AN ANALYSE OF INFANT MORTALITY RATE IN ABIA STATE (A CASE STUDY OF FEDERAL MEDICAL CENTRE UMUAHIA FROM 1995 TO 2004)

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 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.