Mothers' choice of health management services for under-five children with common illnesses: evaluating social workers' impact in Nigerian health sector.

INTRODUCTION: Every child deserves the right to life. In Nigeria like other African countries, a high burden of child mortality prevails. Attaining a low-mortality rate of children entails that mothers who are the primary caregivers are in the best position to provide quality healthcare management. METHOD: With the phenomenological approach in qualitative research, the researchers sourced data using Focus Group Discussions (FGDs) and In-Depth Interviews (IDI) from 38 mothers of various categories. The participants were purposively selected from four government and mission health institutions in a semi-urban Nsukka town, Enugu State. Data were analyzed thematically. FINDINGS: Results revealed that mothers utilize health institutions including government, mission, private, pharmacies and patent medicine vendors when seeking healthcare for their children. Their inability to recognize potential life-threatening conditions is the leading factor in increasing child mortality. Findings show that because participants were concerned about financial challenges; they were ready to adopt traditional medicine as an alternative to modern medicine. The study showed evidence of unsafe strategies mothers adopt for the health management of their under-five children with common illnesses. Participants indicated little knowledge of social workers' engagement in health institutions. CONCLUSION: Healthy living is essential in the protection from illnesses. Since under-five children are vulnerable to illnesses, their mothers should provide them with quality healthcare management. The study recommends that social workers' engagement with health providers and users in semi-urban societies could help propagate healthcare awareness and strategies in mothers' choice of health management for under-five children in Nigeria. Overall, adequate health policy consideration should be given to all under-five children in Nigeria.

Experiential Narratives of Factors Limiting and Boosting Access to Support Services for Women with Obstetric Fistula in Southeast Nigeria.

PURPOSE: Obstetric fistula is a chronic health condition that leaves affected women battered and traumatized, thereby exposing them to social recluse life as a result of associated discomfort and odor. Support services to those with challenging health conditions are reputed to help cushion the adverse effects on them; thus women with fistula and other chronic diseases receiving adequate support will help them to cope and recuperate from such illnesses. This study explores the factors limiting and boosting access to support services for those with obstetric fistulainNigeria. MATERIALS AND METHOD: Focus Group Discussions and In-depth Interviews were employed to obtain data from 44 participants. The thematic data analysis method was deployed in analyzing the data collected. RESULTS: Factors like the limited number of fistula specialist doctors, poor funding, withdrawal from seeking help, long distance, and discrimination limit patients' access to support services and adequate fistula care. The study highlighted that community involvement in fistula care, adequate funding, training, and retraining of professionals will boost support services for fistula patients. CONCLUSION: The study recommends the adoption of a multidisciplinary approach in the management of obstetric fistula patients including the involvement of not only medical personnel but also social workers, families, groups, and community leaders.

Knowledge, Accessibility and Utilization of the National Health Insurance Scheme (NHIS) Among Registered Employees of Federal Government Institutions in Ebonyi State: Lessons for Medical Social Workers.

Like most low-and-middle-income countries, Nigeria has been finding it difficult to meet the basic needs of her populace including their health needs. Nigerians are dying of preventable diseases because of poverty and the lack of a functional healthcare system. As a result, the Nigerian government introduced the National Health Insurance Scheme (NHIS) to cater to the health needs of its population. This study assessed the knowledge, accessibility and utilization of the NHIS among registered employees of federal government institutions in Ebonyi state. The study used Focus Group Discussions (FGDs) and in-depth interviews (IDIs) to collect data from 43 participants. The collected data was analyzed using thematic analysis. Findings revealed that most of the participants have accessed and utilized the scheme and saw it as a good healthcare system. They also reported a lack of most of the prescribed drugs and inadequate personnel at the NHIS clinics which is impacting the effectiveness of the scheme. The paper recommends that NHIS should create more awareness about the scheme, and cover more dependents, drugs, tests, and treatment bills to make it more effective in healthcare delivery.

Obstetric Fistula: Connecting the Interface between Social Work and Social Support Services for the Management and Reintegration of Victims in Ebonyi State, Nigeria.

Obstetric fistula is a chronic health condition that leaves affected women medically, socially, physically, and psychologically battered and traumatized. Those with the health condition live their lives as a social recluse because of the unpleasant smell the disease produces in them thereby making people avoid them. Adequate social support to those affected by the disease from all quarters has helped in the management and prevention of the health condition. This study, therefore, aims at exploring and connecting the link between social work and social support in the management of obstetric fistula in Nigeria and the reintegration of survivors into the society. The study adopted a qualitative approach using interviews and focus group discussions to collect data from 51 participants, and the data were thematically analyzed. The results of the study highlighted the potential roles of social workers in enhancing social support for the management and reintegration of victims of obstetric fistula in Nigeria. The findings also revealed challenges confronting social workers in enhancing social support in fistula victims. Findings from the study have implication for policy development, hence, the full involvement and expansion of the coverage of social workers in maternal and public health is recommended.

A Focused Group Perspective of Risk Factors for Hypertension Among Middle-Aged Adults in Rural Areas of Anambra State, Nigeria.

PURPOSE: Recent records by the World Health Organization show that hypertension is more prevalent in Africa than in other parts of the world, and remains the foremost common risk factor for cardiovascular-related diseases, stroke, renal diseases, and death. However, little is known about the risk factors for hypertension by people from rural areas, especially among middle-aged adults. Therefore, the study examined the knowledge of the risk factors for hypertension among middle-aged adults in rural areas of Anambra state, Nigeria. MATERIALS, AND METHOD: Focus group discussions were used to collect data from 40 middle-aged adults (20 males and 20 females). Two key themes stood out from the data collection guides. These are "awareness of hypertension and its' symptoms" and "knowledge of risk factors of hypertension". RESULTS: The findings showed that the participants were aware of hypertension but lacked in-depth knowledge of the risk factors for the disease. Most participants did not believe that intake of certain foods like starchy foods and excess alcohol consumption could lead to one being hypertensive. DISCUSSION AND CONCLUSION: There is a need for social workers to sensitize and enlighten the middle-aged adults in the study area on the risk factors for the disease.

An Exploratory Study of the Situation of Persons with Disabilities in Nigeria: Practice Consideration for Social Workers.

PURPOSE: Disability is one of the various challenges that people face around the world. People with disabilities are confronted with a lot of challenges, and they experience depression, social marginalization, and isolation. The study aims to explore the situation of persons with disabilities in Nigeria. METHOD: To conduct this study, focus group discussions and key informant interviews were used to collect data from 45 purposively selected study participants (40 persons living with disabilities, and 5 chairpersons of a joint association of persons living with disabilities). RESULTS: Findings showed that some of the challenges facing persons living with disabilities in Nigeria include environmental, educational, and socio-economic challenges. DISCUSSION AND CONCLUSION: In conclusion, to overcome some of these challenges social workers should advocate for inclusive strategies and one way this can be realized is by the domestication and implementation of the Discrimination against Persons with Disabilities (Prohibition) Act, 2018.

It Is a Hoax: Attitude of South-eastern Nigerian Toward COVID-19 and Vaccine: The Need for Social Workers.

Different behavioral shifts have been observed among the country's population against the COVID-19 pandemic since its emergence in February 2020 in Nigeria. At first, people were scared of the pandemic and this was reinforced by their response to the National Center for Disease Control measures. As days go by and with the increasing number of confirmed cases of COVID-19 in Nigeria. To reduce the high burden of the pandemic, efforts were made by scientists to produce the COVID-19 vaccine, and Nigeria received about 4 million doses of COVID-19 vaccine in 2021. Thus, it becomes important to investigate the attitude of Nigerians toward COVID-19 and vaccination against COVID-19. To conduct this study, data were sourced using six focus group discussions involving 30 males and females, respectively. Findings revealed that Nigerians have lackadaisical attitude toward COVID-19 and COVID-19 vaccine owing to insincerity on the part of the government, poverty, belief system, low-level of awareness among others. To change the negative attitude of Nigerians toward COVID-19 and the vaccine, social worker interventions are recommended.

Bridging the Gap: Investigating the Role of Social Workers in Supporting Metastatic Breast Cancer Patients in Nigeria.

Cancer is a disease common in every country around the globe with high incidences and deaths. Receiving a breast cancer diagnosis is often associated with a death sentence which makes the individual exhibit self-denial attributes, mixed negative emotions, depression, and anxiety. This study investigated the gap in supportive care and the role of social workers in the management of metastatic breast cancer patients in Nigeria. This study employed a qualitative method using Key Informant Interviews (KII). A total of 12 healthcare professionals in the area of medical social work, palliative care, and medical oncology were engaged in collecting the required information. The result revealed that social workers play significant roles in every aspect of the cancer care continuum - diagnosis, treatment, reintegration, or palliative care. Social workers help metastatic breast cancer patients in Nigeria, however, there are growing challenges to their roles. Most unskilled professionals often present themselves as social workers who do not meet professional standards or perform the best practice.

Worried of Not COVID-19 but Fear of Hunger and Starvation: Challenges of the Poor Nigerians.

Purpose: Lack of social welfare programs for vulnerable households during the coronavirus outbreak in Nigeria caused severe pain and economic hardship to households as millions suffered hunger in Nigeria and Africa at large.Method: To explore the socioeconomic impact of COVID-19 pandemic in Nigeria, a qualitative study was conducted with 70 participants from Lagos, Nigeria. We conducted 52 individual and 2 group interviews with 18 key stakeholders involved with enforcing lockdown orders. Responses were analyzed in themes using content and discourse analysis.Result: The participants stated that the greatest challenge faced by many amidst the pandemic is hunger and starvation and described government palliatives as grossly insufficient. This is linked to the high population of Nigerians living below poverty line, who depends on daily earning for survival.Discussion: Therefore, these viewpoints must be taken into account by the policymakers and social welfare providers when designing social welfare policies and interventions for poor/vulnerable Nigerians.

Mortality Experiences for Women in Riverine Areas of the Niger Delta and Utilization of Maternal Health Services.

Developing countries grapple with poor maternal health outcomes, and the Niger Delta is no exception. Discourses in the Niger Delta have been dominated by oil resource, with suboptimal attention paid to health outcomes in the region. This study investigated barriers to utilization of maternal health care services in the Okrika local government area of Rivers State, Nigeria. Data were sourced through focus group discussions organized for 21 health care professionals and 24 mothers residing in the area. Analysis was done thematically, relying on relevant qualitative analytical tools. Poor income, ignorance, absence of social support, religion and culture, and health care system inefficiencies were the barriers associated with utilization of maternal health care services. It was clear that maternal health outcomes and the state of health care generally in the Niger Delta do not reflect the enormous resources generated from oil that is plentiful in the region. Results point to an evident need for social work expertise to mitigate these barriers in view of improving health outcomes in the region.

Factors affecting the utilization of prevention of mother-to-child transmission of HIV services in Anambra South, Nigeria

Background: In spite huge leaps in combating the spread and transmission of HIV globally, Nigeria still ranks high in the incidence of HIV among children. The study investigates the factors affecting the utilization of prevention of mother-to-child transmission (PMTCT) of HIV services in Anambra South. Data source and Method: Data from 515 HIV positive women of child bearing age were collected using a structured questionnaire. The data sets were subjected to chi square and binary logistic regression analysis. Result: The results show that 86% of the respondents were aware of the PMTCT strategies while marital status (69.8%), age (70.7%) and place of residence (52.1%) were found to affect the uptake and utilization of PMTCT services. Conclusion: Evidence from the study drew attention to the need for government, social workers and healthcare providers to rise to their responsibilities in encouraging HIV women of reproductive age to utilize PMTCT services in order to achieve African Union Agenda 3

Knowledge of public health challenge of open defecation in rural areas of South-East Nigeria: Implications for social workers

Background: Practice of open defection has growing health concerns especially on rural dwellers and is among leading causes of diarrhea, typhoid fever, cholera, stunting and responsible for the death of children under 5 years in Nigeria. This study seeks to examine knowledge of public health challenges of open defecation among rural residents in south-east Nigeria and implications for social work. Data source and methods: Focus group discussions and in-depth interviews were used for data collected from 52 respondents in Nsukka and Udenu LGAs of Enugu State. Thematic analysis was adopted and phrases with contextual connotations were pulled as illustrative quotes. Results: Lack of toilet facilities makes community members engage in the practice despite knowledge of its public health implications. Conclusions: The study recommends strengthening of government's efforts to eradicate the practice; incorporating social workers as facilitators in public health regulations and advocacy in sensitising households to provide their own toilets