(A CASE STUDY OF FEDERAL MEDICAL CENTRE UMUAHIA FROM 1995 TO 2004)
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
Table of contents
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
2.0 Review of Related Literature
CHAPTER THREE: RESEARCH METHODOLOGY
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
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
5.0 Summary of findings and conclusion
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 period”. 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.
(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.