DETERMINANTS OF ADOPTION OF SELECTED PUBLIC HEALTH INTERVENTION STRATEGIES BY RURAL FARMING HOUSEHOLDS IN ONDO STATE, NIGERIA.

Abstract

Regardless of the number of improved technologies introduced to farmers it may not bring about appreciable increase in production, if the people (farmers) that will adopt the agricultural technologies aimed at increasing output are not healthy or spend several productive hours taking care of sick family members. This study sought to understand the determinants of adoption of selected public health intervention strategies by rural farming households in Ondo state. Specifically, the study determined the socio-economic characteristics of the respondents, the awareness and adoption level of the selected health strategies, effect of both socio-economic and socio-psychological characteristics of the rural farming households on adoption of selected public health strategies; it also investigated the perception, attitude, knowledge and constraints faced in the adoption of the selected public health strategies. In addition the study determined the effect of health extension (health rangers) visits on adoption and sources of health information available to the rural farming household were identified in the study. Finally, some characteristics of the health information sources were investigated with a view to determining their influence on adoption of the selected health strategies. Data from 272 households randomly selected through multistage sampling technique was used. In stage 1, four blocks (local government area) were randomly selected from eight existing blocks in zone 1 of Ondo State Agricultural Development Project (ODSADP) while five blocks were randomly selected from the ten existing blocks in zone 2 of ODSADP. This gave a total of nine sampled blocks in stage I. In stage II, four cells were randomly selected from the eight existing eight cells in each of the nine blocks selected in stage I; this gave a total of thirty six selected cells. In stage III, nine households were purposively selected from each of the thirty six cells selected in stage II, purposive selection was based on having at least a surviving child not above five years in age. Selection was from the list of ODSADP farmers in each of the thirty six cells (communities) to give a total of 324 sampled households, data from 272 households were used because of inadequacies discovered with data from the remaining households. Interview schedule and focus group discussion were used to collect data. The results were described using descriptive and inferential statistics like frequencies, percentages, chi square, regression (Tobit and Logit) and Pearson Product Moment Correlation. Results of the hypotheses tested showed that adoption of immunization was significant at .01 significant level and had positive correlation with the visits by health extension workers (health rangers), (r=.20; P=.00) but not significant for roll back malaria (r= .10; P=.12) and family planning (r=.02; P=.71). Adoption of none of the three selected public health programmes had a significant relationship with visit by agricultural extension workers. Age was significant and negatively correlated (r= -.37; P=0.00) with adoption of family planning and family planning adoption was positively correlated with educational years of the respondents (r= 0.74; P=0.00). Distance of respondents house to the nearest health facility was also significant and negatively correlated with adoption of family planning (r= -.14; P=.02). The analysis showed significance between marital status and family planning adoption (χ2 =8.69; P=.03) Distance of respondents’ house to the nearest health facility was also significant and negatively correlated with adoption of immunization (r= -.235; P=0.00). The significantly correlated socio-economic variables on adoption of roll back malaria were: educational years (r=0.31; P= 0.00), income (r=0.52; P= 0.00) and distance to nearest health facility (r= -.25; P= 0.00) all were significant at 1% level. The Tobit regression analysis for family planning revealed that socio-economic status, change proneness and knowledge had positive signs and had 1.1%, 3.4% and 2.4% marginal effects respectively. The Tobit regression for Roll Back Malaria (RBM) shows that perceived convenience, change proneness and Knowledge had 1.9 %, 1.3% and 3.9% marginal effects respectively on the adoption of RBM and are positively signed. The logit regression result for immunization indicates that perceived effectiveness and knowledge had 1.5% and 2.9% marginal effects, respectively on adoption of immunization and also carry positive signs. The first source of hearing about the three selected public health programmes has no significant relationship with their adoption. The correlation between the characteristics of the health information source and adoption of the health programmes revealed that at 10% level of significance the adoption of immunization was positively correlated with perceived credibility (r=0.12) and perceived accessibility scores (r=0.16) of the information sources; there was also positive correlation between roll back malaria adoption and perceived timeliness (r=0.21) and perceived accessibility (r=0.29) at 10% significance level. In addition it was discovered that majority of the respondents (91.9 percent) were married and male headed household was 94.9 percent of the respondents. The study established the fact that both socio-economic factors and psychological characteristics determine adoption of public health strategies by rural farming households. The psychological characteristics that determines adoption were change proneness, perceived effectiveness, perceived convenience of health strategies, perceived characteristics of health information sources (perceived timeliness, perceived credibility, perceived accessibility) and knowledge while significant socio-economic factors that are determinants in adoption of the selected public health strategies were age, education, distance to health facility, income and marital status. It was recommended that policy makers must take good advantage of these information sources and improve on its timeliness and accessibility. It was also recommended that aggressive trainings and seminars must be embarked upon by government to improve the knowledge of the rural household on these health strategies because many superstitions were still believed by many of the rural people on some of the health strategies. Significance of knowledge should therefore be given adequate attention in order to disabuse their minds on some contrary believes militating against adoption.