An Evaluation of the Perception of Citizens on Health Care Delivery System and Fake Drugs in Delta State
CHAPTER ONE
Objective Of Study
The following are objectives of this study:
- To examine if poor health care delivery system contributes to the prevalence of fake drugs in Nigeria.
- To assess the major factors affecting adequate health care delivery system in Nigeria?
- To assess the implication of the prevalence of fake drugs in Nigeria.
CHAPTER TWO
LITERATURE REVIEW
Theoretical Review
According to Wikipedia, the free encyclopedia, “healthcare systems are designed to meet the health care needs of target populations.” In some countries, the health care system has evolved and has not been planned, whereas in others a concerted effort has been made by governments, trade unions, charities, religious, or other co-coordinated bodies to deliver planned health care services targeted to the populations they service.
The aims of HCDS are to provide high quality care at affordable costs, and be responsive to the health needs and expectations of the population. The practical problem in health care policy is that the pursuit of any two of those goals aggravates the third. Thus, a more accessible system of high – quality care will tend to lead to higher costs, while low cost system available to everyone is likely to be achieved at the price of diminishing quality.
A HCDS can encompass a wide number of settings – from the informal (house calls, emergency medicine at an accident spot) to settings like nursing homes or rest homes, to typical medical settings like doctor’s practices, pharmacist’s pharmaceutical care, clinics, pharmacies and hospitals. The delivery of care refers to how and where medical services are provided.
Health care provision in Nigeria is a concurrent responsibility of the three tiers of government in the country (Rais Akhtar, 1991). However, because Nigeria operates a mixed economy, private providers of health care have a visible role to play in health care delivery. The Federal government’s role is mostly limited to coordinating the affairs of the university teaching hospitals, while the state governments manage the various general hospitals and the local governments focus on dispensaries.
Studies report that 80 to 95 percent of all health problems are managed at home through self-care and that most people who consult a physician have tried treating themselves before seeking medical advice (McGowan, 2009). The seriousness of the health problem and the extent and type of disability, including its affect on daily activities, are the best determinants of whether an individual uses self-care practices or seeks help from a professional.
CHAPTER THREE
METHOD PARTICIPANTS
Research Design
In defining research design, Odo (1992:43), stated that research design implies outlining the name of equipment and other materials the research intends using, applying some to successfully execute the practical aspect of the research study.
A descriptive survey method was used for this study. It is important to determine the method and procedure adopted in this research report since it gives the reader background information on how to evaluate the findings and conclusion.
Research Sample
In all, 103 participants completed the questionnaire, of which 36 were male and 67 were females above eighteen years. They were selected through a random sampling technique.
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One hundred and nineteen questionnaires (119) were given out to be completed. Nine (9) were not returned and seven (7) were not completely filled.
The health care providers who completed the questionnaire were pharmacists, medical doctors, medical laboratory scientists and nurses. The health care consumers were persons who were not members of the health care providers. The participants in study consisted of 56 health care providers and 47 health care consumers. 37 of the participants filled the questionnaire in pharmacies, 47 in Oshimili North LGA General Hospital and 19 in primary school classrooms.
The participants were drawn from Oshimili North LGA. As of 2005 Oshimili North LGA had an estimated disputed population of 561,106 (Wikipedia, 2009). The ingenious people of Oshimili North LGA are primarily of Igbo ethnicity, although there are other ethnicities such as the Hausa, Yoruba, Igala and a few foreigners.
46 participants were from Oshimili North LGA in Delta State.
The mean ages are 37.2, 34.2 and 42.8 for all the participants, female participants and male participants respectively. Also, the standard deviations are 12.8, 10.3 and 7.6 respectively. Equally, the variances are 164.3 for all participants, 105.9 for female participants and 58.4 for male participants.
CHAPTER FOUR
DATA ANALYSIS AND RESULT PRESENTATION
Table 1: shows The use of fake drugs in health care delivery system will have relationship with people’s perception of health care delivery system.
CHAPTER FIVE
DISCUSSION OF FINDINGS, CONCLUSION AND RECOMMENDATION
Discussion of Findings
The study investigated the relationship between fake drug use in health care delivery system (HCDS) and people’s perception of health care delivery system. There was a significant relationship. This result was in an agreement with similar earlier works.
In the study on challenge of counterfeit drugs by Erhun and Babalola (2001), the availability of counterfeit drugs in HCDS was confirmed as over 71% of the respondents in the study indicated. Also, in the study by Odili, Osemwenkha and Okeri (2006), over 74% of the respondents considered counterfeit drugs as a major problem in Nigeria.
In 1998, a similar study by Ogori Taylor revealed that 49.6% of drugs sold in open market were fake, and that 12.8% of this number resulted in fatalities. The study also revealed that those drugs led to 10.8% therapeutic failures.
Looking at Pearson product-moment correlation coefficient study value, (r: 0.60), and Pearson critical value (r: 0.497; p < 0.05), there is a significant positive relationship between the use of fake drugs in HCDS and attitudes and behaviors of people towards HCDS.
Therefore, the hypothesis that there will be a relationship between fake drug use in HCDS and people’s perception of HCDS holds.
Also, the hypothesis, “Fake drugs as drugs with insufficient therapeutic benefits will have relationship with worsening of disease conditions” was confirmed. Furthermore, the third hypothesis, “There will be a relationship between disease complication because of fake drug use in HCDS and health care consumers’ confidence in HCDS” was supported by the results of the study.
Though the results of the study confirmed that people’s perceptions of the HCDS, disease complication and health care consumers’ confidence in HCDS were influenced by fake drugs, the relationships were not as high as expected. After all, fake drugs are both health risks and threats to life. People would be expected to react vigorously to HCDS where such drugs existed.
Perhaps, the amount information on fake drugs available to the public could be so low to push them to react significantly. The media coverage provided on the problem was inadequate. Most probably, they were denied such pieces information.
People have weaker schemas for fake drugs than for genuine ones because the general public has fewer experiences (and thus, fewer cognitive associations) with specific cases of fake drug problems. Thus people’s perceptions are more malleable and open to alteration. As such, this study implies that people are more likely to depend on peripheral information to form impressions of fake drugs.
Health care providers appeared to be highly knowledgeable on the negative effects of fake drugs. However, a good number of them have limited information on the observed effects. This could be because of poor or no reporting of such cases. Also, without formal documentation or report of cases of fake drugs to the appropriate government agencies by health care providers and consumers, the situation would be played down to the detriment of the health care users.
Furthermore, the inability of government to publicize incidences of fake drugs and counterfeiters could impinge on the attitude of people towards fake drugs.
Limitations: though positive relationships were established in the study, items in the questionnaire might not have tapped the true dispositions of the participants. Confounding variables might have influenced the observed relationships. Such third variables include tight work schedules for some of the participants, and doubt that the confidentiality they were assured of was true.
Recommendations
It has been observed in the study that with increase in the use of fake drugs in HCDS there is also a positive increase in the problems associated with them.
Therefore, the following recommendations will reduce the problems of fake drugs in HCDS:
- Governments (at local, state and federal levels) should on periodic basis make known topublic health care facilities, institutions, organizations and individuals that use, supply and or produce counterfeit
- Information on incidences of adverse effects of counterfeit drugs should be disclosed tothe public as they
- Afurther study on the adverse effects of counterfeit drugs is necessary to generate research information on specific cases.
Conclusion
In a broader sense, more experimental quantitative research should be conducted to empirically verify what this descriptive qualitative study has found. In the meantime, this study provides an empirical perspective to the belief that fake drugs are health risks, poisonous and threats to life.
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