Abstract
This study was
aimed at determining the provision, Utilization Levels and Trends of Child
Health Services in the Primary Health Care Centres in Enugu Urban. The
independent variables investigated were maternal age, parity, occupation and
educational attainment. Other socio-economic factor(s) that could influence
utilization of CHS were also considered in the study. The study was limited to
eight components of CHS available in the area of study, while immunization
service, which is one component of CHS, was used to trace the trend of CHS.
Descriptive survey research design was used for the study. Four research
questions and four hypothesis tested at .05 level of significance were
formulated for the study. The population of study was 11,200 mothers of
reproductive age on Enugu
State and 310 mothers and
their babies that utilize CHS in PHC facilities in Enugu Urban. Instrument for
data collection were provision and utilization of CHS questionnaire and Trends
in utilization of immunization inventory both designed by the investigator.
Mean, frequencies, percentages and chi-squire statistical techniques were
employed to analyze data collected. The findings of the study are as follows:
CHS was available in the three PHC in Enugu Urban. All of the eight components
of CHS except exclusive breast-feeding were utilized effectively. The trend of
immunization services utilization over the years 2000 – 2007 was full of
fluctuations. Maternal Demographic
factors studied: Age, parity, occupation and educational attainment had no
statistical relationship to the level of use of available CHS. Availability of
medical personnel in the neighborhood 77.15 percent, ignorance of need of CHS,
40.06 percent, cultural belief 25.83 percent, bad attitude of health care
provides 18.54 percent and procrastination of immunization/clinic days 13.58
percent were socio-economic factors that affected level of utilization of
available CHS.
CHAPTER ONE
Introduction
Background to the Study
Children are the future of any nation or community. They are essential for the survival of any group of people. For this reason and more the focus of international public health concern has been on reducing child mortality and morbidity in order to propagate, preserve, nurture and ensure continuity of the human race. This is rightly so as WHO (2000) reported that recently in the mid 1980s, some fifteen million children under five years of age died each year, representing 30 per cent of all deaths in many countries. This evil trend was addressed through the provision of Child Health Services (CHS).
According to William (1984), CHS are that aspect of medical services that provide essential health services to protect, promote and maintain health and well-being for child bearing families as a unit and for each individual child within that family up to school age (from birth to five years). World Health Organization WHO (1993) stated that CHS is a channel through which medical and health services can be organized to improve the health of the child, prevent diseases and promote growth and development. Tabah (1987) had earlier noted that CHS is an integral part of community health services and has been adopted as Maternal and Child Health Services (MCH).
Starfeiled (2002) asserted that CHS is an integral part of Primary Health Care (PHC) which is concerned with the provision of accessible, integrated, bio-psychosocial health care service by the health care personnel who are accountable for addressing a large majority of personal health needs, developing a sustained partnership with patients and participating in the context of family and community. According to Guagilardo (2004) PHC is recognized as the most important form of health care delivery system for maintaining populations health including child health, because it is relatively in-expensive, can be more easily delivered than specialty an in-patient care (if properly distributed) and most effective in preventing disease progression in a large scale.
       The health of the child and services offered to protect it are influenced by factors classified by Cleason, Edward, Mawiji, and Pathmanathan (2000) as proximate factors (such as non-medical and medical care during the antenatal period, care at birth, preventive and curative care in the post-natal periods) and non-proximate factors such as maternal factors (age, parity and birth intervals). Household and community level factors (such as water supply, sanitation, and housing) then socio-economic development and health services. Diamond (2000) pointed out that there is little doubt that high child mortality rates are associated with high rates of child bearing early child bearing, short birth spacing and high-parity birth. He suggested that effort to reduce high child mortality should not only end in health intervention but should include improvement in women’s education.
Gabr (1985) identified the components of child health care services as follows: immunization services, growth monitoring, oral re-hydration therapy, promotion of breastfeeding, treatment of minor illness and outreach services. These activities are aimed at protecting child health and preventing ill health. Immunizations are given to protect the child against childhood killer diseases. The Federal Ministry of Health of FMOH (2004) identified these diseases as: whooping cough, measles, tuberculosis, tetanus, poliomyelitis, diphtheria and the additional package namely hepatics B and cerebrospinal meningitis. United Nations Children Fund) UNICEF (2002), reported that although most of these childhood killer diseases have been reduced in the developed countries, other diseases and conditions such as malaria, human immunodeficiency virus (HIV), cerebro-spinal meningitis, diarrhea, hepatitis B virus and malnutrition are now topping the lead as childhood killer diseases.
