INFORMATION NEEDS AND RESOURCE UTILIZATION BY PEOPLE LIVING WITH HIV-AIDS: A CASE STUDY OF ESUT TEACHING HOSPITAL PARKLANE ENUGU
The study was carried out on the information needs and resource utilization by people living with Human Immune Deficiency Virus/Acquired Immune Deficiency Syndrome in ESUT Teaching Hospital Parklane Enugu. Health is of utmost important in every human facet, that is the reason why every hand should be on deck to promote it. Chapter one of this research work is concerned with a brief discussion of what HIV/AIDS is, problems facing people living with HIV/AIDS (PLWHA), information needs and resource utilization was focused on. Chapter two deals with review of related literature, the review was focused on HIV/AIDS. Information needs of people living with HIV/AIDS, information used by people living with HIV/AIDS, the extent to which information resources encourage and support the people living with HIV/AIDS, to take positive action to deal with HIV/AIDS, the benefits driven from the used information resources, barriers to access and utilization of information, resources and strategies to overcome the barriers. Chapter three shows the method of carrying out the research. Questionnaire will be used for data collection. Chapter four is the analysis and presentation of data collection and discussion of findings while chapter five deals with the summary of findings, recommendation, conclusion and suggestions for further studies.
TABLE OF CONTENTS
Title page - - - - - - - - i
Approval Page - - - - - - - ii
Dedication - - - - - - - - iii
Acknowledgement - - - - - - - iv
Table of contents - - - - - - - v
Abstract - - - - - - - - viii
1.1 Background to the study - - - 3
1.2Statement of the study----9
1.3 Purpose of the study - - - - 18
1.4 Scope of the study - - - - - 19
1.5 Significant of the study - - - - 20
1.6. Research Questions - - - - - 22
1.7 Operation Definition of Research Concepts 23
REVIEW OF LITERATURE
2.1 Introduction - - - - - - - 25
2.2 Conceptual Framework- - - - - 26
2.2.1 HIV/AIDS - - - - - - - 26
2.2.2 Information needs of people living with HIV/AIDS 33
2.2.3 Information used by people living with HIV/AIDS 36
2.2.4 The extent to which information resources
encourage and support the people living with
HIV/AIDS to take positive action - - - 39
2.2.5 The benefits derived from the use of information
resources by PLWHA - - - - - 43
2.2.6 The bearers to access and utilization of
information resources by the PLWHA - - 45
2.2.7 Strategies to overcome the barriers of access and
utilization of information by people living with HIV/AIDS 49
2.3 Empirical Studies - - - - - 51
2.4Summary of the reviews -----57
3.1 Introduction - - - - - - 60
3.2 Research design - - - - - - 60
3.3 Area of study - - - - - - - 61
3.4 Population of the study- - - - - 61
3.5 Sample - - - - - - - 62
3.6 Sampling Technique - - - - - 63
3.7 Instrumentation - - - - - 65
3.8 Validation of instrument - - - - 66
3.9 Method of data collection - - - 67
3.10 Method of Data analysis - - - - 68
4.0 Data Presentation, Analysis and Interpretation 69
4.2 Discussion of findings
Summary, conclusion and recommendation
5.1 Introduction - - - - - - - 85
5.2 Summary - - - - - - - 85
5.3 Conclusion - - - - - - - 88
5.4 Recommendations - - - - - - 89
5.5 Suggestion for further studies - - - 91
References - - - - - - - 92
Appendix I- - - - - - - 95
Appendix II - - - - - - - 97
CHAPTER ONE: INTRODUCTION
One of the most devastating scourges of our time is the problem of Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS). Undoubtedly HIV/AIDS present a major challenge to human development in Nigeria. Besides poverty, no problem has given Nigeria a more daunting challenge than the present battle with HIV/AIDS. According to Omoniyi (2013), HIV/AIDS can only be transferred through exchange of body fluid such as blood, semen and vaginal secretions. This means that HIV/AIDS cannot be contracted through causal contract with infected person either at work, school or at home. Also Chagbe (2012) opined that the health of the people is the greatest natural resource of a nation upon which their happiness and power as a nation depends.
Moreover, health is of utmost important in every human fact. That is the reason why every hand should be on deck to promote it. For it is when people are healthy that they can work and any nation who’s workforce comprises of sick persons is finished. According to Moonie (2013) is of the opinion that most individuals that are affected by the virus are vulnerable to chains of other diseases and the cost of medication eats deep into their savings. Also, some families who have lost their bread winners to this disease are faced with untold hardship such as non payment of school fees, house rents and the consequences of being seat out of school and thrown out by landlords.
In addition, the information needs needed to fight against HIV/AIDS include: Health education, the control of sexual transmitted disease, the establishment and management of surveillance programmes, prevent mother to child transmission, provide and manage antiretroviral therapy programmes, human resources development and government involvement. These information needs will help to combat HIV/AIDS.
1.1 Background to the study
Managing information is an important part of coping with illness and includes communicative and cognitive activities seeking, avoiding, providing, appraising, and interpreting information. It is complex in that people’s information needs and behavior vary over the course of their illness and along with the availability and quality of information. In recent years, considerable research has been done on how people living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (PLWHIV/AIDS) manage information. However, understanding of the role of information in the HIV/AIDS in ESUT Teaching Hospital, Park lane is still limited, because of the difficulties of reaching different groups of PLWHA.
This study has been designed to reach many segments of the diverse HIV/AIDS community and broaden under standing of how information can better assist PLWHA.
Information can be regarded as a resource that can liberate man. Osuala (2001) refers to information as facts and opinions provided and received during the course of life. A person using such facts generate more information some of which is communicate to others during discussion, by letters, symbols, etc. Aniogbolu, (2008) noted that most information users need information for problem solving, current awareness and recreational purpose. According to Aniogbolu (2008), the importance of information utilization by man to his development is becoming more meaningful to him as his information accumulation ability’s is taking a new dimension with the development of highly sophisticated information technology (Aniogbolu, Anyaobi & Olise, 2010).
Information needs is often understood as vague awareness of something missing and culminating in locating information that contributes to understanding and meaning (Kuhlthau, 2009). Belkin, Brooks and Oddy. (2008) in their part saw information needs as a gap in individual’s knowledge in sense making situations. Accessibility to the right information is necessary for the general well being of the individual, institution or organization.
One of the most devastating sources of our time is HIV/AIDS; undoubtedly HIV/AIDS presents a major challenge to human development in Nigeria. Ojoawo, (2006) apart from poverty, no problem has given Nigeria a more daunting challenge than the present battle with HIV/AIDS. AIDS in indeed devastating Nigerian communities and poses a real threat to poverty reduction effort and the achievement of the United Nation Millennium Development Goals, (UNMDG). Indeed HIV/AIDS presents a serious challenge to Human Development in Nigeria because the exact cause of and spread of the epidemic is still very difficult to calculate.
In Nigeria, the first case of AIDS was diagnosed in 1986. The infection rate has however, grown exponentially. Since then, by June 1999, the Federal Ministry of Health, (FMOH) in Nigeria had recorded 26,276 AIDS cases. Due to fear of stigmatization several cases are not reported through the hospitals, which mean the reported cases were gross under estimations of the rate of occurrence of the epidemic. The National AIDS/STDS Control Progremmes (NASCP) of FMOH estimated that the calculated number of AIDS cases would have reached 590,000 by the end of 1999 (Ojoawo, 2006).
Currently Nigeria has become the first country in Africa to cross the critical epidemiological threshold of 5%. In fact, it has since been projected that by the 2009 in the absence of major changes in sexual behavior and other control measures, the number of people living with HIV would reach 5 million, of the 40 million people identified to be living with the disease, 3.5 million is the estimated number for Nigerian. This amounts to 10% of the 40 million people infected worldwide (UNAIDS/WHO/UNICEF, 2002). In a country like Nigeria, with limited public capacity and resources to combat the problem, the prevalence rate is 80 high that the HIV virus is infecting more than 30 people a day, and the disease is growing faster that the authorities’ response to it. The prevalence report in Nigeria revealed that there is no community in Nigeria with zero prevalence (FMOH, 2009).
Ukwuoma (2008) noted that in 2003 and 2008 National Antenatal HIV Seroprevalence survey in Enugu State recorded the prevalence rate in both 2003 and 2008 as 4.9% and 5.1% respectively.
People living with HIV/AIDS need information to survive. As a matter of fact, information is vital in the daily life of the people living with HIV/AIDS.
It is a medium of social transformation and communication and an avenue for them (people living with HIV/AIDS) to get involved in government programmes and policies about HIV/AIDS. Therefore, good access to information becomes a must for PLWHA. It is therefore, necessary to consider the information needs of people living with HIV/AIDS as well as their information resources. This study sought to investigate the information needs and resource utilization by PLWHA. Using ESUT Teaching Hospital Park lane, Enugu as study setting.
ESUT Teaching Hospital Park lane, Enugu is situated at GRA Enugu North Local Government. It is a reference center for comprehensive treatment and support of people living with HIV/AIDS.
1.2 Statement of the problem
The cause of the disease HIV/AIDS, allover the world, relates to individual social behavior such as casual sex, intra venous drugs use (FMOH, 2008). In Nigeria however, the leading driving force of the spread of the HIV infection includes low level of education, high level of ignorance, cultural practices that encourage multiple sexual partner such as polygamy and concubine, poverty and lack of access to appropriate reproductive health survives and information particularly the illiterate and young people. The practice of traditional surgery such as bloodletting procedures with unsterilized instrument on infertile women, and non observance of infection control procedures by traditional birth attendants who are heavily patronized in Nigeria, may all be responsible for spread of HIV/AIDS in Nigeria.
Other factors blamed for the spread of the epidemic are the other cultural practices that expose people to unsterilized sharp objects used for body scarification and circumcision, the subordinate role of women and their attendant vulnerability which prevents them from negotiating safe sex, ignorance, stigma and discrimination, poverty, illiteracy and the non chalant attitude of some individuals.
In spite of various efforts at both domestic and international levels, Nigeria’s situation seems not to translate to any reliable cheering news about HIV/AIDS epidemic. It is becoming more of a developmental problem than just a health problem. The problem constitutes a major challenge to sustainable human development in Nigeria, which must be a concern for all.
Lack of information resources, lack of awareness of the existence of information resources by the people living with HIV/AIDS, Non-utilization of the available resources by the people living with HIV/AIDS, High level of illiteracy among people living with HIV/AIDS, lack of skilled man power to appropriately organize that available resources in ESUT Teaching Hospital Library for easy accessibility and retrieval by people living with HIV/AIDS are the major problems faced by the PLWHA in ESUT Teaching Hospital Park lane, Enugu.
This study focuses on the information needs and resource utilization by people living with HIV/AIDS (PLWHA). The case study is ESUT Teaching Hospital Park lane, Enugu. The following are the problems facing PLWHA
a. Emptiness: Most people living with HIV/AIDS feel they are empty vessels immediately they have been diagnosed as being HIV positive. The feeling that they have nothing to offer to the society also makes them feel empty and useless. They consequently develop an inferiority complex which worsens their condition. They become helpless.
b. Absence of Counseling: Most people living with HIV/AIDS who know their status were not given pre-test counseling and as such were not prepared psychologically. This affects the psychological well being of the people living with HIV/AIDS (PLWHA), thereby leading to depression. Counseling is important to people living with HIV/AIDS. With counseling, which is supposed to be on-going process, PLWHA gain and demonstrate courage. Lack of counseling services in our hospitals is greatly affecting PLWHA. Even hospitals that have trained counselors do not offer appropriate counseling services and are not committed to work.
c. Lack of Family Support: Experience has shown that some family members abandon and sometimes isolate PLWHA on the grounds that they have tested positive to HIV. This is largely due to lack of awareness in our families such attitudes lead to suspicious among PLWHA. This eventually leads to untimely death in most PLWHA. Hence PLWHA to believe that it is better to die than to live. There is also little or no family support to give hope to PLWHA in most homes.
d. Stigma: This is one of the most subtle and debilitating challenges faced by PLWHA. It inhibits open, honest communication between them and others. Stigma makes the disclosure of the disease by PLWHA within the family difficult. Without disclosure, prevention and care are almost impossible, families and communities are deeply intertwined in the African context and should therefore be supported in preventing stigmatization. This will also promote better self esteem among PLWHA with respect to their careers. It will also eliminate the vicious cycle of self-stigmatization. People living with HIV/AIDS face stigma in the home, in the health care setting, in the religious sector, while the mass media can as well unintentionally promote stigma, though they have potential to shape the attitude, values and perception of a large member of people.
e. Human Rights Violation: Existing human rights instruments confirm that discrimination against PLWHA or those thought to be infected is a violation of their human rights. This is a great challenge facing PLWHA.
f. Discrimination: The acts of stigma constitute discrimination based on presumed or actual HIV positive status constitute discrimination based on presumed or actual HIV positive status and violates human rights due to the stigma associated with the rights of PLWHA. This situation intensifies the negative impact of the epidemic. At the individual level, for example, it causes undue anxiety and distress which by themselves contribute to ill-health. At the level of family and community, it causes people to feel ashamed and to conceal their link with the epidemic, as well as withdraw from participation in more positive social functions. At the level of society, discrimination against PLWHA reinforces the mistaken belief that such action is acceptable and that those infected with HIV/AIDS should be ostracized and blamed. This is a great challenge to PLWHA.
Around the world too there have been numerous instances of HIV/AIDS related cases of discrimination. People with HIV or those believed to have HIV/AIDS have been:
⦁ Segregated in schools and hospitals, and placed under cruel and degrading conductions. Cases of degrading treatment have often been reported in prisons where inmates are often without basic needs, including access to medical care.
⦁ Refused employment
⦁ Denied the right to marry
⦁ Reflected by community
⦁ Killed because of their sero positive status.
⦁ Required when returning to their home country to present themselves for an HIV test. Individuals have being denied the right to return to their country on suspicion of being HIV positive. Others have been denied visa and entry permissions.
In conclusion therefore, continuous advocacy campaigns are needed in response to the challenges faced by PLWHA and to bring about social change. All hand must be on desk to tackle the challenges facing PLWHA. To win the war against HIV/AIDS, PLWHA must be used as agents of change in the society.
1.3 Objectives of the study
The main purpose of this study is to depict a comprehensive picture of information need and resource utilization by people living with HIV/AIDS in ESUT Teaching Hospital Park lane, Enugu. The specific purposes of the study are as follows:
a. To determine the areas in which people living with HIV/AIDS needs information ESUT teaching Hospital.
b. To find out the information resource used by people living with HIV/AIDS in ESUT Teaching Hospital Park lane, Enugu.
c. To determine the extent to which information resources encourage and support the people living with HIV/AIDS to take positive actions to deal with HIV/AIDS in ESUT Teaching Hospital Park lane, Enugu.
d. To determine the benefits derived from the use of information resources by the PLWHA in ESUT Teaching Hospital Park lane, Enugu.
e. To find out the barriers to access and utilization of information resources by PLWHA in ESUT Teaching Hospital Park lane, Enugu.
1.4 Scope of the study
This study is limited to ESUT Teaching Hospital Park lane, Enugu, it investigates the information needs and resources utilization by people living with HIV/AIDS. The research wants to measure the following variables: the areas in which people living with HIV/AIDS need information, the extent to which information resources encourage and support the people living with HIV/AIDS, to take positive actions to deal with the HIV/AIDS, the information resources used by PLWHA, the benefits derived from the use of information resources by the PLWHA, and the barriers to access and utilization of information resources by PLWHA.
1.5 Significance of the study
The significance of this study will be appreciated for the following reasons:
It will accentuate public education and dissemination of information to reduce the stigmatization of persons assumed to be at risk of HIV/AIDS.
This study will also be important because it will provide psychological and social support to people living with HIV/AIDS. They should never be abandoned or treated as social outcasts.
The study is important because it will explore the necessary of the political action, that is social workers, individuals, community to participate with other groups to lobby at the state and federal level on behalf of PLWHA in order to improve their quality of life, protect their civil rights or liberty and to advocates for increased funding for appropriate education, prevention, intervention, treatment services and research.
The study will also serve as database for policy makers in the area of HIV/AIDS.
The findings of the study will help the government improve the scope and efficiency of its information systems and services where necessary to encourage maximum utilization by PLWHA.
It will serve as an information base for future scholars in the area.
Finally, it is hoped that the study will help policy makers, health care providers, health workers, information providers, library and information professionals, and other stakeholders in health sectors to respond positively to the information needs of PLWHA by identifying such needs and exploring avenues to improving will help the PLWHA to be aware of what is available for them, and perhaps make effective use of the available information resources for enhance health condition.
1.6 Research Questions
The following research questions guided the study:
a. To determine the areas in which people living with HIV/AIDS needs information ESUT teaching Hospital?
b. To find out the information resource used by people living with HIV/AIDS in ESUT Teaching Hospital Park lane, Enugu?
c. To what extent do people living with HIV/AIDS seek and share information and what type of resources do they use in sharing and seeking information in ESUT Teaching Hospital Park lane, Enugu?
d. What impact has HIV information had on the lives of PLWHA and on basic demography in ESUT Teaching Hospital Park lane, Enugu?
e. What are the barriers to getting HIV information by PLWHA in ESUT Teaching Hospital Park lane, Enugu?
1.7 Operational definition of research concepts
The following research concepts are defined according to the way and manner the researcher used in this research work.
i. Information Need: It is defined as an individual or groups desire to locate and obtain information to satisfy a conscious or unconscious need.
ii. Resource utilization: This is the proper use of available information and library resources by people living with HIV/AIDS in respect to their health status.
iii. HIV: This means Human Immune deficiency Virus.
iv. AIDS: Stands for Acquired Immune Deficiency Syndrome.
v. PLWHA: Stand for People Living with HIV/AIDS.
HISTORICAL BACKGROUND TO THE STUDY
The university was established as a non residential multi-campus institution. On establishment, the university which was conceived on a presidential model after Harvard University made impressive landmarks and stamped its name as the first University of Technology and first state University of Nigeria.
In 1991, following the creation of Enugu State from old Anambra State the new government change name from ASUTECH to ESUT.
Until 2005 when it was relocated to Parklane Enugu and named ESUT college of Medical/Teaching Hospital..