(A CASE STUDY OF
FEDERAL MEDICAL CENTRE UMUAHIA FROM 1995 TO 2004)
ABSTRACT
We had tried to study the rates of infant mortality
in Abia State.
The aims of this study were to compare the mortality and birth rate of
infants male and female in order to determine whether there is a significant
yearly difference in their mortality and birth rate. Also, to determine whether infant mortality
in Abia State in independent of sex. And
furthermore to determine the future trend cases for birth and death and as well
determine some preventive measures to reduce the infant’s mortality.
It
was found that there was decrease in mortality from year 2000 to 2004 in Abia State. This is due to the aggressive government
policy on the reduction of infant and maternal mortality through the pursuance
of the National Programme on Immunization (NPI) and Expanded Programme on
Immunization (EPI). It was also observed
that there was an increase in mortality as from 1995 to 1999 due to a cholera
epidemic recorded then as published by “your Health Magazine†1998 Vol 3.
Finally,
we advice that good drinking water, good and affordable health services, proper
refuse disposal should be encouraged to reduce the infant mortality in order to
encourage the continuity of our race.
TABLE
OF CONTENTS
Title page
Approval page
Dedication
Acknowledgement
Abstract
Table of contents
CHAPTER ONE
1.0 Introduction
1.1
Historical
Background
1.2
Statement
Of Problem
1.3
Research
Questions
1.4
Aims
And Objectives
1.5
Statement
Of Hypothesis
1.6
Scope
Of The Study
1.7
Limitation
Of The Study
1.8
Definition
Of Terms
CHAPTER TWO
2.0
Review
of Related Literature
CHAPTER THREE: RESEARCH METHODOLOGY
3.0 Introduction
3.1
Sources
Of Data
3.2
Method
Of Data Collection
3.3
Problems
Of Data Collection
3.4
Method
Of Data Analysis
3.5
Wilcoxon
Ranksum Test
3.6
The Chi – Square Test
3.7
Estimation
Of Future Trend Cases
CHAPTER FOUR
4.0 Data
Analysis
4.1
Wilcoxon
ranskum test
4.2
Recorded
birth for infants male and female
4.3
Recorded
death for infants male and female
4.4
Determining
whether infant birth and mortality are independent of sex
4.5
The
chi – square test
4.6
Estimation
of future trend cases
CHAPTER FIVE
5.0 Summary
of findings and conclusion
5.1
Conclusion
5.2
Recommendations
5.3
Bibliography
CHAPTER
ONE
1.0 INTRODUCTION
Since
Nigeria
got her independence in the year 1960, the federal government has been doing a
lot in the following sectors:- Agric-culture, Education, Industries, Health
Services, Banking among others.
In
the area of Health Services, the governments efforts has been to ensure that
she achieves good health for all especially women children. The evidence of her effort is made manifest
in the construction of many public health institutions through out the
states. These include the following:
Hospitals, Health Centres, Health Clinics, maternities and Mobile Clinics.
Recently,
there has been a general increase towards health improvement, this is as a
result of greater awareness, better organization, increased public health
consciousness, changes in medical practices among others; however, these
advances may appear insignificant when compared to the magnitude of the
problems still to be solved especially as it concerns infant diseases and
infant mortality.
According
to the Oxford Advanced Learners Dictionary, Mortal means to die; that cannot
live forever. Encyclopedia Britannica
expressed the state of being mortal as the state of temporalness of living, or
not to live forever.
In these
modern times there have been an increase in world population and stability ad
decline in number would be regarded as abnormal. As Berkley
(1958) said, “modern phrase of recent origin started from the peiod of 1600;
the growth is quite unprecedented in any comparable periodâ€. One can view from the above statement, that
such changes in population are inherently transitory.
In
countries of West Africa records of health did
not start until orthodox medium arrived, but it was recognized prior to the
arrival of the white men. There were
high incidence of killer diseases which affected maternal and infant health
leading to high mortality of infants.
Moreover, the sanitary condition of our local populace, mode of feeding
and general condition leaves much to be desired, also lack of health
infrastructures created problems that led to high infant mortality.
Again,
other causes of infant mortality are recognized killer childhood diseases viz;
measles, malaria, small pox, tetanus, whooping cough, hepatitis, poliomyelitis,
dyphytaria and jaundice. In late 80’s
government of Nigeria
through the National Programme on Immunization and Expanded Programme on
Immunization has achieved a lot to the improvement of infant health.
Now,
according to recent health journals “Health care†the liming legs are fastly
dis appearing, the plague of onchosochaisis caused by the black fly is
gone. Our children and infants are
living today without it. Poliomyelitis
is about being kicked out from the shores of our country courtesy of the three
months immunization programme of year 2000.
1.1 HISTORICAL BACKGROUND OF THE STUDY
The federal medical center Umuahia was built in the
early 1950’s by the joint effort of the protestant churches, the Anglican,
Methodist and Presbyterian churches. The
three churches agree to build a joint hospital and work together as a means and
avenue of a joint Christian medical services and Christian evangelism. Trained and qualified competent Christian
ladies were generally nurses and midwifery and this created an environment for
true Christian gospel and evangelism.
The hospital was first named Union
Mission Joint
Training Hospital. Nurses and student nurses were drawn from
hospitals named by three denominations and located at Iyi Enu Ituk Mbang and
Etinagi all in Calabar to run the hospital.
Later as a mark of appreciation and courtesy to Queen Elizabeth II of
Great Britain when she formally and officially opened the hospital in 1956,
during the regime of his excellency the governor of the Eastern Region of
Nigeria, Sir. Clement Plear, it was renamed Queen Elizabeth
Hospital.
Soon
after its establishment, the hospital gained popularity and reputation, but it
suffered a set back during the Nigeria
civil war from 1967 – 1970 when most of the medical equipments were
looted. Moreover, indigenous
missionaries could not maintain the hospital after the departure of the foreign
missionaries at the end of the war.
Consequently,
it management was taken over by the government, which converted it to a
sepcialsit hospital by the East Central State of Nigeria Edit No 6 of 1972:
with the creation of the Imo State Government, she changed the name of Ramat
specialist Hospital in honour of the later Head of State General Ramat Murtala
Mohammed, under the direction of Navy Captain Ndubuisi Kanu, the then military
governor. I t reverted to Queen
Elizabeth hospital o the 16th
December 1983, sequel to a request by the people of old Imo State.
The hospital was again taken over by the Federal
Government on 1st
May, 1992 and was renamed Federal Medical Centre Umuahia.
The
Federal Medical Centre Umuahia is located at Umuahia the capital of Abia State. The hospital has ten wards, two medical wards
on each for male and female, maternity wards, the pediatrics ward, two
theatres, one for obstetrics and other for general surgery. Other areas of the hospital includes: the
Antenatal clinics, x – ray department, pharmacy and medical laboratories units,
medical records/ statistics among others.
The hospital has two training schools, the school of Nursing and the school of
midwifery. It has a staff strength of
about 720; made up of medical doctors, Nurses, House of Officers, Laboratory
Technicians and Scientists, Accounting of Officers, records Officers,
Pharmacists, Administrative Officers, Attendants, among others.
1.2 STATEMENT OF PROBLEM
The researcher was very much worried and concerned
about the alarming rate at which infants were dying in Abia State
and the following statements and questions below prompted him to go into the
study about the rate of infant mortality in Abia State.
1.
The
rate of infant mortality in Abia
State was alarming.
2.
The
rate of infants mortality may have been more in a particular sex
3.
The
rate of infant’s mortality may have been caused by many factors among which
disease were the chief.
4.
The
rate of infant’s mortality in Abia
State should follow a
particular trend over the years.
5.
There
should be some preventive measures to reduce the number of infant’s death that
may occur in Abia
State.
1.3 RESEARCH QUESTION
1.
What
are the major causes of infant mortality in Abia State?
2.
Is
there any means to compare mortality rate of infant male and female to know
whether there is significant yearly difference in their mortality rate?
3.
Does
infant mortality rate in Abia
State dependent on sex?
4.
Can
the trend of infant mortality in Abia
State be established?
5.
Are
there some preventive measures to reduce the number of infants death that may
occur in Abia State?
1.4 AIMS AND OBJECTIVES
1.
To
compare mortality rate of infant male and female in order to know whether there
is significant yearly difference in their mortality rate.
2.
To
determine whether infant mortality in Abia State
is independent of sex.
3.
To
suggest possible preventive measures to reduce the number of infant deaths that
may occur.
4.
To
determine the trend of the infant mortality rate.
5.
Based
on the findings, recommendation will be made.
1.5 STATEMENT OF HYPOTHESES
This study is testing for the following hypothesis:-
H0: There is significance difference in the
yearly mortality rate of infants male and female.
H1: There is not significance difference in the
yearly mortality rate of infants male and female.
H0: Infant mortality in Abia State
is independent of sex
H1: Infant mortality in Abia State
is not independent of sex.
1.6 SCOPE OF THE STUDY
This project work is restricted to the federal
medical center, Umuahia in Abia
State. The study covers a period of ten years from
1995 to year 2004.
1.7 LIMITATION OF THE STUDY
The researcher was constrained to limit the study to
the federal medical center Umuahia only.
This was chosen as a sample, which will be used for generalized decision
making. The study is limited in scope
because the mortality rate of infants were done for only ten years study and
only one hospital i.e. the federal medical center Umuahia was considered.
There
is the problem of lack of adequate record keeping by the hospital; therefore
retrieval of such information was made very difficult.
The
peoples’ ignorance which include their not recording death of infants that took
place outside the hospitals makes the report of mortality in exact which far
out weigh t hose recorded in any known hospital. Finally, lack of fund and time imposed a
major limitation to this study there by limiting the study t o only one
hospital and just for a period of two months only.
1.8 DEFINITION OF TERMS
The terms used in this study are all Demography
terms and are peculiar t o the subject matter alone.
Below
are some of the terms commonly used in this study, which constitute the
reference terms and will aid data analysis.
Demograph
Mortality
Neo-natal mortality
Morbidity
Disease
Infants
(i) DEMOGRAPHY: This
is the study of human population and some of the factors that causes change in
its composition and size.
(ii) MORTALITY: The state of being mortal, mortal
means that must die; that cannot live forever, a state of temporal living or
existence.
(iii) NEO-NATAL MORTALITY: This
is the mortality of infants within the first 28 days of birth. Some of which are caused by the circumstances
of birth.
(iv) INFANT – MORTALITY RATE: Mortality
rate is the index of death over the index of birth for a given period of at
least one year. Infant mortality can be
defined as the number of death under one year over the number of live birth
times 1000.
i.e D x K Where D is the number of death in
B a particular year.
B is the number of birth in the
same year
K is a constant and is equal to
1,000
Which is No of death under one year x 1000?
No
of live births
This shows clearly the measures within a given year
of chances of birth failing to survive in one year life time.
To calculate separately for the sexes:
Female = No of female death x 1000
No
of female births
Males = No of males death x 1000
No
of males birth
(v) MORBIDITY: Morbidity involves the statistics
of ill health of a population. It
includes the rate of illness, injuries, accidents etc.
(vi) DISEASE: This is the state of being
morbid, it is caused by infections or undergrowth. There are air borne disease, water borne
diseases, insect borne diseases, and sexually transmitted diseases.
(a) Water Borne Diseases: These
are caused by some aquatic living organisms which when they enter human body
cause disease. They include some Fungi, Algae, bacteria etc. Also bad source of water supply where sewage
and refuse are badly disposed can lead to severe cause of water borne
diseases. These diseases include typhoid
fever, cholera, diarrhea, dysentery etc.
(b) Air Borne Disease: These
are diseases which can be contacted or transmitted from a carrier to a healthy
person through the air. Free-living bacteria or parasite transmits these
diseases. These diseases are coughs,
measles, catarrh, whooping cough, chicken pox and polio.
(c) Insect Borne Diseases: These
are diseases carried by insect vectors.
These vectors visits and plague human environs disposing bacterium to
their food. Diseases like typhoid fever,
diarrhea and cholera are carried by housefly.
Mosquitoes carry malaria parasite and trypanosomiasis is caused by
tsetse fly, while onchosochaisis is caused by African black fly.
(d) Sexually Transmitted Diseases: These
are significantly important because some of them affects fertility rate, there
are disease acquired through sexual intercourse between the victim and any
member of the adult population. Examples of such diseases are Gonorrhea,
syphilis HIV/AIDS etc.
(vii) POPUALTION: This refers to the total number
of individuals or items relevant to a phenomenon under investigation.
(viii) STILL BIRTH: This refers to that fetus that
has not developed to a full baby and is release from the utemis prematurely and
as a result couldn’t survive.
(ix) LIVE BIRTH: This refers to full developed
babies or babies born prematurely yet in both cases the babies survived.
(x) MATERNAL MORTALITY: This
refers to all the women that die during the process of child delivery.
(xi) INFANT: These are children between the
age zero to one year.
(xii) INFANT MORTALITY: This
refers to the death of children whose age is between zeros to one calendar
year.
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