FACTORS INFLUENCING UTILIZATION OF PREVENTION OF MOTHER TO CHILD TRANSMISSION

FACTORS INFLUENCING UTILIZATION OF PREVENTION OF MOTHER TO CHILD TRANSMISSION (PMTCT) SERVICES AMONG PREGNANT WOMEN

CHAPITRE ONE

INTRODUCTION

1.1 Background of the Research

There is no dispute about the ubiquity of harmful beliefs and resultant unfavorable attitudes toward the mentally ill (Thara and Srinivasan 2000; Murphy 2002; Botha et al. 2006). The purpose of this study is to uncover the persisting socio-cultural issues that impede the acceptance of mentally ill people in Nigeria, particularly among health care practitioners in Ogun State. Because it is largely subjective, the concept of mental health or illness has a problematic definition. It can only acquire near consistency of meaning in the medical arena, despite the fact that achieving a complete condition of mental health or well-being is nearly impossible. Sufferers of mental illness are members of society, yet they are viewed differently (C.M.H.A. 1993; Murphy 2002; Paterson 2006). As a result, social reactions to the mentally ill differ from one another, because a people’s culture is also a model for human behavior.

African communities have an unusual attitude toward the sick or mentally ill, as evidenced by rejection, disdain, and a negative perception of the sick person (Sharma 1998; Mohammed et al. 2004; Mohammed and Mohammed 2008). A mental disease is a disturbance of one or more of the mind’s functions, such as emotion, perception, memory, or thinking, that causes the person pain and shame in the family and society. There are many different types of mental disorders, but the most prevalent and comprehensive category includes psychoses, neuroses, and mental retardation. Environmental or cultural influences, as well as physiological malfunctions and inheritance, can all contribute to mental disease; they are referred to as functional and organic psychoses, respectively.

According to Allport (1961), an attitude is a “mental and neural state of readiness organized through experience, exerting a dynamic influence upon the individual response to all objects or situations with which it is associated.” Similarly, (Ewhrudjakpor 1995; Mohammed and Mohammed 2008) defines an attitude as a “learned orientation or disposition, toward an object or situation, providing a tendency to respond favorably or unfavorably to the object or situation.” Regardless of how strong these definitions are, it was (Zimbardo and Ebbesen 1969) that defined attitude as “a predisposition, toward any person, ideas, or objects, containing cognitive, affective, and behavioral components.”

Thus, an individual’s disposition becomes an attitude if it includes aspects of knowing and acting. According to Zimbardo and Ebbesen (1969), the affective component of our attitude is a person’s appraisal of liking or emotional response to particular objects or people. The cognitive component is concerned with how an object or person is seen. It is, in fact, the mental image generated in the brain of the individual. This encompasses the individual’s ideas, opinions, and knowledge about the item. The behavior component consists of the person’s overt actions aimed against another person, group of people, or item.

Nigerians make assumptions about their opinions toward those suffering from mental illnesses. In most circumstances, they do so stupidly (Ugwuegbu 1994). According to (Heider 1958), attribution theory describes the rules humans employ to infer the causes of observable behavior. He separates this process into two parts: dispositional attribution and situational attribution. The process of attributing a person’s actions to internal dispositions (attitudes, features, motives) is known as dispositional attribution. While situational attribution refers to attributing a person’s actions to environmental factors such as witchcraft, poverty, beliefs, and so on.

Despite the fact that mental health issues are quite frequent in our culture, people with mental diseases have historically been stigmatized. According to one study, public views toward people with mental illnesses in England and Scotland deteriorated between 1994 and 2003 (Mehta N, et al, 2009). Stigma is supposed to prevent people suffering from mental illnesses from receiving proper medical assistance (Jorm AF, 2000). Lack of information of psychiatric illness may impact stigmatizing attitudes about mental disorders (Schomerus G, Angelmeyer MC, 2008), and contact with people with mental disorders may lead to more positive attitudes and enlightened perspectives. SJ Addison and SJ Thorpe (2004).

1.2 Statement of the Problem

Mental illness is a diseased condition that is considered undesirable for both the affected individual and society because it interferes with the normal functioning of the individual’s mental, psychological, and emotional make-up, blurring the capacity for insight, orientation, judgment, thought, mood, and perception (WHO 2001; WPA 2002). Most traditional communities in Nigeria should look after the mentally ill because they are still a part of the community and there are possible traditional therapeutic regimens to bring them to a relative state of normalcy (Jegede 1981; Adebowale and Ogunlesi 1999; Gureje et al. 2005). In Nigeria, however, the situation is presently different, as mentally ill people remain socially ostracized even after they have been treated (Jegede 2005; Brinn 2000; Binitie 1970). This is in contrast to the communal and close-knit kinship system that characterized African communities and in which each person is responsible for the well-being of the other (Ayorinde 1983). Because their consciousness is affected, mentally ill people are a nuisance, which is why they require treatment and rehabilitation. However, the Nigerian situation is quite different, as the government and the family unit have not done much towards their rehabilitation, as many mentally ill people are not taken care of and are allowed to become vagrants. Furthermore, health workers who should know better appear to have a negative attitude toward such sick people. There is also the issue of cultural elements, which designate such persons as evil possessed and ‘infected’ with witchcraft. The majority of Nigerians think that mental illnesses are caused by supernatural forces (Udoh 2002). As a result, they maintain the unconventional notion that only traditional and syncretic religious healers can provide more effective and long-lasting treatment than orthodox health practitioners.

1.3 The Study’s Aims and Objectives

Healthcare personnel have frequent contact with people suffering from mental illnesses; thus, the purpose of this study is to analyze health workers’ attitudes toward psychiatric patients. This can be further subdivided into the following goals:

i. Determine the causes of healthcare staff’ negative attitudes toward psychiatric patients.

ii. Determine whether adequate healthcare equipment and facilities exist to care for the mentally sick.

iii. To ascertain the effects of fear on health personnel’ attitudes toward psychiatric patients.

iv. To propose essential solutions to the identified difficulties.

1.4 Research Suggestions

i. What are the causes of healthcare staff’ bad attitudes toward psychiatric patients?

ii. Is there adequate healthcare equipment and facilities to care for psychiatric patients?

Is there a link between fear and health personnel’ attitudes toward psychiatric patients?

iv. What are the most likely remedies to the problems identified?

1.5 Proposals for hypotheses

H01: There is no statistically significant link between medical expertise, cultural beliefs, and health personnel’ attitudes toward the mentally ill.

H02: There is no statistically significant association between fear and health workers’ attitudes toward the mentally ill.

1.6 Importance of the Research

This survey will provide information on Nigerians’ overall attitudes toward the mentally ill, particularly health personnel. It will also enhance people’s general knowledge of mental illness, correct all misconceptions about the disease, and push governments and non-governmental organizations to provide more readily available resources for treatment facilities and rehabilitation of mentally ill people.

1.7 Scope of the Research

For the sake of this study, we will solely look at the Federal Neuropsychiatric Hospital in Aro, Abeokuta. As a result, the scope of this study is limited to the Abeokuta area of Ogun State, as additional areas will not be investigated.

1.8 Definitions of Terms

Attitude: a person’s or thing’s way, temperament, attitude, position, etc.; a propensity or orientation, especially of the mind.

Health Workers: These are individuals whose job it is to safeguard and improve the health of their communities.