MEETING HEALTH INFORMATION NEEDS OF PEOPLE WITH HIV AND AIDS THROUGH PUBLIC LIBRARY SERVICES IN BENUE STATE
The study is on meeting the health information needs of people living with HIV and AIDS through public library services in Benue State. Five research questions were developed to guide the study. The descriptive survey research design was used for the study. The population of the study was 16,502 and the sample was 748. The instrument for data collection was the questionnaire. A 46 and 50 items structured questionnaire was developed for public librarians and PLWHA respectively from literature and used for data collection. Experts validated the instruments Cronbach alpha method was used in determining the reliability of the instrument. A reliability coefficient of .786 and .893 for public librarians and PLWHA respectively were obtained. The findings of the research shows that PLWHA have health information needs such as information of treatments of tuberculosis, fever, body itching, diarrhea among others. Public libraries in Benue State provide only four services in meeting the health information needs of PLWHA. These include; photocopying, loan, reference and current awareness services. The major methods employed by public libraries in meeting health information needs of PLWHA are: through newspapers, textbooks, journals/magazines and posters. Several problems militate against meeting the health information needs of PLWHA, such as: inadequate fund/budgetary allocation to public libraries, low remuneration to public librarians, and inadequate staff among others. The recommendations based on the findings were that, public libraries in Benue state should acquire health information resources in the areas of the needs of PLWHA and process same SDI services should be provided by public libraries for PLWHA to meet their health information needs. Benue State government should provide adequate funds/budgetary allocations to equip public libraries. Government should employ more staff. And harmonize the salary structure of the public librarians alongside with their counter parts in other organizations. Government should set aside a special grant for PLWHA to alleviate their poverty and encourage them to access the services of public libraries, more public libraries should be established in Benue State, to repackage health information in various formats and translate programmes in local languages for the illiterate PLWHA.
TABLE OF CONTENTS
Title Page - - - - - - - - - - i
Approval Page - - - - - - - - - - ii
Certification Page - - - - - - - - - - iii
Dedication - - - - - - - - - - - iv
Acknowledgement - - - - - - - - - - v
Table of contents - - - - - - - - - vii
List of Tables - - - - - - - - - - ix
Abstract - - - - - - - - - - - x
CHAPTER ONE: INTRODUCTION - - - - - - 1
Background of study- - - - - - - - - 1
Statement of the problem - - - - - - - - 10
Purpose of the study - - - - - - - - 13
Research questions - - - - - - - - - 14
Research hypotheses - - - - - - - - 14
Significance of the study - - - - - - - - 15
Scope of the study - - - - - - - - - 16
CHAPTER TWO: REVIEW OF LITERATURE -- - - - 17
Conceptual Framework - - - - - - - - 17
The concept of Health - - - - - - - - 18
The concept of Health Information - - - - - - 22
The concept of Information Needs- - - - - - - 22
Types of Health Information Needs - - - - - - 25
The concept of Human Immuno deficiencyVirus and Acquired Immune DeficiencySyndrome 32
The concept of Public Library Services------
Public Library Services - - - - - - - - 40
Awareness of Information Services - - - - - - 49
Methods of Disseminating Health Information - - - - - 50
Problems Encountered in Providing Public Library Services - - - 58
Strategies for Enhancing the Public Library Services - - - - 64
Theoretical Framework - - - - - - - - 70
The Demand Theory - - - - - - - - 70
The Health Belief Theory - - - - - - - - 71
Disconfirmation Theory - - - - - - - - 71
Econometric Theory of the Relationship between Health Information and
Demand for Medical Services - - - - - - - 72
The Information “Use” and User Behaviour Theory - - - - 73
Empirical Studies - - - - - - - - - 74
Summary of the Review - - - - - - - - 79
CHAPTER THREE: RESEARCH METHODS
Design of the study - - - - - - - - - 81
Area of study - - - - - - - - - 81
Population of the study - - - - - - - - 82
Sample and sampling technique - - - - - - - 82
Instrument for data collection - - - - - - - 83
Validity of instrument - - - - - - - - 84
Reliability of instrument - - - - - - - - 84
Method of data collection - - - - - - - - 85
Method of data analysis - - - - - - - - 85
CHAPTER FOUR: PRESENTATION AND ANALYSIS OF DATA - 87
Major findings - - - - - - - - 100
CHAPTER FIVE: DISCUSSION OFFINDING, CONCLUSIONS, IMPLICATIONS AND RECOMMENDATIONS
Discussion of Findings - - - - - - - - 102
Conclusion - - - - - - - - - - 109
Implications of the Study - - - - - - - - 110
Recommendations - - - - - - - - - 112
Suggestions for Further Research - - - - - - - 115
Limitations of the Study - - - - - - - - - 115
Summary of the Study - - - - - - - - 116
REFERENCES - - - - - - - - - 119
Appendix “A”: Sample Composition of PLWHA - - - - 140
Appendix “B”: Letter to the Respondents - - - - - 141
Appendix “C”: Questionnaire for Public Librarians - - - - 142
Appendix “D”: Questionnaire for PLWHA - - - - - 146
Appendix “E”: Reliability of public librarians - - - - - 150
LIST OF TABLES
1. Mean Rating and standard deviation of the Information needs of PLWHA in
Benue State - - - - - - - - - 88
2. Mean and standard deviation of responses of public librarians on public library Services in meeting the health information needs PLWHA in Benue State - 89
3. Mean and standard deviation of responses of PLWHA on the extend of service of Public Libraries in meeting the health information needs of PLWHA in Benue State 90
4. Mean and standard deviation of public librarians on methods employed in
meting the health information needs of PLWHA in Benue State- - - 91
5. Mean and standard deviation of responses of public librarians on problems encounters in meeting the health information needs PLWHA through public
service in Benue State - - - - - - - - 93
6. Mean and standard deviation of responses PLWHA on problems encounter in accessing health information through public libraries services in Benue State. - 94
7. Mean and standard deviation of responses of public librarians on strategies to over come the problems of meeting health information needs of PLWHA
through public services in Benue State - - - - - - 96
8. Mean and standard deviation of responses of PLWHA on strategies to over come the process of accessing health information needs of PLWHA through
public libraries services in Benue State - - - - - - 97
Background of the Study
CHAPTER ONE INTRODUCTION
Health is the general well being of a people. Every human being desires and hopes for good health. The World Health Organization (WHO) in Anshi (2007) has defined health as “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity”. According to Pender (2000), health is the actualization of inherent and acquired human potentials through goal directed behaviours, competent self-care and satisfying relationships with others. The health of an individual can be seen as the extent of his or her continuing physical, emotional, mental and social ability to cope with the environment. As maintained by Priery (2006), health is most cherished and takes the upper and central task of not only the individual, but government and other established groups. WHO (1979), stated that health is wealth therefore a healthy person is a wealthy person. It then implies that one who is not healthy is not wealthy.
Remaining healthy is the priority of every individual .This is because good health is a treasure of inestimable value. When there is preference of disease, such a health condition is said to be bad. It has implications for individual and national economic activities. Indeed, the health of the people not only contributes to better quality of life but also essential for sustained economic and social development of a country as a whole. Abiodum and Kolade (2006), asserts that, people who are ill and weak find it difficult to carry out their responsibilities. This is why with infirmity
people still strive for good health. Ensuring public health often involves restricting the
behavior of individuals for the good of the individual and the community. However, the decision on what should be changed is not only medically oriented but involves social, religious and moral considerations. Adequate and relevant information provide the informal base for making choices. This is a major component of health promotion targeting increase in knowledge and information services relating to health.
The world is becoming more dynamic and the challenges that are enforced by various circumstances such as Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV and AIDS) have come to accentuate the need for the improvement and empowerment of the affected people popularly known as People Living with HIV and AIDS (PLWHA). According to Ijir (2006), chronic diseases are responsible for 70% of health care problems in Nigeria, particularly in Benue State with HIV and AIDS scourge ranking top. Medical research and development activities have been carried out by government and other agencies in finding solutions to the scourge. Nevertheless, medical research and development activities alone can not be able to achieve the WHO 1994 concept of health for all. This has to be accomplished by correspondence action for the implementation of these activities by using the available information and resources to gain health.
Information is indispensable for human existence. Losce (1990) defined information as knowledge communicated or received concerning particular circumstances. Okwilagwe in Aju (2007), defined information as an input which reduces the level of uncertainty in any decision making. With access to information an individual would be lifted from the state of ignorance, illiteracy and poverty to a state
of enlightenment, posterity and literacy. UNESCO (1980), notes that information gives the possessor power to influence and dominate those that have little information. In addition, Daniel (1999), advances that, information is power, happiness and safety. This indicates that, the advancement of any society depends on the level of information obtained at regular intervals. However, societies with little or no information access will suffer health problems, cultural and technological backwardness that will eventually aggravate into chronic poverty.
Base on the above, it has become necessary for a nation to harness the vast amount of information that exists in the world in order not to tow in the line of health problems and backwardness. It is also evidently clear that information is a strong pillar which cannot be ignored by any nation for the benefit of its citizenry. In essence, every human being at one stage or another needs information in order to interact with one another and function effectively in the society. Access to current and relevant information helps an individual to be lifted from the state of unknown to known. Similarly, Sokari (2006), asserts that information is needed for men to be liberated from the shackle of ignorance, misconception, economic stagnation, health problems, social unrest and political instability. For instance PLWHA, government officials, students need information as a tool for development in fast growing economy.
Equally to note, Adeniti (2004), advocates that, everybody needs information to reach their potential and that the more information is available to a system about the system and its environment, the more reliable it becomes and greater its chances of
survival. When information is not available at the appropriate time of need, then its value becomes useless. The most vital information is the information that will be available at the right time of need to enable the individual resolve uncertain ties and problems that would help in decision making process.
Human beings, according to Sawyerr (2008), have different types of information needs. Social or pragmatic information needs. The purpose of a library or any information centre is of course to fulfill some needs for documents and information for its potential users. Such needs may for example be related to activities such as educational, recreational or personal development. The concept of information need in this context is therefore, the desire to acquire new knowledge or facts about something which is considered as essential and worth having in order to satisfy the conscience of individuals as well as enable them to participate fully in societal development.
Looking at the above, it is obvious that everybody has information needs to meet up with the tasks that are considered crucial for survival or necessary for the common good of neighbourhood, community and the nation at large.. The phrase that knowledge is power may be a cliché, yet in today‟s HIV and AIDS pandemic, PLWHA knowledge is arguably the principal intangible resources that they need to possess. That is, PLWHA may lack the knowledge of how to get relief in respect of pains, access to medical care, inadequate knowledge about the disease, the type of food they may need, where to turn for support among others. Eze (1999), maintained that, information plays the role of generating public opinion and sensitizing people‟s
reaction to issues that affect their lives. On the contrary, when PLWHA have inadequate information that could sensitize them to determine their opinion on issues of their health, the consequences will be imperative. However, this can only be achieved if the process of disseminating the needed information is effective and useful to the society.
Information services are carried out in order to spread the authentic news to members of the society about current changes for proper decision-making and societal well being. This is making available new knowledge or ideas known to members of the society so as to enable them improve in their conditions of living as well develop their environment. Mehra (2006), opines that, the ability to secure required information by PLWHA is difficult. This results from a variety of causes including inability to go to places where information may be located, ignorance of a specific place to get information, ignorance resulting from illiteracy, language barrier and inappropriate sources of information. Kontumoya (1992), also noted that, in most countries in tropical Africa, the national information networks are biased against the lower social group. That is, most of the information meant for public consumption are disseminated through newspapers, television or radio stations which are out of reach of the common man especially the rural dwellers. According to Nwakoahu (1999), a society stagnates unless it makes constant provision for the injection and absorption of new knowledge. That is why the public library exists which constitutes network within the total communicated system whose effective use depends upon librarian‟s understanding of the nature of knowledge and its importance to both individual and
Nelson-Tankor (2003), observed that the developmental implications of the Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV and AIDS) pandemic in the Nigerian economic and social relations are enormous and if not checked, it could reverse the gains already made in social and economic development of the country. In Nigeria, HIV and AIDS was first identified in 1985, and reported at an international conference in 1986. From that period up to the present, there has been a steady rise in the prevalence of HIV and AIDS from zero percent prevalence. For instance HIV epidemiological and demographic data released by Federal Ministry of Health (2001) revealed that HIV and AIDS prevalence has risen steadily over the past years. It is now a major public health problem in Nigeria, especially in Benue State. Out of the 20 states in Nigeria that recorded HIV prevalence in 2005, Benue State had the highest prevalence rate of 10%. The state has already surpassed the 5% explosive prevalence phase. [Federal Ministry of Health, 2005]. Information from Benue State ministry of health (BSMOH), (2005), shows that out of the total population of 3,902,638 in Benue State, 238,328 are infected with HIV and AIDS while 25,036 have died.
HIV and AIDS scourge is now a major public health problem in Nigeria particularly in Benue State. As such the federal government in the year 2000 set up the National Action Committee on AIDS (NACA) and directed the states to set State Action Committee on AIDS (SACA) to put in place preventive measures as well as treatment strategies including voluntary confidential counseling and testing management of the impact of HIV and AIDS virus. Being the highest state with HIV
and AIDS prevalence rate in Nigeria, the coordinator of NACA, Professor, Babatunde
Osotimehin offered to erect bill boards conveying HIV and AIDS messages to all the 23 local governments in Benue State as well as produce radio/TV jingles. All over Benue State, HIV and AIDS is causing devastation, destroying communities and families and taking away hope for the future. With the absence of cure, HIV and AIDS diminish quality of life before it takes away life itself. Its emotional and economic impact on the quality of life affects the family, friends, and communities. It affects production as well as household incomes and expenditures. It poses major problems for health systems and health care practices. It diminishes the capacity of societies to provide essential services and plan for the future and it threatens good governance and human security in Benue state. The people of Benue State are no longer immune to the spread of HIV and AIDS. Information officials have identified high rates of alcohol and drug abuse, inadequate healthcare resources and services, high rates of other sexually transmitted diseases (which increases risk in HIV infection) and polygamy as important contributions to increasing transmission rates.
Report from UNAIDS (2005), states that, PLWHA in sub-Saharan countries have special needs of health information and support services due to such factors as stigma and discrimination, extreme psychosocial and psychological pressures. Furthermore, people who are well informed are better able to understand how the infection is transmitted and measures of prevention that are available to them. Aboyade (1987) posits that to produce a desired change in human behaviour, the process by which new information is transferred from one person to another certainly deserves the most attention. In this regard PLWHA need health information especially information relating to HIV and AIDS for survival but hardly knows how to access it.
Information may not be accessed by every person at the time of dissemination; there is need for preservation of information for future use that can be access by the general public through the public library services. This is why Ghosh (2005), declared that HIV and AIDS pandemic has brought challenges that cannot be handled effectively without public libraries.
Achebe (2005), maintained that public libraries are understandably people‟s university, because they serve all categories of users regardless of age, race, sex, religion, nationality, language, ideological base or social status. The public library assembles information of all kinds from countless sources and places it at the command of the individual user. It sustains individual freedom of inquiries, the name, the status, the politics, or religion or purpose of any one of the public library users. Public libraries exist primarily to assist users in meeting their information needs since they are funded from the public sources. According to Ajegomogun (2008), public libraries notably provide free services to anyone who wishes to use them. Such libraries are actively involved in knowledge acquisition, literacy awareness campaign and readership promotion. At the same time library serves as centres for information resources and services. This is a very good environment for PLWHA to access health information resources and to apply the information meticulously.
Public libraries are noted for collecting, organizing and disseminating a wide range of materials relating to the historical, cultural heritage and provide information that will enhance the development of the society. Public libraries assure equal accessibility of information and also provide special services that will serve the interest of some particular groups of users, such as PLWHA. Special services such as
Selective dissemination of information(SDI) counseling services, health extension services, current awareness services, indexing and abstracting services, online and internet services. The libraries have the mandate to provide appropriate information for people at all levels, such information could be in print or electronic format, and consequently provide immediate accessibility in order to facilitate frequent use of information. Public libraries therefore, have important role to play in providing health information services to PLWHA in Benue State. It is obvious that resources for library users are rarely sufficiently powerful or well enough organized to exert pressure on libraries to make their services more responsive to their needs. They also don‟t have the power to influence the library policies more favourably to their needs.
The public library as information disseminating agency have an enormous role to address or meet the health information needs of PLWHA through what may be considered as services. That is by identifying, acquiring and providing for use health documents or pieces of health information which could best help PLWHA. At the same time, public libraries often have limited knowledge of the diverse and complex users‟ needs. To deliver relevant and effective services, public libraries must have adequate knowledge of their users and their respective information needs to be able to ascertain which of the services are suitable to meet a particular need. Equally important is that users need to be aware of services provided by public libraries. Even though services may be provided by public libraries, users may not be aware of such services. This may lead to non use of the services. In this regards Tones and Tilfors (1994), observed that for people to make use of any information system an intervention in form of awareness is usually needed. This can be achieved through the media vis-à-vis information. According to Nolte (1997), a fundamental purpose of
awareness is helping people to know and do better things they will be doing. As maintained by Ghosh (2005), the turbulent and challenging information environment calls for continued research to ensure that the needs of health information of users such as PLWHA are satisfactory met. It is against this background that this study attempts to investigate the extent in which public library services are meeting health information needs of PLWHA in Benue State.
Statement of the Problem
In Benue state the impact of HIV and AIDS is felt at all levels notably from the view point of the agricultural, economic and social impact. Against the background of the fact that Benue state is potentially an agrarian state and fondly called the Food Basket of the Nation, the labour force of the state is jeopardized. Out of the population of 4 million, one and half people are infected with HIV and AID. 75036 people have already died (National Sentinel Survey 2003). The impact of HIV and AID on the infected communities and sectors are unique, different and cannot be compared with other infectious diseases. This is because at the present Benue State has relatively young population and at transition point of high fertility and declining mortality rate. Hospital records at the Federal Medical Centre Makurdi 2008 indicated that about 70% of hospitalized cases are HIV and AIDS. Also 65% of death cases at the hospital constitute PLWHA and related cases. Among this number of death cases women and young people constitute the highest number.
Due to the high damage of HIV and AIDS scourge in Benue State a lot of programmes have been established to cater for the health needs of PLWHA. There is
the National anti-retroviral programme where it is expected that thousands of people with the disease will have the anti retroviral drugs. There is also the national action committee on AIDS and Benue state action committee on AIDS which is responsible for executions and implementation of activities under the HIV and AIDS emergency plan (HEAP). Both the national and Benue state governments spending on HIV and AIDS has been increasing gradually and other international donors have contributed to the funding of programmes aimed at providing lasting cure, prevention and treatment of the disease.
However, it is noted that those measures have not commensurate the outcome. In other words the reduction in the cases of HIV and AIDS infection does not reflect the gigantic policies, spending and programmes rolled out for it. In order to change or improve people‟s knowledge, attitudes and skills in health related areas, an intervention in form of health provision/education is usually needed. This can only be done through a medium known as information [Aju 2007]. The legal information AIDS is that, individuals living in United States who have HIV disease may be protected by: the rehabilitation Act of 1973; state and local laws; and the Americans with Disabilities Act of 1990(ADA). The Rehabilitation Act of 1973 when congress enacted title vii of the Civil Rights Act of 1964, it specifically included certain groups. Prohibiting employment discrimination based on race, religion, sex, and national origin, while specifically excluding legal protection for individuals based on age or disability. Pressure from special interest groups resulted in congress enacting the age, discrimination in employment Act of 1967 and the Rehabilitation Act of 1973. Benue
state legal information regarding AIDS has just been enacted in 2008. it also seek
protection to PLWHAs in their work place, such as discrimination. A survey carried out by MacDaniel in Mabawonku (1998) to determine how willing by patients reveal personal problems shows that a significant number of patients provide inaccurate or incomplete information to the questions asked. Sometimes, this is due to the fact they do not even know their problems or cannot articulate their needs.
Adequate acquisition of health information by PLWHA is an essential tool for the prevention of HIV transmission, prevention of opportunistic diseases by PLWHA and cure of so many illness and will have excellent health and then be in a better position to effectively participate in education, employment and other activities in the society. The key tenet of this health information service provision view point is that PLWHA need to posses‟ stored information for their healthy living. This will make them to be useful to themselves, their families and entire society. Although we have witnessed health information services provision in Benue state by public libraries, but some basic questions remained unanswered. The people of Benue state questioned the relevance and appropriateness of public library services. Are the services meeting the health information needs of PLWHA?
If yes why is it that HIV transmission, the prevalence rate of HIV and AIDS as well as death toll of PLWHA is still high in Benue State? The answer to this remains a mirage. It is expressed in sentences such as public libraries can meet the information needs of the general public including PLWHA. Yet there is no systematic body of empirical evidence to support this assertion. This was the challenge that prompted this
current research. The problem of this present research therefore put in a question form is, are public library services meeting health information needs of PLWHA in Benue State? Although other scholars have investigated on different aspects of health information needs, their researches were not on health information needs of PLWHA. For example Njongmeta and Ehikhamenor (1998), “Health information needs and services in Cameroon”. Ozioko (2007), “Reproductive Health information Needs of Rural Women in Enugu State”. In view of the fact that no known research has been carried out prompted the present research.
Purpose of the Study
The major purpose of the study was to investigate the extent to which public library services are meeting health information needs of PLWHA in Benue State. Specifically, the purpose of the study is to:
1. identify the types of health information needs of PLWHA in Benue State;
2. identify the services provided by public libraries in meeting health information needs of PLWHA in Benue State;
3. ascertain the extent of awareness of public library services by PLWHA in meeting their health information needs in Benue State.
4. ascertain the effective methods employed by public libraries in meeting health information needs of PLWHA in Benue State;
5. identify the problems in meeting the health information needs of PLWHA through public library services in Benue State;
6. determine the strategies that can be employed to overcome the problems of meeting health information needs of PLWHA through public library services in Benue State.
The following research questions are formulated to guide the study.
1. What are the health information needs of PLWHA in Benue State?
2. What are the services provided by public libraries in meeting the health information needs of PLWHA in Benue State?
3. To what extent are PLWHA aware of public library services in meeting health information in Benue State?
4. What are the effective methods employed by public libraries in meeting health information needs of PLWHA in Benue State?
5. What are the problems encountered in meeting the health information needs of PLWHA through public library services in Benue State?
6. What are the strategies that can be employed to overcome the problems of meeting health information needs of PLWHA through public library services in Benue State?
1. Is there no significant relationship between the public library services and health information needs of PLWHA.
2. Is there any significant relationship between provision of health information services and health status of the society.
Significance of the Study
This study on meeting health information needs of PLWHA through public library services in Benue state will be of immerse benefit to various groups of people particularly public librarians, government, PLWHA, the study will reveal the health information needs of PLWHA; services and methods employed provided by public libraries in meeting such health information, as well as awareness of public library services by PLWHA. Problems encountered by public libraries in providing services. The revelation of such knowledge will enable public librarians to acquire health information resources in such areas and repackage them appropriately for PLWHA. Public librarians will know whether or not PLWHA are aware of services provides. This will enable to employ more effective methods as well as tackle the problems encountered by PLWHA in accessing health information.
The government will know that health information is an important tool PLWHA must possess; the government by this revelation will know that public libraries are the institutions that can provide services inorder to meet PLWHA health information needs; equally important is that, the government will involve public libraries in their HIV and project, so as to address PLWHA health information needs. The government will see the need to make adequate funds and budget allocation for public libraries to provide effective services to PLWHA.
The PLWHA will benefit from the study because they will know the importance of health information; they will also know that public libraries provide services for their health information needs.
Other stakeholders will benefit from this study as they also will know the importance of health information for PLWHA as well as work in partner with public libraries, in providing adequate health information services to PLWHA.
The result of the study will add to scholarship in this area and will provide relevant background information to other researchers who may be working in related areas.
Scope of the Study
The study is on meeting health information needs of PLWHA in Benue State through public library services. The study covered, such areas as: the health information needs of PLWHA; public library services in meeting health information needs of PLWHA. The extent of awareness of health information services by PLWHA in meeting their health information needs. Methods employed by public libraries in meeting health information needs of PLWHA; the problems encountered by the public library in meeting the health information needs of PLWHA; and strategies to meet the health information needs of PLWHA through the public library services.
The study covered Federal Medical Centre Makurdi and other selected General Hospitals in selected local government areas in the three senatorial zones of Benue State, as well as the state Library Board and public libraries in the selected local government areas..