Appraisal of Radio Programmes as a Tool for Empowering Nursing Mothers in the Fight Against Infant Mortality - AZ Research Consult (MBA MSc Dissertation/thesis Project Writer) Nigeria

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APPRAISAL OF RADIO PROGRAMMES AS A TOOL FOR EMPOWERING NURSING MOTHERS IN THE FIGHT AGAINST INFANT MORTALITY

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CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND TO THE STUDY

Effective communication is only possible where the correct message is disseminated to the right audience at the right time through the right channels. The importance of radio broadcasting is growing from strength to strength because it is a tool of mobilizing, sensitizing, educating, informing and entertaining the mass of its listening audience in and across the globe.

Radio broadcasting according to Adamu (2006) cited in Okpoko (2012:62) is the most universal form of mass communication. In Africa, cheap transistor radio set have brought the oral tradition over the air wave to millions of rural African villages, towns and cities thereby breaking the barrier of illiteracy and poverty of information among Africans.

Katz (1976), adds that the impact and the role that radio plays in the development of any society is for societal overall development, integration and safeguard which cut across all the facets of its socio-cultural existence. This was corroborated by Nwuneli (1985) that radio accompanied with sound effects played an important role of information and mass mobilization of the public about the effect of spinal meningitis and cholera epidemic in Nigeria. Schramm (1964) adds that the most impressive demonstration of the impact of radio was in mass mobilizing the public to participate in the real act of democratic governance.

However, community radio in its reach to the people is a veritable tool and for this reason, is considered for taking awareness message and health related issues to the millions of people who live and work in different communities (Moemeka 1986). Effective communication with the community people and their active participation in the programmes that affect them is essential for every community.

Through proactive and pragmatic radio programmes that are carefully designed, produced and packaged with the socio-cultural patterns of the community taken into consideration, it would go a long way in empowering nursing mothers in the fight against infant mortality, particularly in Kaduna state.

Radios are effective mechanisms to increase access in the developing world because they are inexpensive, have broad coverage, and sometimes battery-powered, and no literacy is required to operate them. At least 75 percent of the worldŸs population is within easy access of some form of broadcast technology, primarily radios (Mefalopulos 2008:193).

However, one of the Millennium Development Goals is the reduction of infant mortality by two thirds between 1990 and 2015. Thus, Mojekwu & Ajijola (2011:164), observes that progress in infant mortality reduction remains unacceptable in Sub-Saharan Africa; with special reference to Nigeria, the giant of Africa. Available statistics suggest that infant mortality levels continue to be high and exhibit wide geographic disparities. This was corroborated by Ladipo (2009:11), who reveals that the northern part of Nigeria has generally worse indicators and is also the region where polio has proven most difficult to control. Poverty and inadequate knowledge is another factor that contributes to the disparity. Ejike (2012:26) states that in the north, poverty ranges about 70%, while in the south it ranges between 25% in the southeast to about 35% in the southwest. For a little analysis: between the northeast and the northwest, there is little disparity of about seven percentage points in terms of poverty reduction (op cit).

A maternal death has implications for the family, the community and the society in general. However, its impact is most immediate and especially severe on young children. According to the WHO, one million children worldwide are left motherless every year, primarily because their mothers had no access to or could not afford quality health care. These children are also more likely to die within two years of their mothersŸ death.

Similarly, infants are in many ways the most vulnerable group to adverse effects of environmental health because they are sensitive not only to conditions in their immediate environment after birth, but also to the pre and post-natal health of their mothers, and the quality of the health support services (Nuria 2003) cited by (Mojekwu & Ajijola 2011). According to UNICEF (1990) cited in Umoh, Okesina & Dimkpa (1996:102), many maternal and child health-care problems are embedded in the cultural beliefs, values, practices and norms of the community. Here, many parents believe that the death of their infants is caused by external factors such as care givers, relatives, anger of gods etc. As a result of such belief, most parents sometimes find it difficult to accept modern medical care for their infants. Also, Umoh & Okesina (1995:238) reveals that the act of attributing causality to internal or external factors have no scientific basis. For example, the Ogbanje as supposedly a child who dies repeatedly and returns to the mother to be reborn, is one of such superstitious belief. This is because peopleŸs perception about an Ogbanje child is that it is almost impossible to bring back again when dead.

Additionally, Odu & Dotun (2007:148) opines that there are anti-effective properties present in human milk which helps to fight against many childhood diseases that leads to long “ term effects like intelligence, socialization and personality development of children. UNICEF (2008:12) further reveals that breastfeeding can reduce the number of deaths caused by acute respiratory infection and diarrhoea – two major child killers – as well as from other infectious diseases. It also contributes to the health of mothers, and creates a bond between the mother and child. Appropriate infant feeding can save lives, ensure optimal growth and development, and contribute to the achievement of the Millennium Development Goals.

Despite these advantages, many mothers still do not practice giving the breast milk in the appropriate way to their children (Odu & Dotun 2007:148). Moreover, research indicates close link between the health of the newborn with the health of their mothers. Ladipo (2009:14) observes that about 30-40% of neonatal and infant deaths result from poor maternal health and inadequate care during pregnancy, delivery, and the critical immediate postpartum period. Data also suggest that a motherŸs health affects the overall well-being of the child. Ejike (2012) adds that Nigeria is second to India in terms of absolute number of maternal death and regrettably, despite abundant resources, contributes more than 10% of all global maternal and under 5 deaths. This is where awareness creation by government and non-governmental organisations has a major role to play.

Hence, Riman & Akpan (2010:120) reveals that Nigerian government has over the years been in serious pursuit of programmes and policies that will ensure improvement and stability in the health status of her citizens. As such, several policies targeted at reducing infant mortality rate, improving maternal and child health as well as improved nutritional health status of the people had been established. Policies on infant health include: National Child Health Policy, National Policy on Infant & Young Child Feeding, National Strategic Plan for Implementing Global Strategy on Infant & Young Child Feeding, and National Maternal, Newborn and Child Health Strategic Document (FMJ 2009). Such policies were meant to have direct effect on the health of the poor particularly those residing in rural areas where access to health services are either limited or absent (Riman & Akpan 2010).

However, because human behaviour is a major factor in health outcomes, investments in health must focus on behaviours as well as health facilities and service provision. Solving health problems requires that people understand and are motivated to adopt or change certain behaviours. For instance, the socio-cultural factors that influence infant mortality abound. UNICEF (2008:16) reports that it is believed that tribal marks which pose health hazards is one of the practices influenced by culture and is observed in some parts of Nigeria. The type of incision made for scarification especially with unsterilized razor blades may lead to infant death. Therefore, such beliefs have made the task of reducing infant mortality, very difficult especially in Nigeria.

Additionally, efforts to promote general awareness of public health issues, which is the traditional goal of information, education, and communication programs have built a good foundation for health activities. Mothers should be thought that exclusive breastfeeding for the first six months of life reduces infant mortality linked to common childhood illnesses and under nutrition. The low rate of exclusive breastfeeding in Nigeria may, in part, be due to traditional beliefs, practices and rites. For example, in Yoruba and Bini communities, Davis-Adetugbo (1997) cited in Agho, Dibley, Odiase, & Ogbonmwan, (2011) says exclusive breastfeeding is considered dangerous to the health of the infant who is thought to require water to quench thirst or stop hiccoughs. Furthermore, because the majority of women deliver outside health facilities across the community, the Baby-Friendly Health Initiative strategy alone may not have a positive effect on exclusive breastfeeding rates (Agho et al 2011).

As such, radio programmes, for instance, should centre on teaching the community women that breastfeeding is a key tool in improving child survival and exclusive breastfeeding for the first six months of life can avert up to 13 per cent of infant mortality (UNICEF 2008).

Therefore, for such health programmes on radio to be effective, they need to influence nursing mothers and health care providers to modify their behaviours in ways that will promote healthier lives. This is in order to correct some traditional belief as Umoh et al (1996) explains that the divination system through which the oracle (Babalawo in Yoruba, Dibia in Ibo, Boki in Hausa etc) communicates messages between the people and the gods of their fore-fathers is still practiced. The importance of this is that for those who believe, information given by the oracle greatly affected their lives and behaviours. Therefore, this can influence their attribution of illness.

As such, radio health programs on infant mortality must work to influence nursing mothers to take preventive action at the household level, and build effective community support for health-seeking behaviours. This would go a long way in changing the attitudes and behaviours of the communityŸs attribution to illnesses and also reinforce the desired healthy behaviours of nursing mothers.

1.2 STATEMENT OF THE PROBLEM

The purpose of the family as a social institution in all societies whether simple or complex is to procreate in order to perpetuate the society by providing it with new members. And also to protect the child until he/she is able to take care of himself/herself and to train him/her in socially acceptable behaviour and norms. In African societies, the duty of taking care of infants usually rests on women. Thus Palmer (2001) opines that women in the traditional society were by social and physiological make-up responsible for child rearing and home keeping.

The reports of infant mortality abound in our newspaper reports, radio, televisions and oral media. Hornby (2000) reports that every year, nearly 11 million children die before reaching their fifth birthday; and most often they die within their first year of life. And most of these deaths take place mainly in developing countries of Africa, Asia and Latin America. This is very worrisome. Also, 340,000 infants die every year during delivery and shortly afterwards especially if the mother dies in child birth (WHO, 2006).

In Nigeria, for instance, it was reported from the National Demographic Health Survey (NDHS) (2008) that the infant mortality rate was 75 per 1,000 live births on average. The data were presented as follows: NDHS (2003) 100 per 1,000; 1990 was 87 per 1000 and 1999 was 75 per 1000. This tended to show that infant mortality is more or less on the increase in Nigeria.

The challenges became what are the strategies and programmes for empowering nursing mothers to reverse this trend in our society. Despite the involvement of government and non-governmental organizations in encouraging mothers to practise exclusive breast feeding, the trend continue to worsen. This therefore leads to increased infant mortality rate in the country. It is believed that this trend could be reversed. Slusser & Lange (2002) have suggested exclusive breast feeding among nursing mothers to the babies for six months. Yet this has not worked as some mothers fail to give the natural milk to their babies up to this recommended time, mainly because many employers and bosses frown at mothers coming to work with their babies and this disturb the nursing mothers psychologically; hence they resort to giving their babies industrial and artificial cow milk instead to lessen their problem.

Similarly, the media have been in the forefront for the campaign on meeting the 2015 target of the Millennium Development Goals (MDGs) in Nigeria, of which radio have identified with. Thus, Goal (4) of the MDGs which directly addresses the reduction of infant mortality by two thirds between 1990 and 2015, makes it expedient for an appraisal of radio programmes as a campaign tool for empowering nursing mothers particularly and the public in general on infant health.

1.3 AIM & OBJECTIVE OF THE STUDY

The main objective of the study is to examine the role of radio programmes in empowering nursing mothers to curb infant mortality in Kaduna state. Specific Objectives of the Study:

To determine the extent of media coverage on infant mortality in Nigeria;
To show the role of radio programmes in empowering nursing mothers about infant illnesses;
To find out if radio stations in Kaduna state package relevant programmes to empower nursing mothers, such as the practice of exclusive breastfeeding, immunisation and etc;
To identify the problems associated with infant mortality and the role of radio programmes;
Suggest communication improvement measures to reduce infant mortality in Kaduna state.

1.4 RESEARCH QUESTIONS

The study shall attempt to answer the following questions:

Is the media effective as a medium of educating nursing mothers about infant illnesses?
What are the problems militating against the use of radio in solving the problems of infant mortality?
Are radio stations in Kaduna state packaging relevant programmes to empower nursing mothers such as the practice of exclusive breastfeeding, immunisation and etc?
What roles are radio programmes playing in addressing the problems of infant mortality?
How can relevant radio programmes create the necessary awareness to reduce infant mortality in Kaduna state?

1.5 SIGNIFICANCE OF THE STUDY

The study seeks to contribute to knowledge on areas of infant health and communication measures to empower nursing mothers in addressing the scourge of infant deaths in Kaduna state, and Nigeria as a whole. There is a dearth of research from the perspective of communication as it relates to infant health in Nigeria. Therefore, this study becomes imperative at a time like this that Nigeria is seeking to meet the MDGs target of 2015.

The result of the findings shall educate women generally on the best practices for the upkeep and growth of their infants. Thus, it would encourage media practitioners to direct more attention and coverage to maternal and child health issues particularly infants as it pertains to the MDGs Goal.

Nursing mothers would also be empowered to be proactive in the fight against infant mortality in Nigeria which would go a long way in improving the child health status of the country. Hence, the study revolves around the family, it would be relevant to all Nigerians seeking to have children in future.

1.6 SCOPE OF THE STUDY

The study shall focus on nursing mothers in Kaduna state and using radio programmes to empower them in the fight against infant mortality. NDHS (2008) revealed that Kaduna State has high infant mortality rate of 115 per 1,000 live births and a burden of disease profile. Kaduna state shall provide a comprehensive study area of infant mortality and using relevant radio programmes to empower nursing mothers.

1.7 LIMITATIONS OF THE STUDY

The major limitation in the review of relevant literature is the dearth of literature in the humanities as regards infant mortality and empowering nursing mothers. Also, in the pilot study, the midwives/nurses refused to grant the researcher interview in order to test the validity and reliability of her instruments. Also, most women found on the streets in the course of the study did not accept to grant the researcher interview or answer questionnaires as it looked sort of suspicious to them. Therefore, the major limitation of the study is that nursing mothers outside the hospital facilities could not be reached as they are scattered all around the city of Kaduna state. And because of the literacy level of the populace, most nursing mothers refused to cooperate with the researcher.

1.8 DEFINITION OF KEY TERMS

All key terms used in this study are defined within the context for which they were used in order to give a proper understanding of how they operate.

Radio Programmes: specific radio programmes that focuses on maternal and child health in the radio stations broadcasting in Kaduna state.

Radio Stations: A radio station is a set of equipment necessary to carry on communication via radio waves.

Nursing Mothers: are lactating women caring for infants not more than one year old.

Infant Mortality: is the death that occurs among children before their first birthday.

Empowerment: is the required information necessary to equip nursing mothers on how to avert infant deaths.

Behaviour Change: improved behaviour among nursing mothers in the different communities of Kaduna state on infant health.

Cultural Beliefs: the belief that the death of an infant is caused by some sort of divinity like the anger of gods, an žogbanjeŸ child that is best to be left to die, the dictates of village žoracleŸ or priest and similar beliefs.

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