of Ogbomoso?

1.4     Research Objectives

The general objective of this study is to investigate attitude of people towards epilepsy and its effect on the society

The specific objectives of the study include:

i.      Determine the societal  beliefs of Ogbomoso communities  regarding the causes, symptoms and treatment of epilepsy

ii.     Assess the societal attitudes towards people living with epilepsy in Urban and Rural communities of Ogbomoso;

iii.   Determine the levels of social support towards people living with epilepsy in urban and rural communities of Ogbomoso, and

iv.    Evaluate the socio-demographic factors responsible for different societal attitude and levels of social support towards the persons with epilepsy.

1.5     Significance of the Study

Stigmatized attitude is accepted as one of the major barriers to the appropriate treatment of persons living with epilepsy. Actions to address the stigma and discrimination associated with epilepsy are being organized in the developed countries but little has been done to address the issue in Nigeria. Prior to embarking on such programme in Nigeria, the base –line attitude that will be object of change must be assessed.

This study would provide information on societal attitude and provision of social support towards person with epilepsy. This information would help in developing educational programmes which seek to reduce stigma and discrimination towards people with epilepsy.

The study might be a source of policy formulation, legislation and successful integration of mental health promotion, treatment and rehabilitation into the primary health care services in Nigeria.

1.7       Delimination of the Study

This study was delimited to individual between 18 to 64 years of age residing in urban and rural communities of Ogbomoso in Oyo State, Nigeria. It was delimited to the respondent irrespective of their religious application, educational level, employment status, socio- economic status and ethnicity.