ABSTRACT
To achieve the state of complete physical, mental and social
well-being of the population there is need to create awareness and stimulate
actions from the community to achieve health. However, there seems to be no
relationship between health practices and the information available on people’s
health in Anambra State. The central issue of this study is to identify the
factors responsible for the spread of glaucoma in Anambra State by studying the
records of adult patients in the three general hospitals in Anambra State with
functional eye clinics for the period between 2002 and 2006 with appropriate
research questions and hypothesis formulated tot obtain data for the solution.
The literature on past studies on the factors influencing the incidence of
glaucoma and its management in Nigeria is reviewed. The Social Learning Theory
and the Health Belief Model (HBM) are used as the theoretical framework. The
study is designed as both a descriptive and a Cohort Survey seeking to describe
the distribution and incidence of glaucoma within Anambra state of persons who
experienced the same life event within 2002 to 2006. The random sampling
technique was used with the multi-stage sampling procedure and the use of
tables and percentages in data presentation. The Chi squared (X2)
was used in testing the hypotheses proposed. Factors influencing the incidence
of glaucoma among adult patients in general hospitals in Anambra state between
2002 and 2006 based on 1446 patients and 200 questionnaires administered on
general hospitals staff included family history, increased 10P and others with
a variable incidence rate and an increased level of public awareness. The
increase in health education and eye examination centers are recommended and
the level of awareness of the glaucoma disease and its control is recommended
for more intense studies.
CHAPTER ONE
INTRODUCTION
Background
to the Study
Millions of people living in
Nigeria are cut off from the mainstream of economic and social development due
to heavy burden of diseases. Among these diseases is glaucoma which is the
result of too much pressure in the eye. It is usually believed to begin after
the age of 40 (forty) years and is a common cause of blindness (Mohammed,
2001).
Responsibility for health care
in Nigeria is shared among the constitutional tiers of government: federal,
state and local. The local governments are supposed to take care of the primary
level (emphasizing preventive Medicare), while state governments are
responsible for the secondary level (emphasizing curative Medicare), and the
federal government is in charge of the tertiary level of care (emphasizing
referral Medicare) to which teaching and specialist hospitals belong. This
implies that there are basically three health care levels in Nigeria: primary,
secondary and tertiary health care levels. (Anyanwu, Oyefusi, Oaikhegn, &
Dimowo 1997: 608).
In Nigeria, glaucoma
constitutes a medical, public health and socio-economic problem. This is
because Nigeria is found to be one of the most endemic countries in the world,
accounting for a sizeable proportion of the global cases, with about 6.7
million patients with glaucoma worldwide (WHO, 1992). The damaging and
insidious nature of glaucoma make it spread gradually without being noticed but
causes serious harm.
The Basic Health Service (BHS)
scheme formed an important health programme of the Third Development Plan
(1975-1980) and Fourth Development Plan (1981-1985) of the Federal Government.
Under the BHS the government intended to significantly improve the modern
health care system of the country within the framework of a three-tier national
comprehensive health care delivery system mentioned earlier. Record achievement
from the implementation of the BHS shows increases in personnel and
institutions. For example, the number of registered medical practitioners in
Nigeria rose from 10,399 in 1981 to 16,145 in 1987 (Mbanefo, Soyibo &
Anyanwu) 1996.
However, the unsuccessful
implementation of the BHS programme made the federal government to embark on a
new direction health care delivery which makes Primary Health Care (PHC) the focus.
There was need for close involvement of the local
governments, local communities, and individuals in the implementation of the
PHC in collaboration with the other two tiers of government. Activities that
formed part of the PHC include: National Programme on Immunization (NPI),
Campaign against River blindness, Oral Rehydration Therapy (ORT), among others
(FMH, 1988).
The incidence of glaucoma among
adult patients refers to the rate of occurrence of this disease. In
epidemiology the interest is in the number of new cases arising in a given
period of time in a specified group of people.
The American Academy of
ophthalmology (1983) notes that an estimated 2 million people have been
identified as having glaucoma. Of these 889,000 are visually impaired, 67,150
are legally blind and each year an additional 5,500 people become blind from
glaucoma. Equally, in 1997 glaucoma caused 36,000 hospital admission in
America, 25 million office visits and more than $440 million spent on direct health
cost on glaucoma.
It is from the implication of
the data as given above and the fact that glaucoma is one of the avoidable
causes of blindness that the need to maintain adequate and effective health
care delivery system becomes imperative. Therefore this study examines the
factors responsible for the occurrence of glaucoma among adult patients in
Anambra state (2002-2006).
Statement
of the Problem
For Nigeria to achieve the
state of complete physical, mental and social well-being of the population
there is need to create awareness and stimulate actions from the community to
achieve health. This can be accomplished through an effective health education
which according to Onukwubiri (1994), bridges the gap between health information
and health practices. It is any combination of methods designed to facilitate
voluntary change of behaviours of individuals or groups to promote health.
In Anambra state there seems to
be no relationship between health practices and the information available on
people’s health. The researcher observed during her clinical posting to Eye
clinic at the General Hospital Enugwu-ukwu that most adult glaucoma patients
reported to the clinic when their eye conditions had
deteriorated. Furthermore, the adults suffering from the disease are not aware
of the disease occurrence.
The central focus of this study
therefore borders on identifying the factors responsible for the spread of
glaucoma in Anambra State. In other words what are those constraints to
effective primary health care delivery and health education in the state. This
is done by studying the records of adult patients in the three General
Hospitals in Anambra State with functional eye clinics for the period between
2002 – 2006.
Purpose
of the Study
The broad purpose of the study
is to examine the factors influencing the incidence of glaucoma among adult
patients (in general hospitals) in Anambra state (2002 – 2006) and to highlight
the problems resulting from lack of information on factors influencing the
incidence of glaucoma.
The
specific objectives of the study include:
1.
To determine the incidence of
glaucoma among adult patients in Anambra state between 2002 – 2006.
2.
To verify the incidence of glaucoma
in relation to family history in Anambra state between 2002 – 2006.
3.
To identify the incidence of
glaucoma in relation to gender in Anambra state between 2002 to 2006.
4.
To identify other factors
influencing the incidence of glaucoma in adult patients in Anambra state from
2002 – 2006.
5.
To ascertain the number of people
affected by glaucoma in relation to age from 2002 – 2006.
6.
To determine the relation between
health information and incidence of glaucoma in Anambra State, and
7.
To examine the level of awareness of
the glaucoma in Anambra state.
Significance
of the Study
The result of the study will be
of immense benefit to health institutions, community members, researchers and
government. The study on the factors influencing the incidence of glaucoma will
give a preview of the level of incidence for intervention strategic planning.
Furthermore, this research will
help to create awareness of the disease to the community members, as well as
serve as related literature to other researchers by providing a fore-knowledge
of what is obtainable and available on the ground as it concerns the area of
study.
Scope
of Study
The study is a determination of
the factors influencing the incidence of glaucoma in adult patients in Anambra
state between 2002 and 2006. This means that only available data on adult
patients who visited the General Hospital in Awka, Enugwu-ukwu and Onitsha are
used for the study. Another delimitation is that adults between the ages of 40
years and above and studied as our interest is mostly on open angle glaucoma.
Research
questions
1.
What is the incidence of glaucoma
among adult patients in Anambra state between 2002 and 2006?
2.
What is the incidence of glaucoma in
relation to family history in Anambra state from 2002 – 2006?
3.
What is the incidence of glaucoma in
relation to gender in Anambra state from 2002 – 2006?
4.
What other factors influence the
incidence of glaucoma in adult patients in Anambra state from 2002 – 2006?
5.
What is the number of people
affected by glaucoma in relation to age from 2002 – 2006?
6.
How does health information effect
the incidence of glaucoma in Anambra state?
7.
What is the level of awareness of
glaucoma in Anambra state?
Hypotheses
of the Study
Ho1:
There is no significant relationship between the incidence of glaucoma disease
among different age groups of the study from 2002 – 2006.
Ho2:
There is no significant difference in the incidence of glaucoma between males
and females of the study group from 2002 – 2006.
Ho3:
There is no significant difference in the incidence of glaucoma and hereditary
among the study group from 2002 – 2006.
Ho4:
There is no significant relationship between health information and the
incidence of glaucoma in Anambra state.
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Item Type: Project Material | Size: 71 pages | Chapters: 1-5
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