REPORT ON THE COMMUNITY HEALTH ASSESSMENT (DIAGNOSIS)

OF IBIDO COMMUNITY, SAGAMU, OGUN STATE.

(MAY, 2024)

BY

GROUP B

2023/2023 PRE-CLINICAL SESSION

CERTIFICATION
This is to certify that this is a record of the original research work carried out by
the entire members of GROUP B of 2023/2024 preclinical students of the faculty
of Basic Medical Sciences, Olabisi Onabanjo University Teaching Hospital,
Sagamu, Ogun State.

….…………………..
……………………….
Dr. Jeminusi Dr. Alabi
Consultant supervisor Head of department

I
 DEDICATION
We express our gratitude to the divine for guiding us through this research
endeavor. Our heartfelt dedication extends to our mentors and supervisors in
Community Medicine, as well as to the esteemed King and residents of Ibido
community.

II
 ACKNOWLEDGEMENT
We extend our heartfelt thanks to God for granting us wisdom and resilience
throughout our research journey. This report stands as a collective effort, and
we acknowledge the significant contributions of numerous lecturers, supervisors,
and community health consultants (namely, Drs. Alabi, Mautin, Jeminusi, and
Amoran). Special appreciation goes to those who provided guidance and
meticulously reviewed our manuscripts; your mentorship is truly valued.

Gratitude is also extended to the King and residents of Ibido community for
their indispensable cooperation and warm hospitality. We are equally indebted
to Miss Osoba and Mrs. Onakoya, our field supervisors, for their unwavering
support during our community fieldwork.

Lastly, we extend our sincere appreciation to all individuals who directly or

indirectly aided us in the successful completion of our literature review and field
research..

III
GROUP MEMBERS
1. ADESINA OLORUNTOMI JOHN MED/21/22/0013
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.

IV
32.
33.
34.
35.

V
TABLE OF CONTENTS
TITLE PAGE
CERTIFICATION
DEDICATION
ACKNOWLEDGEMENT
GROUP MEMBERS
TABLE OF CONTENT
LIST OF TABLES

CHAPTER ONE...........................................................................................................1
1.0 INTRODUCTION..................................................................................................1
1.2 STATEMENT OF PROBLEM.............................................................................2
1.3 OBJECTIVES.........................................................................................................2
1.3.1 General Objective:.................................................................................................2
1.3.2 Specific Objectives:...............................................................................................3
1.4 JUSTIFICATION OF STUDY.............................................................................3
1.5 IBIDIO COMMUNITY.........................................................................................4
1.5.1 Ancestry and Migration.........................................................................................4
1.5.2 Political Dynamics:...............................................................................................4
1.5.3 Socio-economic dynamics.....................................................................................5

VI
VII
 CHAPTER ONE

1.0 INTRODUCTION

Communities residing in the periphery of societal structures often exhibit heightened

vulnerability to health risks. This susceptibility arises from various factors inherent in
rural environments, as highlighted by ‘Suluku et al. (2024)’. Notably, the consistent
interaction between rural inhabitants and both domestic and wild fauna significantly
amplifies their exposure to communicable diseases. Moreover, ‘Derek et al. (2022)’
underscored the prevalent inadequacy of potable water sources in these locales,
further exacerbating the incidence of water-borne illnesses within these communities.
Malnutrition is another pivotal determinant predisposing rural populations to various
ailments (Weber, 2024). Additionally, divergent health-seeking behaviours,
characterized by reliance on alternative healthcare providers, coupled with challenges
in accessing and affording services from conventional healthcare facilities, compound
the health-related predicaments encountered by these communities. Consequently, a
proactive approach is imperative, wherein pre-emptive community diagnosis assumes
paramount importance in safeguarding community well-being. Rather than adopting a
reactive stance that responds solely to individuals after they have transitioned into
patients, prioritizing community-wide health assessments allows for the anticipation
and mitigation of potential health threats.

Furthermore, it is imperative to acknowledge that amidst these challenges, rural

settings harbour indigenous systems that function effectively. Engaging in community
diagnosis offers a twofold opportunity: first, to gain insights from these existing
systems, and second, to proffer tailored recommendations aimed at augmenting and
complementing established practices. This approach recognizes pragmatic constraints
that often preclude the wholesale replacement of existing systems within rural
contexts and advocates for synergistic enhancements. For instance, initiatives may
incentivize traditional birth attendants to refer complex cases to nearby healthcare
facilities, thereby fostering a collaborative healthcare ecosystem. In essence,
community diagnosis serves as a foundational pillar for effectuating targeted
interventions and formulating actionable recommendations conducive to enhancing
the health trajectories of rural communities. By undertaking comprehensive

1
assessments of the prevailing health dynamics, stakeholders can delineate informed
strategies aimed at fortifying community resilience and ameliorating health outcomes.

1.2 STATEMENT OF PROBLEM

Worldwide, rural communities face numerous health challenges due to factors that
predispose them to poor health outcomes. These challenges are particularly
pronounced in developing countries, where the interplay of poverty, ill health, and
low productivity creates a downward spiral for many rural populations (Strasa, 2003,
Kumar & Kumar, 2019). The field of community medicine has evolved to address
these issues by promoting healthier lifestyles among rural dwellers through
interventions based on cross-sectional community studies.

In Nigeria, rural communities confront several daunting health challenges, including

inadequate access to clean water and healthcare facilities (Tesole et al., 2022).
Unhygienic conditions and certain cultural practices incompatible with good health
exacerbate these issues, often leading rural and peri-urban populations to adopt
various health-seeking behaviors in response to the lack of conventional healthcare
(Sinharoy et al.,2019)

The Ibido community, a peri-urban settlement near Sagamu, exemplifies these

challenges. It comprises a mix of residential and rural populations, highlighting the
urgent need to assess the community's health status. This assessment is crucial not
only for planning targeted interventions but also for extracting lessons that could
enhance the broader practice of community diagnosis.

1.3 OBJECTIVES

1.3.1 General Objective:

The general objective of this study was to survey community health needs in Ibido
community.

2
1.3.2 Specific Objectives:

1.To assess the prevalent health-related problems in the Ibido community.

2.To investigate the quality of water, sanitation, and hygiene in the Ibido community.
3.To examine the nutritional status of households in the Ibido community.
4.To assess the health-seeking behaviors of families in the Ibido community.
5.To make reasonable recommendations that would further foster good health and
health practices in the Ibido community.

1.4 JUSTIFICATION OF STUDY

Peri-urban areas, strategically located near urban centers, yet maintaining many rural
characteristics, are significant in nations such as Nigeria. Despite congestion in urban
regions, a considerable segment of the population live in these rural and peri-urban
communities. Hence, prioritizing health and well-being is essential for overall societal
health
These communities face diverse challenges. Nwokoro et al. (2020) pointed out issues
ranging from inadequate hygiene practices to a lack of safe water for drinking and
bathing in rural areas of Enugu, Southeast Nigeria, which often predisposes these
areas to epidemics.
In many African rural and peri-urban regions, agricultural practices dictate lifestyles,
with residents consuming seasonal carbohydrate-rich diets that are necessary for
labor-intensive farming. This contrasts with findings from other regions, such as the
Arctic city studied by Heuet et al. (2017), where no seasonal variations in food
security were observed despite the community's partial reliance on subsistence
livelihoods.
Moreover, the availability and accessibility of healthcare in remote or peri-urban areas
is severely limited. Many areas are equipped only with primary healthcare facilities,
which are often understaffed because of healthcare professionals' reluctance to work
in less-developed settings (Cao et al., 2021). Sociocultural factors also significantly
impact healthcare utilization. Deborah et al. (2020) demonstrated that local beliefs
and economic barriers restrict access to modern medical services in Uganda.

3
Considering these challenges, it is critical to conduct regular community diagnoses in
rural and peri-urban areas to enhance health and implement the necessary
interventions. This is particularly urgent for communities like Ibido settlement near
Sagamu, which has over 1,000 residents and has not undergone any published
community health analysis in the last decade. The lack of recent data highlights the
importance and urgency of the present study.

1.5 IBIDIO COMMUNITY

HISTORY OF IBIDO COMMUNITY

Ibido community is a significant community in the present day Sagamu Local

Government Area of Ogun State, Nigeria. It is situated in a peaceful rural setting and
is located under ward 15 of the Sagamu LGA.
Ibido is one of the 40 traditional towns of Remoland, South western Nigeria. Ibido
also happens to be one of the 13 towns including Makun, Igbepa, Offin, and others
that united to form Sagamu in 1865. Despite its small size, Ibido community has a
remarkably rich cultural heritage.
Origin
Ibido originated from the Old Ilé Ifè known as the the Ancestral Home of all Yorùbá
people. It was originally known as Ubido compound in Ilé Ifè and was close to the
Ìremo compound which is the present day Remo kingdom.
Migration and Settlement
Their forefathers were hunters and often called the real warriors. Due to their nature
and means of survival, they migrated from Ile Ife and branched at three different
places before settling on where is known as Orile Ibido around 600-700AD based on
the guidance of their gods. Orile Ibido is also called Aladie presently due to poultry
business prevalent in that area and is located after government secretariat just before
toll gate Sagamu along Sagamu-Benin expressway.
Due to wars, the Ibido people fled Orile Ibido to settle settle in their current location
in the present day Sagamu in
1865. They settled there just before Makun and Igbepa. Their land extended up to the
present day Central Mosque and as far as Falawo market. Due to the generosity and
kindness of the Ibido people, Makun and Igbepa we given part of the land to also

4
create a settlement from themselves. Makun and Igbepa were part of the 13 towns
who fled their original settlements in times of war to form the modern day sagamu.
Ruling Houses/ dynasties
Originally, there were 3 ruling houses in Ibido Kingdom but during the reign of the
maternal grandfather of the present King(HRH Alayeluwa Oba Kolawole Adesina
Adeyemi Solomade I) In 1957, a fourth ruling house was added,which was gazetted in
1958 expanding the number of ruling families in the town. Here are the 4 ruling
houses of the present day Ibido town:
•Obayorunwa ruling house
•Ayangbuwa ruling house
•Deruwa ruling house
•Solomade ruling house
Royal fathers
The Kingship of Ibido- town is rotated among the four dynasties. When the time
comes for a new king to ascend the throne, the kingmakers ('afobaje') consult the ifa
oracle to select the incoming King from the next Ruling House in succession. The
Afobaje include;
–Lisa
–Oluwo
–Apena
–Olotu Omoba
–Olotu Iwarefa
–Olotu Ijo
–Losi
–Ogbeni odi
The last two kings of Ibido town have been:
● HRH Oba Taoreed Adebayo of Obayoruwa ruling house.
● HRH Oba Olufemi Akinsanya of Lenuwa ruling house.
HRH Ayeluwa Oba Kolawole Adesina Adeyemi Solomade I; Negbuwa of Ibido is the
current King of Ibido community.
Hierarchy/ Rulership
In the palace of the Negbuwa of Ibido Land, there is a certain hierarchy which ensures
the maintenance of law and order. As at the time of this documentation, this is the
palace hierarchy in Ibido land as well as the current occupants of the seats:

5
•Kabiyesi- HRH Alayeluwa Kolawole Adeyemi Adeshina
•Lisa- High Chief Samuel Oludayo Osho
•Oluwo- High Chief Morayo Eniitan Kalejaiye
• Losi- High Chief Kayode Soremekun
•Odofin- High Chief Ayo Olugbenga Oredeko
•Iyalode- High Chief Abosede Sotunbo
There are other prominent positions in Ibido land that help to maintain order, and
these include:
•Apena- High Chief Samson Ogundalu
•Olotu Iwarefa- High Chief Olugbenga Oredeko
•Olotu Omooba- Chief Musa Ayodele
•Olotu Ijo- Chief Bashiru Hassan (Elemosho)
•Abgon- Chief Olusegun Oduntan
•Jagun- Chief Olufemi Sosanya
•Otunba Okunrin- Otunba Jeje Lambo (Jenise)
•Otunba Okunrin- Otunba Sotumbo
•Otunba Okunrin- Otunba Dele Adenuga
•Otunba Obinrin- Otunba Tawa Afolabi
•Baale Tajudeen Ogunowo
•Erelu- Chief Mrs Khadijat Olukoya
•Yeye Ase- Mrs Olutayo Oyekanmi
•Olori Awode- Mrs Falilat Lasisi
•Iyalode Ase- Mrs Oyetola Ibimo
•Baale Nurudeen Elegbeji of Elegbeji village
•Baale Tajudeen Ogunowo
Each of these dignitaries have their specific duties: Kabiyesi is the overall head and
ruler of the kingdom, Lisa is his right hand man and second in command (although he
can never be king himself), the Oluwo is the head of the Iledi section of Ibido Land,
Apena is the man in charge of Public Relations in the palace, to mention a few.
Some of these dignitaries are heads of subkingdoms while others simply attend to
specific needs. These include Olotu Iwarefa(whuch is important in averting
foreseeable dangers through ominous signs in the spiritual realm through rituals)
These levels of administration ensure the sane progression of events in the land.

6
Customs and Traditions
Just like many other communities, the Ibido community has certain traditions which
are peculiar to them, some which similar are to those of other communities and some
which are entirely unique.
When it comes to the deities they worship, there are at least four of them
which have their listed individual festival periods below:
•Odun Agbodu- August
•Odun Oro- September
•Odun Eluku- September
•Odun Agemo- July
•Odun Balufon

The deity which is peculiar to Ibido town is Agbodu, which is believed to be the
protector of the people, and prevents people from practicing dangerous and dark
magic as there will be dire consequences. The festivals of the above listed gods would
involve periods of making traditional rituals and presenting it to their gods in
specific locations in their community. It would also involve merriment and
celebration for those things which they claim their sacrifices enable the gods to
provide to them: Agbodu is believed to be responsible for all-round success; Oro and
Eluku forestall bad happenings; Agemo protects the children of the land. Of all the
gods they worship, Agbodu is the most worshipped god and it is uniquely worshipped
in Ibido land and believed to be the protector of Ibido town however, the Agemo
festival brings home many indigenes from far and wide for celebrations. Another
commonly celebrated festival in Ibido and its related communities is the Balufon
festival which also unites people after long times of being separated by distance.
The taboos of Ibido community are a list that is probably non exhaustive as some are
general to the community while some are specific to periods of rituals and individuals
involved in the activities. Flaunting any of these may result in a mysterious
disappearance, bad luck or even death. Some of them include:
• One must not use evil charm
• Uncleanliness (anything that interrupts the purity of indigens) of any sort before
rituals are made is forbidden, e.g sexual relations, eating specific foods such as
groundnut (epa) or melon seed soup (egusi), getting distracted by appetizing farm
produce on the way to/ at the ritual site, etc.

7
•Two siblings do not go to worship a particular deity at the same time
•Women are disallowed from seeing deities during rituals or periods where sacrifices
are made.
These taboos serve to provide a means of identification for the people of Ibido Land.
Another important way wherein people of Ibido land can be recognized is by their
peculiar oriki, a eulogy developed to praise natives and remind them of their heritage:
Omo Agbodu
Omo ibido elewa ala
Omo ibido Ote.
In addition to their hierarchy, there are certain distinctive features of the dressings of
the Chiefs such as colour of the beads(blue, red and black); adornment of high chiefs
with a cow-skin looking cloth known as Saki which is worn on the shoulder by Chiefs
bearing their Family's title. As such, the Otunba and Baale do not use Saki. When a
chief or important person dies, the entire chiefs are present and an etutu (ritual) is
performed before the person is buried.

Trade and Commerce

The people of Ibido community possess a large heart indeed and it reflects in their
business endeavours. There is no business they cannot get involved in, provided it
will not stand as a contradiction to the ways of the land and its gods. In other words,
all means lead to an end of money making for them, provided the means are not an
abomination. In their parlance, any good thing can bring aje (the god that ensures that
good returns and sales come to them). The festival of this god is not celebrated locally
in Ibido, however. Due to the fact that they are not at currently situated at the final
settlement of the people, they do not really have many standard infrastructure.
However, these are already in view and would be in full fledged use at later dates.
Proposed landmarks for the new Orile Ibido community in Sagamu would include:
General Hospital, Market, police station, government school, hospital, etc
.

8
 CHAPTER TWO

2.0 LITERATURE REVIEW

2.1 Community
A community embodies individuals sharing common beliefs, traditions, customs, and
language, residing in a specific area characterized by stability and distinct identities.
Communities vary from family to village, with designated leaders chosen by members
fostering a shared sense of coexistence.
2.1.1 Types of Communities
1. Communities based on interests: Individuals with similar passions or hobbies
connect through common pursuits (Smith 2007).
2. Action-oriented communities: Collective missions to enact changes or improve
specific aspects of their environments (Davies 2010).
3. Place-based communities: Rooted in geographical boundaries, uniting individuals
in the same area (Porter and Shaw 2017).
4. Practice-based communities: Comprising professionals or individuals in similar
fields is bonded by shared expertise and activities (Wenger, 1998).
5. Circumstance-based communities: Emergence from external events or situations,
bringing individuals together due to shared challenges or circumstances (Williams &
Hall, 2000).
2.1.2 Organization, Functions, and Roles of the Community
Community organizations aim to positively impact social health, overall well-being,
and functional efficiency across various contexts. Community organizations serve
engagement and empowerment goals, enhancing internal capacities and marginalized
group influence (Hardcastle et al., 2011; Minkler, 2013; Green & Haines, 2012;
Horton & Freire, 1990; Warren, 2017).
Communities fulfill key roles and functions, including economic activities,
socialization, social control, community engagement, and mutual support (Warren,
1978).
2.2 Health
The World Health Organization (WHO) defines health as 'a state of complete
physical, mental, and social well-being and not merely the absence of disease or
infirmity' (WHO, 1948). Widely accepted among health professionals and

9
researchers, this definition emphasizes that good health goes beyond simply being
free from illness; it entails functioning well across various aspects, including
biological, psychological, social, and spiritual dimensions. Achieving comprehensive
well-being relies on access to health care, nutrition, exercise, and supportive
relationships.
In contrast to the traditional medical model, which focuses solely on the absence of
disease and clinical intervention, this definition aligns with the biopsychosocial health
model that considers physiological, psychological, and social factors.
However, some critics have argued that this perspective may be impractical,
suggesting that most individuals remain unhealthy for prolonged periods of time.
Additionally, it may overlook the growing population grappling with chronic illnesses
and disabilities, potentially contributing to overmedicalisation. An alternative
definition, proposed by Huber et al. (2011), defines health as 'the ability to adapt and
self-manage,' recognizing an individual’s capacity to adapt to circumstances as
essential for health. This viewpoint acknowledges the subjective nature of health,
which varies depending on individual contexts and needs, although some see this
subjectivity as a limitation owing to its lack of objectivity and measurability.
2.3 Community Health
The development of public health has resulted in significant modifications to methods
used to enhance the health of community members. It is still difficult to adequately
characterize community health and distinguish it from the adjacent fields of public
health practice, community involvement, or other relevant community development
initiatives (Goodman et al., 2014).
The term ‘community health practice’ describes the delivery of healthcare services
with the goals of early disease diagnosis, identification of occupational and
environmental risks to health, and disease prevention within the community. The goal
of the Nigerian model of community health practice is to enhance community health
and well-being using an all-encompassing and inclusive strategy. It stresses the
empowerment of people and communities to take charge of their own health and
acknowledges the significance of community involvement in healthcare decision
making (Dotimi et al., 2023).
Social determinants of health (SDOH) play a pivotal role in shaping community
health outcomes. According to the World Health Organization, SDOH is a condition
in which people are born, grow, live, work, and age’ (WHO, 2012). These factors

10
include socioeconomic status, education, physical environment, employment, social
support networks, and access to health care. Braveman and Gottlieb (2014)
highlighted the profound impact of these determinants on health disparities, indicating
that individuals from lower socioeconomic backgrounds are more likely to experience
poorer health outcomes due to limited access to resources and opportunities.
2.3.1 Major Community Health Problems
A health issue can be characterized as the gap between the current situation and the
desired state (Smith, 2007). Community health problems may arise internally or
externally (Brown et al. 2015). Health challenges can present varying levels of
severity (Johnson et al., 2020).
Examples of Community Health Concerns
1. Child Abuse: Extending beyond physical harm, child abuse encompasses any
mistreatment by adults that threatens the child (Gilbert et al. 2009).
2. Domestic Violence: Acts of violence within a
victims’ domestic sphere involving partners, family members, or close relatives
(García-Moreno et al., 2006).
3. Access to Nutritious Food: Ensuring that individuals have the resources to obtain
the necessary food for proper nutrition (FAO et al. 1996).
4. Accidental Injuries: Unintended incidents occur without direct intent (World Health
Organization 2008).
5. Teenage Pregnancy: A significant contributor to maternal and child mortality, with
associated health risks for pregnant adolescents (UNFPA et al. 2021).
6. Substance Abuse: Excessive consumption of psychoactive substances can lead to
physical, social, or emotional harm (NIDA et al. 2021).
7. Depression: Conditions involving mood fluctuations, including bipolar disorder
(World Health Organization 2021).
8. Sexually Transmitted Diseases: Infections transmitted through sexual contact (CDC
et al. 2021).
9. Access to Clean Drinking Water: Inadequate sanitation is linked to transmission of
waterborne diseases (WHO et al., 2018).
10. Illiteracy: Low health literacy is associated with poor health outcomes (Berkman
et al., 2010).
2.3.2 Factors Affecting Community Health

11
Community health is influenced by various factors and faces numerous challenges
that affect the well-being of both individuals and communities.
1. Lack of Access to Healthcare.
Limited availability of healthcare facilities in underserved areas (Adebayo et al.,
2019).
- Shortage of healthcare professionals, particularly in rural communities (Ogunbode et
al., 2020).
Financial barriers and high healthcare costs (Onwujekwe et al., 2018).
2. Socioeconomic Factors:
Influence of socioeconomic status (SES) on health outcomes (Adebowale et al.,
2017).
Educational attainment and its impact on health knowledge and behavior (Kabiru et
al. 2016).
Income inequality is associated with health disparities (Oyekale 2019).
3. Environmental Factors:
- Exposure to environmental hazards such as air pollution and inadequate sanitation
(Akinbami et al. 2021).
Impact of climate change on community health (Oyekale, 2020).
Access to clean water and sanitation facilities (Oyekale, 2018).
4. Lifestyle Choices and Behaviors
- Unhealthy diet and sedentary lifestyle contribute to the rise of non-communicable
diseases (Oyekale, 2017).
Substance abuse and addiction affect community well-being (Adeloye et al., 2020).
Mental health challenges and the need for improved mental healthcare services
(Atilola et al., 2019).
2.4 Community Diagnosis
Community diagnosis involves a thorough assessment of a community's health status
considering its social, physical, and biological environments. The goal was to identify
health issues, assess available resources, and establish priorities for health initiatives
in collaboration with the community.
Community diagnosis typically involves identifying and quantifying the health
problems affecting the entire community, including mortality and morbidity rates. It
also aims to pinpoint the factors associated with these issues, identifying those at risk
or in need of health care services. This process combines aggregate and social

12
statistics with a deep understanding of the local context to determine the healthcare
needs.
2.4.1 Community Health Diagnosis
Community health focuses on the well-being of community members and is often
assessed by examining the social determinants of health (SDOH). These determinants
significantly affect health outcomes and risks.
Communities typically comprise individuals who share common characteristics,
leading to similar health care challenges. Factors such as geographical location,
environment, genetics, income, education, and social relationships significantly
influenced individual health outcomes.
The key components defining a healthy community include economic stability,
education accessibility and quality, healthcare accessibility and quality, neighborhood
and physical environment, and social and community contexts.
Collectively, these social determinants shaped our understanding of healthy
communities.
2.4.2 Methods Used in Community Diagnosis
The four most commonly used methods for community diagnosis are as follows:
1. Data collection: Involve gathering information about prevailing health issues in the
community.
- Engagement with Community Members
- Review of Health Service Records
- Community Surveys or Small-Scale Projects
- Observational Assessment
2. Data Analysis: Involves categorizing collected data into specific groups to extract
meaningful insights.
3. Prioritizing Health Problems: Arranging health issues based on significance and
considering factors such as scale, severity, feasibility of resolution, and
community/government concerns.
4. Developing an action plan: Outline strategies for implementing interventions aimed
at disease prevention and control.
2.4.4 Types of Data to be Collected in Community Diagnosis
The project should gather quantitative and qualitative data, including demographic,
epidemiological, health service, and behavioral data. Population censuses and
statistical data are crucial.

13
2.5 Segments of Community Diagnosis
Aligned with the goals and objectives of our community diagnosis program, this
literature review consisted of eight primary sections.
1. Housing, water, and environmental health
3. Pregnancy and maternal health care
4. Children immunization
5. Prevalent disease
6. Availability of health care facilities
7. Nutritional health
These segments will serve as the focal points of our questionnaires and will enable us
to accomplish the objectives established by our team for community health
assessment.
2.5.1 HOUSING, WATER AND ENVIRONMENTAL HEALTH
A house serves as a vital space where people perform their daily activities and water
is essential for life, emphasizing its crucial role in health. Environmental health
encompasses various physical, chemical, and social factors that influence human
wellbeing. Ensuring a clean and healthy environment is essential to prevent the spread
of diseases.
Access to clean water and safe housing is fundamental for human survival and
welfare, especially in developing nations, such as Nigeria. Promoting awareness and
positive practices regarding environmental health are crucial for maintaining a healthy
living environment. Lack of access to clean water and proper sanitation leads to
numerous deaths globally, and affects productivity and livelihoods.
This study aimed to assess the housing conditions, water safety, and environmental
health of Ibido. The key objectives include understanding water purification methods,
proximity to water sources, community involvement in sanitation, and waste disposal
practices. Ultimately, this study sought to determine whether existing health issues
among residents were linked to water quality and sanitation practices.
2.5.2 FAMILY PLANNING
Family planning is a critical component of reproductive health programs aimed at
promoting maternal and child health, reducing unwanted pregnancies, and
empowering individuals and couples to make informed decisions regarding their
reproductive lives. In Nigeria, family planning initiatives have gained momentum in
recent years; however, significant challenges have persisted.

14
Nigeria, the most populous country in Africa, is facing substantial challenges related
to population growth, maternal mortality, and limited access to reproductive health
services. Additionally, Okigbo et al. (2017), Nigeria's population is projected to
double by 2050, exacerbating the pressure on already strained health systems and
resources. Addressing these challenges requires comprehensive family planning
programs that cater to diverse sociocultural contexts and groups.
Sociocultural factors significantly influence family planning practices in Nigeria.
Traditional beliefs, religious norms, and gender dynamics often shape attitudes
towards contraception and family size preferences (Oye-Adeniran et al. 2014). For
instance, misconceptions about contraceptive methods, fear of side effects, and
opposition from religious leaders can hinder contraceptive uptake by women and
couples (Ijadunola et al., 2015). Understanding and addressing these sociocultural
barriers are crucial for designing effective family planning interventions tailored to
local contexts.
Barriers to Family Planning Access and Utilization
Despite efforts to expand access to family planning services, significant barriers
persist in Nigeria. Supply side challenges, including stockouts of contraceptive
commodities, inadequate healthcare infrastructure, and limited skilled personnel,
hinder service delivery and uptake (Ahanonu et al. 2018). Furthermore, demand-side
barriers, such as low awareness, misconceptions, and socioeconomic disparities,
contribute to low contraceptive prevalence rates, particularly among marginalized
populations (Sedgh et al., 2016). Overcoming these barriers requires a multifaceted
approach that addresses both the supply- and demand-side factors.
Role of Government and Policy Initiatives
The Nigerian government has made significant strides in prioritizing family planning
within the national health agenda, as evidenced by the development of strategic
frameworks, policies, and guidelines to guide program implementation (FMOH,
2017). However, translating policy commitments into tangible outcomes requires
sustained political will, adequate resource allocation, and effective coordination
among stakeholders at all levels (Izugbara et al. 2017).
Community-Based Approaches and Innovative Interventions
Community-based approaches play a vital role in increasing family planning and in
addressing local needs and preferences. Initiatives such as community health outreach
programs, mobile clinics, and peer education have been effective in raising awareness,

15
dispelling myths, and increasing contraceptive acceptance (Adebowale et al. 2019).
Moreover, innovative interventions that leverage technology, such as mobile health
platforms and social media campaigns, hold promise for reaching remote populations
and engaging young people in family planning discussions (Adam et al., 2020).
Reaching family planning goals is a slow process in Nigeria. Funding for family
planning services is uneven and inconsistent owing to its significant reliance on
outside donors. Therefore, increased domestic resource mobilization through
government funding is required. (Mbachu et al. 2023). By prioritizing investments in
family planning and adopting a multi-sectoral approach, Nigeria can empower
individuals and couples to make informed choices about their reproductive health,
leading to healthier families and communities.
2.5.3 PREGNANCY AND MATERNAL HEALTH CARE
Mothers and children make up over 2/3 of the whole population; hence, there is
increasing concern and interest in maternal and child healthcare, that is, health
services provided to mothers (women of childbearing age) and children. The focus of
maternal and child healthcare is the reduction of maternal, infant, and childhood
mortality and morbidity as well as the promotion of reproductive health and the
physical and psychosocial development of the child and adolescent within the family.
(Dash 2017)
Pregnancy and maternal health care are fundamental components of the public health
system. To ensure the well-being of both the mother and child, we examined the
dynamics of pregnancy, maternal healthcare, and the role of local communities in
ensuring positive outcomes for mothers and newborns.

Access to maternal health care: Access to maternal health care services remains a
significant challenge worldwide, particularly in low-resource settings. According to
Ahmed et al. (2020), barriers to access include geographical distance, a lack of
transportation, financial constraints, and cultural beliefs. Ensuring equitable access to
maternal healthcare services is crucial for reducing maternal mortality and improving
maternal and neonatal outcomes (Gabrysch & Campbell, 2009).
Quality of maternal healthcare: The quality of care during pregnancy and childbirth
significantly affects maternal and neonatal outcomes. Bohren et al. (2015) highlighted
the importance of respectful maternity care, emphasizing the need for dignified and
compassionate treatment of women during childbirth. Quality improvement initiatives

16
such as the WHO Safe Childbirth Checklist (Spector et al., 2018) have shown promise
in enhancing the quality of maternal healthcare services and reducing adverse
outcomes.
Maternal healthcare infrastructure in Africa: Africa faces significant challenges in
providing adequate maternal healthcare infrastructure including access to skilled birth
attendants, health facilities, and essential medical supplies. According to Ahmed et al.
(2020), many African countries lack sufficient healthcare facilities and skilled
personnel, which leads to high maternal mortality rates. Limited infrastructure
exacerbates the risks associated with pregnancy and childbirth, particularly in rural
areas where access to healthcare services is scarce (Yaya et al. 2020).
Sociocultural Factors Impacting Maternal Health: Traditional beliefs, practices, and
societal norms often influence women's decisions regarding pregnancy and childbirth
(Adjiwanou and Legrand 2013). For instance, cultural preferences for home births and
reliance on traditional birth attendants can hinder access to skilled maternal health
services (Chimatiro et al. 2018). Additionally, socioeconomic disparities and gender
inequalities contribute to disparities in maternal healthcare utilization, with
marginalized women facing greater barriers to accessing essential services (Tarekegn
et al., 2019).
Community-based Interventions: Recognizing the importance of community
involvement, several initiatives have focused on improving maternal health outcomes
through community-based interventions. These interventions leverage existing
community structures, such as women's groups, community health workers (CHWs),
and traditional leaders, to promote maternal health education, antenatal care, and
skilled birth attendance (Colbournet al., 2013). Studies have shown that community-
based approaches can significantly improve maternal health knowledge, increase
antenatal care attendance, and reduce maternal mortality rates in resource-limited
settings (Lewycka et al. 2013).
Role of Technology in Maternal Health: The advent of technology has revolutionized
maternal healthcare delivery in Africa. Mobile health interventions such as text
messaging services and mobile applications have been utilized to disseminate
maternal health information, provide appointment reminders, and facilitate
communication between healthcare providers and pregnant women (Owusu-Addo et
al., 2020). Telemedicine platforms have enabled remote consultations and medical

17
support for expectant mothers in underserved areas, thereby improving access to
skilled maternal health services (Baker et al. 2019).
Challenges and Future Directions: Despite progress in maternal healthcare delivery,
significant challenges persist in ensuring universal access to quality services in
African communities. These challenges include inadequate funding, weak health
systems, cultural barriers, and limited human resources (Amoakoh-Coleman et al.
2016). Addressing these challenges requires a multifaceted approach involving
increased investment in healthcare infrastructure, targeted community-based
interventions, and strengthened partnerships among governments, NGOs, and local
communities.
Pregnancy and maternal health care in African communities are influenced by a
complex interplay of socioeconomic, cultural, and infrastructural factors. Although
challenges remain, community-based interventions, technological innovations, and
collaborative efforts hold promise for improving maternal health outcomes and
reducing maternal mortality rates across the continent. By leveraging local resources
and community networks, stakeholders can achieve equal access to quality maternal
health services among women in local communities.
2.5.4 CHILDREN IMMUNIZATION
Children in sub-Saharan African countries are at risk of being exposed to various
vaccine-preventable diseases, such as whooping cough, chicken pox, measles,
mumps, rubella, diphtheria, and polio. Therefore, immunization of children at specific
periods according to a standard immunization schedule is of utmost importance to
fortify their immune systems against these diseases.
However, in sub-Saharan African countries, complete and effective immunization is
sometimes not achieved, particularly in rural areas.
In an analysis of demographic and health survey data from 25 sub-Saharan African
countries to examine child vaccination (Firew Tekle Bobo et al., 2022), it was
discovered that 56.5% of children received full vaccination, 35.1% received
incomplete vaccination, and 8.4% remained unvaccinated.
In particular, Nigeria suffers from low immunization coverage. According to a
systematic search conducted by Davies Adeloye et al. (2017) on 26,960 children, the
estimated percentage of fully vaccinated children was 34.4%, with the south-south
zone having the highest at 51.5% and the northwest zone having the lowest at 9.5%..

18
According to de Figueiredo et al. (2023), current WHO/UNICEF estimates of routine
childhood immunization coverage reveal the largest sustained decline in vaccine
uptake in the past three decades, with pronounced setbacks across Africa. This study
hints at a decrease in the level of confidence regarding the effectiveness of vaccines.
Factors such as barriers to parent/caretakers, lack of knowledge of immunization,
distance to access points, financial deprivation, lack of partner support, and distrust in
vaccines and immunization programs hinder full immunization coverage. ( Benjamin
et al.,. 2020).
The availability of human resources can also influence immunization coverage. In a
study conducted by Anand and Barnighausen (2007) to test whether health worker
density affects vaccination coverage in developing countries, it was discovered that a
higher density of health care workers improves access to vaccination services, thereby
increasing vaccination coverage.
Appropriate measures must be implemented to increase the immunization rate in
children and minimize mortality.
Therefore, awareness of the effectiveness of vaccines through appropriate
channels( television, radio, news articles, and community health programs),
improvement in the health worker-to-patient ratio, and regular immunization
approaches in rural communities can improve immunization coverage for children in
Africa.

2.5.5 PREVALENT DISEASES

Community diagnosis is an important tool for assessing the prevalence of diseases in
communities, proposing the causative factors of the disease, and providing ways to
stop or reduce the incidence of disease in that community.
A study conducted in Tigray, Ethiopia, to show the prevalence and environmental
determinants of cutaneous, by Mekman et al. (2019) found that the disease was
predominantly zoonotic, and integrated interventions were recommended to stop the
disease.
Another study conducted in nine communities in Nigeria by Owolabi Lukman et al.
(2019) showed that the prevalence of epilepsy in Nigeria was higher in rural areas
than in urban centers.
A study conducted in Hausa Communities in Kano State, Nigeria, identified the
prevalence of malaria in these communities. It also showed that even with a high level

19
of education and a good attitude of the study population towards the disease, there
were still gaps in their knowledge regarding the use of appropriate preventive
practices. Therefore, awareness programs towards the good preventive practices
against malaria was recommended.( Dawaki Salin et al 2016)
Nwaneri et al. (2017) conducted a study in the Umum Orlu local government in Imo
State Nigeria. This study showed that the knowledge and awareness of the
respondents about breast cancer was very low, with some women believing that the
disease was caused by ancestral forces. Therefore, there is a need to improve health
education programs to dispel myths about the disease and improve positive health-
seeking behavior among women.
From these findings, we can infer that the cause of disease prevalence in a community
ranges from low education to zoonotic diseases.
One of our goals in the Ibido community is to identify any prevalent diseases among
members of the community, propose a cause, and educate them on methods to stop or
reduce the occurrence of the disease.
2.5.6 AVAILABILITY OF HEALTH CARE FACILITIES
The availability of health facilities in Nigeria is a critical issue affecting the overall
health outcomes of the population. Adequate infrastructure, medications, medical staff
with the necessary training, and diagnostic medical equipment are necessary for
efficient provision of healthcare services. The delivery of healthcare services in
Nigeria is frequently marred by inadequate funding and bad management, which has
an impact on the scope and caliber of healthcare provided.(Oyekale 2017)
The geographic distribution of health facilities in Nigeria is uneven, with a significant
disparity between the urban and rural areas. Rural areas are particularly underserved,
resulting in limited access to health care services for a large proportion of the
population. According to a study by Abimbola et al. (2015), rural regions in Nigeria
suffer from a shortage of health facilities, exacerbating health disparities and
contributing to poorer health outcomes. The authors emphasized that many rural
communities are more than 10 km away from the nearest health facility, creating
substantial barriers to accessing essential healthcare services.
The quality of infrastructure in Nigerian health facilities varies widely, with many
facilities lacking basic amenities and resources. A comprehensive assessment by
Adeloye et al. (2017) found that a significant number of health facilities in Nigeria
were in a state of disrepair, with issues such as inadequate water supply, unreliable

20
electricity, and poor sanitation. These deficiencies not only compromise the quality of
care, but also pose significant risks to patient safety.
Adeloye et al. (2017) highlight the need for substantial investments in health
infrastructure to improve service delivery and health outcomes. The authors argue that
without addressing infrastructure challenges, efforts to improve healthcare access and
quality will be severely hampered.
The distribution of healthcare workers is a critical factor that influences the
availability and functionality of health facilities in Nigeria. There is a marked
imbalance in the distribution of health care professionals, with a higher concentration
in urban areas than in rural regions. According to a report by the Federal Ministry of
Health (FMOH, 2018), approximately 70% of Nigeria's healthcare workforce is
located in urban areas where only 30% of the population resides. This disparity results
in a significant shortage of healthcare workers in rural areas, limiting the capacity of
healthcare facilities to provide adequate care.
Efforts to address this imbalance include policies aimed at incentivizing healthcare
workers to work in underserved areas. The FMOH has implemented several initiatives
such as providing financial incentives and career development opportunities to attract
and retain healthcare workers in rural and remote areas (FMOH, 2018).
Effective health policies can enhance the distribution and quality of health facilities,
whereas ineffective policies can exacerbate the existing disparities. According to
Okpani and Abimbola (2015), the Nigerian government's Primary Health Care (PHC)
under a one-roof policy, which aims to integrate and streamline primary health care
services, has the potential to improve the availability of health facilities across the
country.
PHC under the one-roof policy seek to ensure that primary healthcare services are
delivered in an integrated manner, with adequate funding and resources allocated to
health facilities at the local level. Okpani and Abimbola (2015) argued that the
successful implementation of this policy could significantly improve access to
healthcare services, particularly in underserved rural areas.
2.5.7 NUTRITION
Nutrition is an integral part of a community's health and wellbeing. Community
nutritional needs are important, as they affect mortality, birth rate, and the risk of non-
communicable diseases (blood pressure and diabetes ), whether healthy or
malnourished. Nutrition is a crucial aspect of human rights and progress, with

21
undernutrition posing significant threats to children's well-being and hindering
national developmental goals. Despite often being unseen, its impact is profound.
Ensuring adequate healthcare and nutrition for children is essential to securing the
nation’s future. Undernutrition, as defined by UNICEF, arises from insufficient food
intake and is exacerbated by recurrent illnesses, leading to indicators such as being
underweight, stunted growth, and nutrient deficiencies. Studies have also emphasized
the role of poor nutrition and infectious diseases in exacerbating malnutrition.
Malnutrition can stem from various factors including inadequate nutrient intake,
limited healthcare access, and socioeconomic disparities. Poverty plays a significant
role in shaping nutritional status by restricting access to nutritious foods and health
care services. Cultural practices, gender dynamics, and educational attainment,
particularly among women, influence dietary habits and health outcomes within
communities.
Furthermore, environmental factors, such as poor sanitation and overcrowding in
urban slums, can exacerbate malnutrition by increasing susceptibility to infections and
limiting access to clean water and proper waste disposal facilities. Addressing these
multifaceted determinants through community-focused programs and interventions is
crucial for achieving sustainable improvement in nutritional status. Recognizing the
complex interplay among social, economic, and environmental factors is essential for
developing effective intervention strategies aimed at promoting better nutrition and
health outcomes.
2.5.1 Housing, Water, and Environmental Health
A house serves as the cornerstone of daily life and provides shelter and space for
various activities. Water is an essential resource for life and plays a pivotal role in
maintaining health. Environmental health encompasses a wide array of physical,
chemical, and social factors that influence human wellbeing. Ensuring a clean and
healthy environment is crucial for mitigating the spread of disease (Bobo et al., 2022;
Dash, 2017).
Access to clean water and safe housing is paramount for human survival and welfare,
particularly in developing nations, such as Nigeria. Raising awareness and promoting
positive practices regarding environmental health are critical for fostering healthy
living environments. The absence of clean water and proper sanitation contribute to
numerous deaths globally and impede productivity and livelihoods (Bobo et al., 2022;
Dash, 2017).

22
This study aimed to evaluate the housing conditions, water safety, and environmental
health status of the Ibido community. Key objectives included understanding water
purification methods, assessing proximity to water sources, gauging community
involvement in sanitation efforts, and examining waste disposal practices. Ultimately,
this study seeks to establish any correlation between existing health issues among
residents and water quality and sanitation practices.
2.5.3 Pregnancy and Maternal Health Care
Pregnancy and maternal health care are cornerstone components of public health
systems that aim to ensure the well-being of both mothers and children. Access to
maternal health care services remains a significant challenge worldwide, particularly
in low-resource settings. Addressing barriers to access, ensuring equitable access to
quality care, and improving the quality of maternal healthcare services are critical for
reducing maternal mortality and improving maternal and neonatal outcomes
(Gabrysch & Campbell, 2020; Gabrysch and Campbell, 2009).
In Africa, inadequate maternal healthcare infrastructure exacerbates the risks
associated with pregnancy and childbirth, particularly in rural areas that have limited
access to healthcare services. Sociocultural factors, including traditional beliefs and
gender dynamics, influence maternal health-seeking behaviors, highlighting the need
for culturally sensitive interventions tailored to local contexts (Adjiwanou & Legrand,
2013; Tarekegn et al., 2019).
Community-based interventions that leverage existing structures, such as women's
groups and community health workers, have shown promise in improving maternal
health outcomes in resource-limited settings. Technology, including mobile health
interventions and telemedicine platforms, has revolutionized maternal healthcare
delivery, facilitated access to skilled maternal health services, and improved
communication between healthcare providers and pregnant women (Colbourn et al.,
2013; Owusu-Addo et al., 2020).
Despite progress, significant challenges remain in ensuring universal access to quality
maternal health care services in African communities. Strengthening health systems,
addressing socioeconomic disparities, and increasing investments in healthcare
infrastructure are essential for improving maternal health outcomes and reducing
maternal mortality rates across the continent (Amoakoh-Coleman et al., 2016; Yaya et
al., 2020).
2.5.4 Children Immunization

23
Children in sub-Saharan Africa face significant risks of vaccine-preventable diseases;
however, achieving complete and effective immunization coverage remains a
challenge, particularly in rural areas. Factors such as barriers to access, lack of
knowledge, financial constraints, and distrust of vaccines hinder full immunization
coverage (Bobo et al., 2022; Benjamin, Bangura, et al., 2020).
Nigeria in particular struggles with low immunization coverage and disparities across
regions. Efforts to increase immunization rates require awareness campaigns,
improvements in health worker-to-patient ratios, and regular immunization outreach
in rural communities. Additionally, addressing socioeconomic disparities and
leveraging technology for information dissemination are crucial for improving
immunization coverage and minimizing child mortality (Bobo et al., 2022; Benjamin,
Bangura, et al., 2020).
2.5.5 Prevalent Diseases
Community diagnosis is instrumental for assessing disease prevalence, identifying
causative factors, and proposing interventions to mitigate disease incidence. Diseases
prevalent in communities can range from infectious diseases to non-communicable
ailments, and are influenced by factors such as education level, cultural beliefs, and
environmental conditions (Mekman et al., 2019; Owolabi Lukman et al., 2019;
Dawaki Salin et al., 2016; Nwaneri et al., 2017).
Addressing prevalent diseases requires a multifaceted approach that involves health
education, community engagement, and infrastructure improvements. By leveraging
local resources and community networks, stakeholders can implement targeted
interventions to promote healthier communities and reduce disease burden (Mekman
et al., 2019; Owolabi Lukman et al., 2019; Dawaki Salin et al., 2016; Nwaneri et al.,
2017).

2.5.6 Availability of Health Care Facilities

The availability of health facilities in Nigeria significantly impacts overall health
outcomes; however, challenges such as inadequate infrastructure and healthcare
workforce imbalances persist. Rural areas are particularly underserved, exacerbating
health disparities and limiting access to essential health care services (Abimbola et al.,
2015; Adeloye et al., 2017; FMOH, 2018).

24
Addressing infrastructure challenges and healthcare workforce imbalances requires
substantial investment and policy initiatives aimed at improving healthcare access and
quality. Initiatives like
Primary healthcare (PHC) under the one-roof policy aims to integrate and streamline
primary healthcare services, potentially improving access to healthcare services,
particularly in underserved rural areas (Abimbola et al., 2015; Adeloye et al., 2017;
FMOH, 2018).
Effective health policies and increased investments in healthcare infrastructure are
crucial for enhancing the distribution and quality of health facilities across Nigeria,
ultimately improving health outcomes and reducing health disparities (Okpani &
Abimbola, 2015).
2.5.7 Nutrition
Nutrition is a fundamental aspect of community health and well-being, influencing
mortality rates, birth outcomes, and the risk of non-communicable diseases.
Malnutrition, stemming from inadequate nutrient intake and socioeconomic
disparities, poses a significant threat to children's well-being and national
development goals (UNICEF).
Addressing malnutrition requires comprehensive strategies targeting socioeconomic,
cultural, and environmental determinants. Community-focused programs and
interventions can promote better nutrition and health outcomes by addressing barriers
to access, raising awareness, and improving dietary habits within communities
(UNICEF).

25
 CHAPTER THREE
3.0 METHODOLOGY
3.1 STUDY AREA AND COMMUNITY AREA
The community under investigation was preselected by the department. The study was
conducted in the Ibido community located in Sagamu, one of the 20 local government
areas in Ogun State. Entry into the community was initiated on May 14, 2024, with
the initial visitation directed towards Ibido Palace, serving as the royal residence of
the Ibido community. This process was conducted under meticulous supervision of
Ms. Osoba.

3.2 ETHICAL CONSIDERATIONS

Following a comprehensive briefing regarding our intentions, approval was sought
and obtained from traditional rulers and community leaders of the Ibido community.
The research methodology employed was noninvasive, primarily encompassing house
enumeration and questionnaire administration. Stringent measures were implemented
to ensure confidentiality of all participant information and respondent interviews.

3.3 STUDY DESIGN

This was a descriptive, cross-sectional, and community-based study.

3.4 STUDY POPULATION, HOUSE ENUMERATION AND MAP DESIGN.

The study population comprised of households residing in the Ibido Community. A
total of 96 habitations (comprising 192 households serving as the sampling frame)
were enumerated, excluding structures that were incomplete or designated for non-
residential purposes. A social map of the community was meticulously drawn by hand
to delineate land and area boundaries. This task was accomplished through
collaborative efforts with community members and local leaders, who provided
crucial information. Various landmarks and pertinent geographical features, including
health facilities, social group structures, and religious sites, were identified and
plotted on a map based on the insights provided by community leaders. Subsequently,

26
the map underwent revisions and corrections based on our observations and feedback
from community members, ultimately culminating in a finalized, comprehensive
representation of the community's layout and features.

(Map Image)
IBIDO COMMUNITY MAP

3.5 SAMPLE SIZE DETERMINATION

The sample size was determined using the formula:
2
N × Z × p × ( 1− p )
n=
( N −1)× E2 +Z 2 + p × ( 1 − p )
Where:
n= Required sample size
N= Study Population (192 households)
Z= Z score (1.96, Corresponding to 95% Confidence interval)
p= estimated proportion of population with characteristic response (0.5,
maximum variability)
E= Marginal Error (0.05, at 95% Confidence Interval)

Thus n≈129
To Accommodate invalid and incomplete responses,~20% was added to the sample
size:
Administered Questionnaires = 129 +26 =156 questionnaires.

3.6 STUDY MATERIAL/INSTRUMENTS

The primary data for this investigation were procured through a meticulously
designed semi-structured questionnaire, in accordance with the objectives of this
study. Two distinct methodologies for questionnaire administration were employed,
contingent on the respondents:
1. Self-administration.
2. Interview-based administration.

27
3.7 SAMPLING TECHNIQUE
To ensure equitable representation, a simple random sampling technique employing
the balloting method was employed to select houses within the community.
Subsequently, each household was sampled and presented with a questionnaire for
data collection.

3.8 EXCLUSION CRITERIA.

1. House not habited
2. Non responsive individual

3.9 DATA ANALYSES

Statistical analyses were conducted using Microsoft Excel and the Statistical Package
for the Social Sciences (SPSS) version 23. Continuous variables were succinctly
summarized using descriptive statistics, encompassing means, standard deviations,
95% confidence intervals (95% CI), and minimum and maximum values. The sample
size was determined using a 95% confidence interval. The chi-squared test was used
as the analytical tool in this study.

28
 CHAPTER 4

4.0 RESULTS

4.1 General Demography of Ibido Community

4.1.1 Age

Fig 4.1 shows age distribution amongst the females, age class of 40-44 recorded the
highest (16.5%) followed by the age group 65 and above(12.9%) , age 50-54 and age
age 45-49 recorded 11.8% each. Age class 60s -64 below 5% greater than ≤20 2.4%)
while age group 21-24 recorded the lowest 0%.

65 and above 12.9%

60-64 4.7%
55-59 5.9%
50-54 11.8%
45-49 11.8%
Age (years)

40-44 16.5%
35-39 7.1%
30-34 11.8%
25-29 9.4%
21-24 0.0

≤20y 2.4%

percentage of sample

Fig.4.1: Age distribution amoung females in Ibido Community

Male
Fig 4.2 shows age distribution amongst the males, age class of 50-54 recorded the
highest (17.0%) followed by the age group 65 and above and 60-64 (14.9%) , age 35-
39 recorded 12.8% . Age class 40-45, 10.6%, 25-29. 8,5% while age group 40-44 and
30-34 recorded the lowest 2.1% each.

29
 65 and above 14.9%
60-64 14.9%
55-59 4.3%
50-54 17.0%
45-49 10.6%
Age(Years)

40-44 2.1%
35-39 12.8%
30-34 2.1%
25-29 8.5%
21-24 4.3%
≤20y 8.5%

Percentage of sample

Fig.4.2: Age distribution among males in Ibido community

4.1.2 Sex
Fig 4.3 shows the sex distribution of the respondents. Female recorded higher value
(67%) with male recording 33%.

42; 33%

87; 67%

Male Female

Fig.4.3: Sex distribution of respondents

4.1.3 Marital status

30
Female
Widow/Widower, Single, 8%
13%

Divorced, 7%

Married, 72%

Fig

Male

31
 Divorced; 4.44444444444444; 4%
Single;
17.7777777777778;
18%

Married;
77.7777777777778;
78%

4.1.4 Religion

Female

Traditional, 2.4%

Islam, 31.0%

Christianity, 66.7%

Fig4.1 Piechart showing religious distributtion of female in Ibido community

32
Males

Islam, 35.6%

Traditional, 53.3%

Christianity, 11.1%

4.1.5 Formal Education level

Female

33
 Ter- Prima
None, 5% ry,
tiary,
13% 20%

Secondary, 62%

Males

6.66666666666667; 7%

17.1428571428571; 17%

61.9047619047619; 62% 14.2857142857143; 14%

Primary Secondary Tertiary None

34
Ethinic groups in Ibido community

3.10077519379845;
3%

96.8992248062015;
97%

Yoruba Other tribes

Type of Marriages

35
 Not Married now,
13.95%

Monogamy, 55.04%
Polygamy, 31.01%

Head of households
Others; 1.55038759689922
Father;
20.1550387596899

Mother;
78.2945736434108

36
Total Number of people in house

above 10 7
10 4
9 4
Number of people in house

8 9
7 13
6 18
5 26
4 20
3 15
2 11
1 8
0 5 10 15 20 25 30
Frequency

Number of children in the family

37
 above 8 2
8 4
7 4
6 4
Number of children

5 17
4 16
3 27
2 25
1 18
0 12
0 5 10 15 20 25 30
Frequency

Employment Status

Full House- Formally Em-

wife;
Unemployed; 8.52713178294574; ployed;
0.7751937984
9% 17.829457364
49612; 1% 3411; 18%

Self-employed;
72.8682170542636; 73%

Occupation

38
 77
Frequency

31

10
7
2 2
Education Health Services Trading Agriculture Unemployed
Ocupation sector

4,2 Prevalent Health Conditions

39
4.2.1 Illness in the last 3 months

Yes, 57, 44%

No, 72, 56%

40
Table 4.1 Prevalence of diseases in Ibido Community
Distribution of illnesses in Ibido( in the last 3 months)

Disease Frequency(n) Percentage(%)

Malaria 41 71.9
Typhoid 8 14.0
Malaria and typhoid 1 1.8
High Blood Pressure 4 7.0
Diabetes 1 1.8
Eye condition 1 1.8
Epilepsy 1 1.8
Total 57 100
Diseases often affecting children in households
Disease Frequency Percentage (%)
Malaria 60 46.5
Post-nasal drip 5 3.9
Typhoid 15 11.6
Cough 11 19.3
Malaria and typhoid 2 1.6
Tooth ache 1 0.8
Malaria and Cholera 1 0.8
None 34 59.6
Total 57 100

41
Table 4.2 Potential factors that can influence disease incidence/distribution of air
related diseases

Number of inhabitants per room

Inhabitant per room Frequency(n) Percentage(%)

1 27 20.9
2 45 34.9
3 29 22.5
4 13 10.1
5 9 7.0
6 4 3.1
7 2 1.6
Total 129 100
Number of windows per room
Number of window Frequency Percentage (%)
1 36 27.9
2 87 67.4
3 6 4.7
Total 129 100
Cooking method
Method Frequency Percentage(%)
Stove 4 3.1
Gas 94 72.7
Wood 7 5.4
Charcoal 5 3.9
Gas & Charcoal 18 1.4
None/ Eat out 1 0.8
Total 129 100
Location of cooking
Location Frequency Percentage (%)
Room 19 14.7
Passage 40 31.0
Kitchen 54 41.9
Shop 2 1.6

42
Outside 13 10.1
Does not cook 1 0.8
Total 129 100
Type of oil used in cooking
Oil used Frequency Percentage(%)
Palm Oil 80 62.0
Bleeched Palmoil 30 23.3
Groundnut oil 15 11.6
Both palmoil and 3
2.3
groundnut oil
None 1 0.8
Total 129 100

2 Risk factor to vector related diseases

A. Rodents

43
 35; 27%

94; 73%

Yes No

Exposure to rodents infestation at Ibido community

B MOSQUITOES

Table 4.2 Potential factors that can influence disease incidence/distribution of Malaria

44
Presence of stagnant water around the house
Stagnant water around? Frequency Percentage(%)
Yes 46 35.7
No 83 64.3
Total 129 100
Use of window net
Window net? Frequency Percentage (%)
Yes 91 70.5
No 38 29.5
Total 129 100
Mosquito management method
Method Frequency Percentage(%)
Mosquito coil 32 24.8
Mosquito net 26 20.2
Insecticide 46 35.7
Insecticide and coil 19 14.7
None 6 4.7
Total 129 100
Malaria Prevalence among respective management methods
Method Frequency Percentage (%)
Mosquito coil 16 20.5
Mosquito net 3 3.8
Insecticide 20 25.6
Insecticide and coil 12 15.4
None 27 34.6
Total 78 100

C Lifestyle that poses risk of developing Chronic disease

A Use of substance

45
 Yes; 34; 26%

No; 95; 74%

Yes No

Table 4.1 Substance Use in Ibido Community

Substance Use
Type Frequency(n) Percentage(%)
Alcohol 14 41.2

46
Bitter Kola 11 32.4
Marijuana 4 11.8
Cigarettes 5 14.7
Total 34 100
Frequency of Substance Use
How Often Frequency Percentage (%)
Daily 18 52.9
Occasionally 5 14.7
More than 3 times daily 11 32.4
Total 34 100
Soda Consumption
Consume Soda? Frequency Percentage(%)
Yes 109 84.5
No 20 15.5
Total 129 100
Type Of Soda Consumption
Coca Cola 19 17.4
Pepsi 59 54.1
Fearless 6 5.5
Fanta 15 13.8
Malt 7 6.4
7up 2 1.8
Teem 1 0.9
Total 109 100

Table 4.1 Family health events/trends

Hereditary Diseases
Present? Frequency Percentage(%)
Yes 13 17.8
No 116 82.8
Total 129 100

47
Type of Hereditary Diseases
Hereditary Diseases Frequency Percentage (%)
Sickle Cell 8 61.5
Asthma 5 38.5
Total 13 100
Famiy addiction pattern
Family Member(s) that Frequency
Percentage(%)
smoke
Yes 29 22.4
No 100 77.6
Total 129 100
Familmy Member(s) that drink
Yes 36 27.9
No 93 72.1
Total 129 100
Recent Mortality in Family
Any in last 3 years? Frequency Percentage(%)
Yes 30 23.3
No 99 76,7
Total 129 100
Cause of death Frequency Percentage (%)
Old Age 15 50
Accident 3 10
Illness 12 40
Total 30 100

4.3 WATER SANITATION AND HYGIENE

4.3.2 WATER

Table 4.1 Water in Ibido community

Major Water source
Type Frequency Percentage(%)
Borehole 115 89.1

48
Tanker 6 4.7
Well 6 4.7
Rain 2 1.5
Total 129 100
Proximity of water source
Proximity Frequency Percentage (%)
Very Near 45 34.9
Near 58 45.0
Far 19 14.7
Very far 7 5.4
Total 129 100
Partcipants that drink water from source
Drink from water Frequency
Percentage(%)
source?
Yes 111 86.0
No 18 14.0
Total 129 100
Participants that practised some form water purification
Purify Water? Frequency Percentage (%)
Yes 30 23.3
No 99 76.7
Total 129 100
Purification method employed by participants
Method Frequency Percentage (%)
Boiling 16 53.3
Water Guard application 14 46.7
Total 30 100

49
4.3.2 SANITATION AND HYGIENE

Table 4.1 Sanitation and hygiene in Ibido community

Toilet Hygiene
Type of Toilet used Frequency Percentage(%)
Water Closet 49 38.0
Pit latrine 80 62.0
Total 129 100

50
Frequency of cleaning toilet
How often? Frequency Percentage (%)
Daily 55 42.6
Weekly 70 54.3
Monthly 4 3.1
Total 129 100
Food hygiene
How often do you clean Frequency
Percentage(%)
the place you cook?
Everyday 96 74.4
Once a week 17 13.4
3 times a week 3 2.3
Monthly 10 7.6
None 3 2.3
Total 129 100
Drainage system
Type Frequency Percentage (%)
Open gutter 87 67.4
Closed gutter 36 27.9
None 6 4.7
Total 129 100
Cleaning of gutter
Practised? Frequency Percentage (%)
Yes 70 54.3
No 59 45.7
Total 129 100
Freuency of gutter cleaning
How often Frequency Percentage(%)
Everyday 34 48.6
3 times a week 16 22.8
4 times in a week 7 10.0
Once a month 13 18.6
Total 70 100.0

51
4.4 HEALTH SEEKING BEHAVIOURS OF FAMILIES IN IBIDO
COMMUNITY

4.4.1 Use of the Primary health care facilities in the town

52
 No; 23; 18%

Yes; 106; 82%

Yes No

4.4.2 Frequency of Healthcare facility visit

Frequently; 25; 19%

Occasionally; 104; 81%

4.4.3 Perception of affordability of health care faculties charges

53
 Unaf-
fordable
29%

Af-
ford-
able
71%

4.4.4 Availability of required drugs at the health centre

Unavailable
Drug availability

Available

0 20 40 60 80 100 120
Frequency

4.4.5 Perception of health providers attitude at the primary healthcare facility

54
Table 4.1 Evaluation of local health workers by people in Ibido community
Perception of health workers
Evaluation Frequency Percentage(%)
Warm 96 90.6
Too formal 6 5.7
Repulsive 4 3.8
Total 106 100

4.4.5 Family health seeking behaviours

able 4.1 Actions taken by family of sick in Ibido community

When family Member is ill

55
Step taken Frequency Percentage(%)
Hospital visit 85 65.9
Self-medicaltion practice 20 15.5
Herbal remedy 12 9.3
Hospital +Herbal 4 3.1
Self + Herbal 4 3.1
Hodpital + self 2 1.6
None 2 1.6
Total 129 100

4.4.6 Frequently used Medications

able 4.1 Distribution of regularly taken medications

56
Drug taken regularly
Type Frequency Percentage(%)
Pain relief 40 31.7
Malaria and typhoid meds 10 7.6
Malaria med 50 38.8
Hypertention control 15 11.6
Herbal remedies 14 10.9
Total 129 100

4.4 NUTRITIONAL STAUS OF PEOPLE IN IBIDO COMMUNITY

57
Table 4.1 Nutritional status
Frequency of feeding
Number of meals per day Frequency Percentage(%)
Once 30 23.3
Twice 32 24.8
Trice 54 41.8
More than trice 13 10.1
Total 129 100
Most consumed food classes
Food class Frequency Percentage (%)
Carbohydrate 96 74.4
Protein 28 21.7
Both Carbohydrate and 5
17.2
Proterin
Total 129 100
Frequency of consumptiom of certain food
Meat or Fish Frequency Percentage(%)
Daily 74 57.4
3 times a week 20 15.5
Weekly 8 6.2
Occasionally 9 7.O
Never 18 14.0
Total 129 100
Fruits Frequency Percentage(%)
Daily 24 18.6
3 times a week 29 22.5
Weekly 20 15.5
Occasionally 54 41.9
Never 2 1.6
Total 129 100
Dairy products Frequency Percentage(%)
Daily 14 10.9
3 times a week 16 12.4
Weekly 18 14.0
Occasionally 71 55.0

58
Never 10 7.8
Total 129 100
Eggs Frequency Percentage (%)
Daily 25 19.4
3 times a week 37 28.7
Weekly 25 19.4
Occasionally 40 31.0
Never 2 1.6
Total 129 100
Cereal/Grains Frequency Percentage (%)
Daily 66 51.2
3 times a week 17 13.2
Weekly 10 7.8
Occasionally 21 16.3
Never 15 11.6
Total 129 100
Vegetables Frequency Percentage(%)
Daily 36 27.9
3 times a week 54 41.9
Weekly 20 15.5
Occasionally 16 12.4
Never 3 2.3
Total 129 100
Food Taboos
Present? Frequency Percentage(%)
Yes 33 25.6
No 96 74.4
Total 129 100
Forbidden Food
Pork and Dog 26 78.8
Fish 2 6.0
Okro 5 15.2
Total 33 100

59
60
REFERENCES
Suluku, R., Macavoray, A., & Kallon, M. (2024). Establishment of Community-Level
Epidemiological Surveillance Systems to Reduce Disease Incidence in Rural
Communities of Sierra Leone. https://doi.org/10.9734/bpi/rudhr/v2/7725A

Dereck, P., Shende, K., & Fonteh, N. (2022). Prospects and Challenges of Water
Management Stakeholders in the Rural Communities of the Noun Division, West
Region, Cameroon. *Environmental Management and Sustainable Development, 11*,
27. https://doi.org/10.5296/emsd.v11i4.20455

Hassan, S. (2023). Problems Associated with Drinking Borehole and Polluted Water
in Local or Rural Community in Nigeria.

Weber, A., Delgado‐Zapata, R., Fineman, M., Jimenez-Zambrano, A., Pfluger, B.,
Cunningham, M., Calvimontes, D., Ryan, E., & Lamb, M. (2024). Assessment of
Community Readiness to Address Malnutrition in Rural Southwest Guatemala.
*Public Health Challenges, 3*. https://doi.org/10.1002/puh2.164

Strasser, R. (2003). Rural health around the world: challenges and solutions. *Fam
Pract, 20*(4), 457-463. https://doi.org/10.1093/fampra/cmg422

Kumar, R., & Kumar, P. (2019). Healing the heart of healthcare: Leaving No One
Behind: Impact of 15th World Rural Health Conference New Delhi. *J Family Med
Prim Care, 8*(10), 3077-3082. https://doi.org/10.4103/jfmpc.jfmpc_868_19

Tseole, N. P., Mindu, T., Kalinda, C., & Chimbari, M. J. (2022). Barriers and
facilitators to Water, Sanitation and Hygiene (WaSH) practices in Southern Africa: A
scoping review. *PLoS One, 17*(8), e0271726.
https://doi.org/10.1371/journal.pone.0271726

Sinharoy, S. S., Pittluck, R., & Clasen, T. (2019). Review of drivers and barriers of
water and sanitation policies for urban informal settlements in low-income and

61
middle-income countries. *Util Policy, 60*, 100957.
https://doi.org/10.1016/j.jup.2019.100957

Nwokoro, U. U., Ugwa, O., Onwuliri, C. D., Obi, I. F., Ngozi, M. O., & Agunwa, C.
(2020). Water, sanitation and hygiene risk factors associated with diarrhoea morbidity
in a rural community of Enugu, South East Nigeria. *Pan Afr Med J, 37*, 115.
https://doi.org/10.11604/pamj.2020.37.115.17735

Huet, C., Ford, J. D., Edge, V. L., Shirley, J., King, N., & Harper, S. L. (2017). Food
insecurity and food consumption by season in households with children in an Arctic
city: a cross-sectional study. *BMC Public Health, 17*(1), 578.
https://doi.org/10.1186/s12889-017-4393-6

Cao, W. R., Shakya, P., Karmacharya, B., Xu, D. R., Hao, Y. T., & Lai, Y. S. (2021).
Equity of geographical access to public health facilities in Nepal. *BMJ Glob Health,
6*(10), e006786. https://doi.org/10.1136/bmjgh-2021-006786

Koltai, D. C., Dunn, T. W., Smith, P. J., Sinha, D. D., Bobholz, S., Kaddumukasa, M.,
Kakooza-Mwesige, A., Kajumba, M., Smith, C. E., Kaddumukasa, M. N., Teuwen, D.
E., Nakasujja, N., Chakraborty, P., Kolls, B. J., Nakku, J., Haglund, M. M., & Fuller,
A. T. (2021). Sociocultural determinants and patterns of healthcare utilization for
epilepsy care in Uganda. *Epilepsy & Behavior, 114*(Part B), 107304.
https://doi.org/10.1016/j.yebeh.2020.107304

62