ASSESSMENT ON THE LEVEL OF AWARENESS OF HIV / AIDS

Introduction

Background to the Study

The Acquired Immunodeficiency Syndrome (AIDS) is caused by the human imunedeficiency virus (HIV), which destroys the cells in the body that combats infections. Although, recent medical advances have caused a shift from the mindset of a terminal disease to one of a chronic manageable conditions in some areas of the world. This new approach brings challenges of its own, as the disease is eventually fatal (Forri et al, 1997).

HIV has brought about a global epidemic far more extensive than what was predicted even a decade ago. The issue of HIV/AIDS is not only relevant to medical documentation, but is complex and highly politically charged, affecting all communities regardless of race, age or sexual orientation (Ginsberg, 1995). At the end of the year 2000, it was estimated that there were 36.1 million adults and children living with HIV/AIDS, the vast majority of whom live in the developing world, with more than twenty five million living in the continent of Africa (Global Summary of the HIV/AIDS Epidemic, 2000 and 2001).

Care givers to HIV/AIDS patients need to be highly trained so as to effectively give succour to those who are stigmatized as a result of the contraction of the disease (HIV/AIDS). According to Adams, formal care giving services for the elderly and the diseased individuals are those services bureaucratically provided by non familial and non-informal social systems. Although, families provide majority of care scourge of HIV/AIDS disease and other aliments, formal services also exists in order to support those living with the dreaded disease. Individuals offering care-giving services need to be exposed to training through constant attendance of seminars, workshops, orientation and in-service programmes. These programmes should also be given to other individuals who are not infected with HIV/AIDS so as to prevent the contraction of the disease and to avoid its spreads in the society.

The World Heath Organisation has a set a goal for all Nation’s Heath for all by the year 2000 and the Nigerian health sector has adopted this slogan in the last decade. However, some of the major constraints facing Nigeria include poverty, inadequate human resources, inadequate personnel in the medical sector (the few are concentrated in the cities) illiteracy, poor funding of the health sector (less than 20% of the Gross National Product GNP), and finally lack of information and research into the state of the nation’s health (Ogunba, 2002).

In order to have sustained progress towards our dream or “Health for all by the year 2000”, the health needs for the nation must as a matter of urgency, include some of the following:

1. Collection of reliable epidemiological data for all the important endemic diseases, especially, the dreaded HIV/AIDS disease, in our country, as well as research inputs into our heath delivery systems so as to determine:
2. Effectiveness, efficiency, efficacy and cost effectiveness of our efforts at all costs;
3. New tools, methods and management strategies and acceptabilities by the rural people of our concepts and vision for improved and modern medical care;
4. Behaviours, attitudes and environmental factors that may enhance or mar introduction of modern medical concepts into the background of long-time relationship and confidence in the “traditional healers and native doctors”.

The initial outlay for conducting the studies mentioned above may appear high but such data would become rewarding in the long run and make the health delivery service more reliable and cost effective. The tropical developing environment encourages the rapid spread of disease, especially HIV/AIDS, mostly in the rural illiterate setting. It is therefore, mandatory to have mass medical/health education incorporating literacy classes coupled with the production of potable drinking water that will control common preventable diseases such as guinea-worm infection, schistosomiasis, amaebiasis and soil-transmitted helminth infections. These account for 40% of our hospital admissions/attendance and constitute a severe drain on our national health status and economy (Akintayo, 1990).

Idabawa (2002) states that HIV/AIDS is one of the greatest unresolved challenges of our time, threatening the life thread of the entire human race. It has the propensity to wipe out decades of progress and development of affected nation. It has devastating effects on world economy as all countries of the world are directly or indirectly affected. HIV/AIDS thrives on and accelerates poverty, destroys good health and affects education negatively. It also retards the political climate of affected nations, and seriously reduces life expectancy, in the year 2002, about 5 million people were infected with HIV. About 42 million people in the world are living with the virus. From this frightening number, 3.6 million are Nigerians. Over 20 million people have died from AIDS since the first case was diagnosed and 1.7 million were Nigerians.

The statistics is both frightening and overwhelming, for example, though the first case of the virus diagnosed in Nigeria was in 1986, statistics shows increasing cases of the scourge. It has continued to spread steadily from 1.8% in 1998, to 3.8% in 1994, 4.55 in 1999 and 5.8% in 2001. A very high prevalence of 6.8% is found among 15 − 49 age group. This is very alarming as this group is about half of the country’s population reproductive workforce. Nigeria, having crossed the threshold of 5% which is the potential stage of the endemic, is at the crossroads and must take serious and urgent actions to stem the pandemic.

According to Omolewa (1990) caregivers on HIV/AIDS are important role models and they should be aware of this. They require training and support to meet the demands within and outside the country. The nature of HIV/AIDS education makes it mandatory for training need to go beyond basic awareness, training to include establishing relevant and appropriate codes of practice and ethics of the profession. It includes reviewing personal attitudes to ensure that what is taught is what is practiced as caregivers and trainers must live by examples. The caregivers must also acquire specific skills for teaching or impacting the knowledge about the nature of HIV/AIDS and how not to contract it, especially, as such skills are expected to ensure behavioural change.

Specialized teacher education and training to cater for the peculiar needs of HIV/AIDS education poses another challenge in the fight against the HIV/AIDS endemic. Training teachers or the caregivers for HIV/AIDS education, means training virtually all the teachers and caregivers, which is not a mean feat. Capacity building for HIV/AIDS education means colossal expenditure on men and materials. This requires support the caregivers must be well prepared and must be supported in the social work on HIV/AIDS through pre-service and in-service education and training (Kelly, 2000).

Pre-service and in-service education and training/retraining are very important in the delivery of risk education for HIV/AIDS patients. This will ensure that new resources, knowledge and even approaches are considered from time to time and updated. Moreover, new approaches like enquiry-based, rights-based and gender sensitive education which are known to work very well are integrated in their training. Many of these approaches encourage active participation and skills development (Achizie, 2001).

According to Njinja (2001) in every activity, initiative or intervention, resources are needed. Implementation cannot take place in a vacuum. Resources include: human, materials and financial. Human resources in the fight against HIV/AIDS through education include professionally trained HIV/AIDS educators, policy makers, Naval personnel, administrators, social workers and mobilizes, media personnel, community teachers, parents, teachers and partners/stakeholders. Material resources include all teaching and learning materials, curriculum, supplementary texts etc. Financial resources entails funding required for the training of personnel and production of materials. They also need research, monitoring and evaluation.

Statement of the Problem

The problem facing care-givers on HIV/AIDS disease, is the inability of the care-givers to be exposed to proper training which will further expose them to taking adequate care for those suffering from the deadly disease. Due to the inadequacy of training programmes for trainers of care-givers on HIV/AIDS, few individuals who present themselves as HIV/AIDS care-givers carry out their jobs without much experience and skills with which to take care of those infected with the disease. As a result of lack of appropriate training programmes for the trainers of caregivers on HIV/AIDS, there exists misinformation and mismanagement of the disease in Nigeria. The impact of the programme of training the trainers of HIV/AIDS has not yielded any positive result in Nigeria as a country, and this has resulted in further spread of the disease while government and other agencies on HIV/AIDS are helpless and have nothing to offer as solution to the problem. This study examines the impact assessment of training the trainers’ programme of caregivers on HIV/AIDS disease in Lagos State.

Purpose of the Study

This study examined the impact assessment of training the trainers programme for HIV/AIDS caregivers in Ojo Naval Barracks in Lagos State. The specific purposes of the study include:

1. To find out the impact of training on health care delivery among health workers in Lagos State.
2. To find out whether there is a difference between caregivers who received training and those who did not.
3. To examine whether there is adequate training given to the HIV/AIDS caregivers in the society.
4. To differentiate the HIV/AIDS care given by men from those given by women.
5. To examine the causes of HIV/AIDS endemic in the country.
6. To proffer possible solution to the problem of HIV/AIDS in the society.

Research Questions

The following research questions were raised in this study:

1. To what extent will there be an impact of training of personnel on health care delivery among HIV/AIDS caregivers?
2. Will there be any difference between the service delivery of HIV/AIDS caregivers who underwent training and those without training?
3. Is there adequate training given to the caregivers on HIV/AIDS?
4. How can we differentiate between an HIV/AIDS caregivers by men from those given by the women?
5. To what extent can we examine the causes of HIV/AIDS in the society?
6. How can we proffer solution to the problem of HIV/AIDS in Nigerian society?

Research Hypotheses

The following research questions were formulated for testing in this study:

1. There will be no significant impact of training on health care delivery among health workers in the country.
2. There will be no significant relationship between the service delivered by male HIV/AIDS caregivers and those given by the female ones.
3. There will be no significant difference between the service delivery of HIV/AIDS caregivers who are trained and those who are not.

Significance of the Study

This study will be beneficial to the following individuals:

(1) HIV/AIDS caregivers will benefit from the study because it will help them to be able to exhibit the strategies with which to handle the HIV/AIDS patient, pass information that will be relevant to people who are not even living with the disease. The findings and recommendations of this study will help caregivers on HIV/AIDS to be acquainted with much facts that would go a long way in assisting the people living with the disease and to help those who are not living with the disease to abstain from the acts that will expose them to the danger of having the disease. The recommendations of this study will no doubt, change the orientation of HIV/AIDS caregivers amongst the Navy, and make them work effectively.

(2) Government: The government will be acquainted which correct facts on HIV/AIDS caregiving. The recommendations and findings made in this study will help the government, especially the agencies responsible for HIV/AIDS will be able to have an insight on how best to handle the disease called HIV/AIDS.

(3) Society: The society will no doubt benefit from this study because it will assist the society to be acquainted with all the facts concerning the HIV/AIDS which is the health problem of many nations these days.

(4) The study will be a reference point to many researchers and new researchers, and even students who will need this material to carry out further researches on HIV/AIDS and caregiving.

Scope of the Study

The study examined the impact assessment of training the trainers programme for HIV/AIDS caregivers in Ojo Naval Barracks in Lagos State.