University of Nigeria Research Publications

NNAJI, Ndubuisi

Aut

hor

PG/MA/96/22838

Title

Communication Strategy and Adoption of New Practice in the Nigeria Guinea Worm

Eradication Programme

Facu

lty

Arts

Dep

artm

ent

Mass Communication

Dat

e

October, 1998

Sign

atur

e

UNIVERSITY OF NIGERIA

NIGER B l N D E R ~ CO. 8 ('nivrrri~y Marker R m d . Box 1006, Pltone: 042-771 719 Nsukka.

-

COMMUNICATION STRATEGY AND ADOPTION OF NEW PRACTICES IN THE NIGERIAN

GUINEA WORM ERADICATON PROGRAMME

A RESEARCH PROJECT SUBMITTED TO THE DEPARTMENT OF MASS COMMUNICATION

UNIVERSITY OF NIGERIA NSUKKA

IN PARTIAL FULFILMENT OF THE REQUIREMENT FOR rIll13 AWARD OF THE DEGREE OF

MASTER OF ARTS (M.A.) IN MASS COMMUNICATION

NNAJI, NDUBUISI (PG/MA/96/22838)

OCTOBER 1998

CERTIFICATION

Nnaji , Ndubuisi, a postgraduate s tuden t of the

Department of Mass Communication, Universi ty of Nigeria ,

Nsukka, with t h e r e g i s t r a t i o n number ~ ~ / ~ A / 9 6 / 2 2 8 3 8 , has

s a t i s f a c t o r i l y completed t h e requirements f o r t h e course

and research work f o r t h e degree of Master of Arts (M.A.)

i n Mass @ommunication. The work embodied i n t h i s r e p o r t

i s o r i g i n a l and has n o t , t o t h e bes t of my knowledge,

been submitted i n p a r t o r i n f u l l f o r any o t h e r diploma

o r degree of t h i s o r any o the r u n i v e r s i t y ,

D r . S.O. ~ d e m i i i Supervisor

D r . S. 0. Idemi l i Ag. Head of Department

\ Prof. David 0. ~ h d

Externa l Examiner

D E D I C A T I O N

To

My e lder brother

OKECHUKWU NNAJI-AN1 (1 962-1 985 )

who could n o t l i v e t o see

the dream come true.

iii

ACKNOWLEDGEMENT

I owe a debt of g r a t i t u d e t o a whole lo* of

ind iv idua l s and organiza t ions whose a s s i s t a n c e helped

i n one way o r t h e o t h e r t o make t h i s p roJec t poss ib le .

Foremost among t h e l o t i s D r . S.O. Idemi l i who l e n t h i s

weal th of experience i n the supervis ion. M r . Tobin

Tubona, t h e Guinea Worm Corper, 1994/95, in Idanre Local

Government, who nur tured my i n t e r e s t on t h e programme,

M r . T.A. Akinkagbe, ehairman of NIGEP Task Force, Akure,

Ondo S t a t e and M r . L.W. Nweke, Secre tary of Enugu S t a t e

NIGEP Task Force, a l l deserve huge measures of my

apprec ia t ion .

I n my mind a l s o a r e S t e l l a A . J . Goings, MOD., MPH.,

t h e head, h e a l t h s e c t i o n of UNICEF, Nigeria , M r . Martin

Udeh of PPFN, Enugu, Miss JOE. Maduagwu of Department of

Rel igion, U.N.N. , who always prodded a t me; M r . R.M.

Onwuka of the Department of Philosophy and Mrs. E.C. Igu

o f the Nnarndi Azikiwe Library f o r the f i n e r , c l e a r e r

p r i n t s .

A whole l o t of thanks go t o Prof. S.A. Ekwelie,

Dean, Facul ty of A r t s , f o r his well-meaning c r i t i c i s m

of t h e proposal.

To God be t h e g lory .

CERTIFICATION

DEDICATION

ACKNOWLEDGEMENT

TABLE OF CONTENTS

LIST OF TABLES

ABSTRACT

CHAPTER:

ONE INTRODUCTION 1.1 Communication i n S o c i a l Change .. 1.1.1 Communication and Dif fus ion of Innovation 1.1.2 The Guinea Worm Eradication Promarme 1.2 1.3 1.4 I * 5 1.6 1.7

TWO 2.1 2.2 2.3 2.4 2.5 2.6

THREE 3.1 3.2 3 *3 3.4 3.5 3 .6

- Statement of t h e Problem . . Purpose of t h e Study . . Theore t i ca l Framework .. Sign i f i cance of t h e Study . . Research Quest ions . Def in i t ion of Concepts . . LITERATURE REVIEW . The Direc t ion of t h e Review . The Diffusion-Adoption Model .. The Innovation-Diffuslon Process Media Use i n t h e Diffusion of Innovations Multiple-step F l ~ w i n t h e Difussion Process Summary of L i t e r a t u r e . METHODOLOGY The Method of Research . . Population of the Study . . Sample Size . Sampllng Procedure . . Research Instruments . . Method of D a t a Analysis . .

PAGE

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ii

iii

iv

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v i i

1 1 2 5

10 11 12 14 14 15

17 17 17 20 21 30 32

34 34 34 35 35 37 37

PAGE

CHAPTER : FOUR DATA PRESENTATIOM AND ANALYSIS

4.1 Framework of Analysis . . 4.2 The Message on &he Guinea Worm Disease 4.3 Sample C h a r a c t e r i s t i a s of t h e Population 4.4 Dominant Communication Channels Used

by t h e People i n Guinea Worn Endelmie Vi l l ages . . . .

4.5 Modes of Communication Used t o Disseminate t h e Message on Guinea Worm Disease .. . .

4.5.1 The Advocacy Pro jec t . . 4.5.2 Mass Media Capaci-by Building P r o j e c t 4.5.3 Community P a r t i c i p a t i o n and Empower-

ment . . . . 4.5.4 Mobil izat ion of NGO . . 4.6 Exposure t o t h e Message on Guinea Worm

Disease ... . . 4.7 Adoption of New P r a a t i c e s Prescr ibed

by t h e Message on Guinea Worm Disease 4.8 Rela t ionship Between Exposure Level

and Adoption Rate . . FIVE SUMMARY, CONCLUSION AND FLEXOMMENDATIONS

5.1 Summary . . . . 5.2 Provis ion of Safe Water Sources 5.3 Conclusion . . . . 5.4 Recommendations . .

REFERENCES .. APPENDICES . .

LIST OF TABLES

TABLE

4. I

4.2

4 . 3

it.4

PAGE

Age D i s t r i b u t i o n of Sample Population 41

Educational D i s t r i b u t i o n of Sample Population 42

Income Brackets of Sample Population 43

Occupational D i s t r i b u t i o n of Sample Popula- t i o n . . . . 43

Reliance on Channels of Mass Communication 45

Dominant Channel of Information Used i n Endemic Vi l l ages . 47

Knowledge of t h e Message on t h e Guinea Worm Disease . . . . 57

Source of Information on t h e Message on Guinea Worm f o r 173 Respondents who were Exposed . . . . 58

Knowledge of t h e Ac t iv i ty of NIGEP 59

Respondentst Opinion of t h e Guinea Worm Disease . . . . 60

Reason f o r Boiling o r F i l t e r i n g of Water by 61 Respondents . 61

Reason f o r Assis tance t o Guinea Worm Victims by 92 Respondents . . 62

Problems Encountered in.Tryin.g t o Adopt New H a b i t s f o r Guinea Worm Prevention 64

Best Method t o Eradica te Guinea Worm a s Suggested by Samples . . 66

v i i

ABSTRACT

The guinea worm elimination project i n Nigeria i s

one circumstarrce where a c lear ly defined mass communica-

t ion strategy was integrated t o other variables t o check

one of the most painful and degrading a f f l i c t i o n s t o

a f fec t human beings. Indeed, t h e country was believed by

the World Health Organization (WHO) t o contain nearly 60

per cent of dracunculiasis or the guinea worm disease i n

the whole world. Today, despite the recent reports of

the resurgence of cases of the disease i n pa r t s of the

country, the nation i s on the verge of being ce r t i f i ed

guinea worm f ree by WHO i n 1999.

The main strategy of the programme include the

effect ive coordination between the provision of safe

drinking water, and health and hygiene education of

people i n endemic v i l lages by international.agencies and

non-governmental organizations. The thrus t of the

programme is the ttmessage on guinea worm disease."

This study examines the ro le of mass communication i n

the success of the elimination project.

The survey research method w a s used whereby 200

samples were drawn from three endemic vi l lages i n two

s t a t e s - Enugu and Ebonyi. Data were generated through

v i i i

a ques t ionnai re and an in terv iew schedule.

Ques t ions were on the content of the message on

guinea worm d i sease ; the dominant channels of communica-

t i o n used by the people i n endemic v i l l a g e s ; t h e modes

of communication used by NIGEP t o disseminate t h e message;

exposure of the people i n endemic v i l l a g e s t o t h e message;

adopt ion of new p r a c t i c e s based on exposure t o t h e

message, and t h e r e l a t i o n s h i p between t h e l e v e l of

exposure and t h e r a t e of adopt ion of new hab i t s .

From t h e data analysed, t h e fol lowing f i n d i n g s

emerged:

- while r ad io was the dominant channel of mass

communication r e l i e d on f o r information by t h e

v i l l a g e r s , the i n t e r p e r s o n a l (face-to-face) channel

was used by the major i ty of t h e v i l l a g e r s (65.5%)

t o disseminate information;

- NIGEP appl ied an a r t i c u l a t e d mass communication

po l i cy which focussed on g r a s s r o o t s mobi l iza t ion ,

h e a l t h educat ion, and provis ion of s a f e water

sources;

- exposure t o t h e message on guinea worm d i sease was

very high, wi th as much as 86.5 p e r cen t of t h e

sample being exposed;

- adoption of practices prescribed by the message was very low; indeed, there was no significant relation-

sh ip between the level of exposure to the message

and the rate of adoption of new practices;

- MIGEP1s success is traceable to the effective combination of mass communication with the provision

of sources of safe drinking water.

This researcher recommends, for further research,

the use of a longitudinal design in a similar study as

well as a historical/anthropological design. It is

also recommended that NIGEPts strategy be used for the

entire health care delivery system .

CHAPTER OblE INTRODUCTION

1.1 Communication i n S o c i a l Chanp;e

Communication i s a v i t a l f a c t o r i n s o c i a l change.

Though communication does n o t always produce change,

n e i t h e r does the r a t e of change always equal communication

i n t e n s i t y , the c r u c i a l r o l e of communication i n t h e change

process has always been acknowledged.

Lerner and Schramn (1967) noted t h a t communication

i s no t always able t o produce s o c i a l and economic change,

although most l i k e l y it c o n s t i t u t e s one p r e r e q u i s i t e f o r

such change. Also, Katz (1972b)holds t h a t communication

of one kind o r another p lays a p a r t i n every s t a g e of t h e

change process: t h e r o l e of communication is t o provide

people i n t h e s o c i a l system w i t h information about t h e

need f o r change, information about what change can occur,

about a v a i l a b l e a l t e r n a t i v e s , about t h e means of change

and t h e b e n e f i t s that can accrue from such change.

Commulrication i s t h e s o c i a l process by which

information, idea o r f e e l i n g passes from a sender t o the

r ece ive r . According t o W i l l i a m Albig (1 956:33), a l l

s o c i a l processes and a l l s o c i e t a l forms a re .under l ined

by t h e t r a n s f e r of meaning between indiv iduals . In

Albig 's words, NComrnunication is t h e fundamental s o c i a l

process i n t h a t t h e way i n which meanings a r e t ransmi t ted

must i n e v i t a b l y a f f e c t a l l o t h e r s o c i a l processes and t h e

r e s u l t a n t forms, folkways, mores and i n s t i t u t i o n s N (p.34) .

I n t h e context of s o c i a l change communication i s

concerned with the s i g n i f i c a n t a l t e r a t i o n of the s t r u c t u r e

and funct ion of t h e s o c i a l system as a r e s u l t of new i d e a s

o r innovat ions d i f f u s i n g through the system. The p lace

of communication i n t h e change process i s pointed out by

Loomis and Beegle (1963:7) thus:

As elements of s o c i a l systems a r e a r t i c u l a t e d i n s o c i a l a c t i o n s , t h e process of communication, decis ion- making, boundary maintenance, and s o c i a l - c u l t u r a l l inkage a r e of s p e c i a l importance.

1 .I. 1 Communication and Dif fus ion of Innovation

Dif fus ion i s another term f o r communication - t h e

s p e c i a l process by which innovat ions i n t h e form of new

knowledge, p r a c t i c e o r ob jec t spreads throughout t h e

s o c i a l system. What makes d i f f u s i o n s p e c i a l i s that it

aims t o bring about over t behaviour change a s a g a i n s t

changes i n knowledge and a t t i t u d e , which a r e t h e a i m s of

a l l communication experience. In d i f f u s i o n research ,

t h e knowledge and persuasion e f f e c t s are merely i n t e r -

mediate s t e p s i n t h e i n d i v i d u a l ' s decision-making

process leading eventua l ly t o o v e r t behaviour change - e i t h e r adoption o r r e J e c t i o n of t h e innovat ion (Rogers

and Shoemaker, 1971:16). For example, the awareness of

a p a r t i c u l a r family planning method does n o t always

e l i c i t compliance from members of the s o c i a l system; such

awareness i s only a s t e p t o the dec i s ion t o adopt o r

r e j e c t the method. Such a dec i s ion i s u l t ima te ly taken

based on c u l t u r a l d i s p o s i t i o n , with r e l i g i o n playing a

prominent r o l e .

Four c r i t i c a l elements a r e involved i n t h e d i f f u s i o n

of an innovation (Rogers and Shoemaker, 1971 and Katz

e-t a1 1963). They are: - -9

(1) the innovat ion, which i s an ob jec t , i d e a o r

p r a c t i c e ;

(2) which i s communicated through c e r t a i n channels;

( 3 ) over time;

(4) among members of a s o c i a l system,

Some c h a r a c t e r i s t i c s of an innovation t h a t can

enhance i t s adoption a r e i t s r e l a t i v e advantages.

Measured i n economic terms, t h e idea , ob jec t o r p r a c t i c e

must be b e t t e r than t h e i d e a it supersedes and capable

of bringing a s o l u t i o n t o a s o c i a l problem. The innova-

t i o n must be compatible wi th the norms, va lues and needs

of %he s o c i a l system. It must be a s r e l a t i v e l y complex

t o understand o r use as it must be t r i a b l e . F i n a l l y ,

it must possess observable r e s u l t s ,

Communicating the innovation can be c a r r i e d out

through the mass media such as rad io , t e l e v i s i o n , news-

paper o r f i l m , The impl ica t ion of using the mass media

channels i s t h a t the audience cannot i n t e r a c t d i r e c t l y

with t h e communicator. It is a one-way experience from

t h e sender t o t h e r ece ive r . Communication can a l s o be

through formal and informal s o c i a l channels wi th opportu-

n i t y f o r a two-way flow o r i n t e r a c t i o n between indiv iduals .

According t o Katz -- e t a1 (1963), "time i s t h e key t o

d i f f u s i o n researchn. There i s a time l a g i n t h e

innovat ion dec i s ion process whereby t h e ind iv idua l passes

from the lirst con tac t o r knowledge of t h e innovation

through i t s adoption o r r e j e c t i o n , The time element is

a l s o measured i n t h e innovat iveness of ind iv idua l s i n

the s o c i a l system, t h a t i s , t h e r e l a t i v e e a r l i n e s s o r

l a t e n e s s with which ind iv idua l s adopt t h e innovation.

Time i s a l s o measured according t o t h e innovat ion8s r a t e

of adoption o r t h e r e l a t i v e speed with which ind iv idua l

members o f the s o c i a l system adopt t h e innovation.

Based on t h e r a t e of adoption, Rogers (1983:226 - 311) c l a s s i f i e d ind iv idua l s i n t o - f i v e innovator-adopter

ca tegor ies :

Innovators - who a r e descr ibed a s venturesome

and eager t o t r y new ideas ;

Ear ly adopters - described as respectable ,

with t r a i t s of opinion leadership ;

Early n a j o r i t y - with a b i l i t y t o i n t e r a c t

with t h e i r peers , but hardly with leadership

traits;

Late major i ty - described as s k e p t i c a l and

adopt an innovat ion because of inc reas ing

pressure o r economic necess i ty ;

Laggards - mostly conservat ive and near-

i s o l a t e s whose po in t of re ference i s the pas t .

1.1.2 The Guinea Worm Eradica t ion Programme

~ u i n e a worm is a long, thread-l ike nematode worm

t h a t l i v e s as a subcutaneous p a r a s i t e i n m a n and animal.

Known b io log ica l ly as Dracunulus medinensis, i t is

found mostly i n t r o p i c a l regions of Afr ica and Asia.

Dracuncul iasis i s a water-borne d i sease t ransmi t ted when

water contaminated with t i n y crustacean cyclops ( a l s o

known a s copepods) i s drunk by man o r animal.

When inges ted , the cyclops d i e i n t h e d i g e s t i v e

process thereby re leas ing t h e i n f e c t i v e l a rvae of t h e

worm. After a year-long incubat ion during which mating

occurs between the male and female worm, t h e male d i e s ,

while t h e female worm migrates down the t i s s u e s of t h e

abdomen v i a t h e i n t e s t i n e . The a d u l t worm emerges

through the sk in , usual ly the l e g o r foot . The emerging

worm measure from 60cm t o 90cm long and about 1.5cm wide.

Transmission cyc le of guinea worm starts when a

p a t i e n t with the worm comes i n t o con tac t with t h e source

of dr inking water - pond o r stream. The a d u l t female

worm e j e c t s hundreds of thousands of l a rvae i n t o t h e

water. These l a rvae a r e then swallowed by t i n y water

cyclops '*

According t o World Wild l i fe Fund Radio (1997), about

20 mi l l ion people i n Afr ica, Ind ia and Pakis tan a r e

a f f l i c t e d by d racuncu l i a s i s . I n Nigeria , a survey by t h e

World Health Organization (WHO) i n 1990 i d e n t i f i e d 12,000

v i l l a g e s i n Nigeria as g-uinea worm endemic. This involves

about 1.5 mi l l ion households o r about 9.6 mi l l ion people

( ~ g b o d o , 1997:B11) . A g loba l e f f o r t t o e rad ica te t h e I t f iery se rpen tu

began i n 1980 with the proclamation of t h e i n t e r n a t i o n a l

decade f o r s a f e dr inking water and s a n i t a t i o n by WHO. I t

was then pro jec ted t h a t guinea* worm would be eradica ted

by December, 1995. I n Nigeria , t h e Nigeria Guinea Worm

Eradica t ion Programme (wIGEP) was s e t up i n 1988 t o

coordina te an i n t e g r a t e d a c t i o n involving a hos t of

i n t e r n a t i o n a l agencies and non-governmental organiza t ions

( ~ ~ 0 s ) . Notable among them a r e t h e WHO, WICEF, Global

2000, UNDP, Japanese I n t e r n a t i o n a l Coordinating Agency

(JICA), Guinea Worm Eradica t ion Foundation ondo don),

USAID, Peace Corps, among o the r s .

NIGEP has f o u r zonal o f f i c e s around the country t o

coordinate i t s a c t i v i t i e s . They a r e the South-West zone

badan an), North-West ( I l o r i n ) , North-East ( Jos) and the

South-East zone (Calabar); a l l headed by Zonal F a c i l i t a t o r s .

There a r e a l s o NIGEP s t a t e o f f i c e s i n t h e m i n i s t r i e s of

h e a l t h and t h e n a t i o n a l headquarters i n t h e Federal

Minis try of Health. There a r e f o u r major components of

t h e programme, as pointed ou t by Ukwuoma (1992:5).

They are:

(1 ) Health education,

( 2 ) S o c i a l (community mobi l iza t ion) ,

( 3 ) Survei l lance , and

(4) In tervent ion .

The s t r a t e g y f o r h e a l t h education aims t o disseminate

t h e "message on guinea worm d i s e a s e n t o enhance a c t i v e

p a r t i c i p a t i o n from v i l l a g e r s i n t h e dialogue t o promote

f a c t s about prevent ing the d i sease . The message on t h e

guinea worm d i sease forms the theme of t h e campaign

through t h e mass media and o t h e r channels of communication

ac ross t h e country. The campaign comprises r a d i o and

t e l e v i s i o n j i n g l e s , h e a l t h t a l k s i n English and l o c a l

languages, d i s t r i b u t i o n of audio c a s s e t t e s and films on

guinea worm c o n t r o l , and school and v i l l a g e dramas ( W F

Radio: 1997). One of such programmes i s "Let them Liven,

a c h i l d s u r v i v a l programme sponsored by UNICEF. It i s

broadcast on Radio Nigeria , Ibadan, Kaduna and Enugu.

Topics covered inc lude r a i n water harves t ing and s torage ,

water bo i l ing and f i l t e r i n g , i n a d d i t i o n t o c h i l d c a r e

i s sues .

The community mobil izat ion component of t h e programme

involves the mass education of endemic v i l l ages on

methods of prevention of the spread of the disease. This

includes demonstration of water f i l t e r i n g and treatment,

as well a s provision of a l t e r n a t e water supply sources

through community e f f o r t and the support of l oca l , s t a t e

and federa l governments and in te rna t iona l organizations.

The messages of community mobilization are:

Guinea worm comes from drinking water contain-

ing guinea worm larvae. It is no t caused by

the gods o r "jujun, nor i s it a curse.

Persons with guinea worm sores o r b l i s t e r s

who s t ep i n t o the ponds of water contaminate

the water with guinea worm larvae. These

persons should not be allowed t o s t ep i n t o

drinking water sources.

Good neighbours should help those who have

guinea worm by fetching water f o r them.

Water contaminated with guinea worm larvae

can be made safe t o dr ink by f i l t e r i n g

through a c l o t h o r by boiling.

When people have guinea worm, farmers cannot

work, mothers cannot take proper care of the

family and children m i s s many days of school.

Guinea worm makes people suf fe r .

Surveil lance i s done through Village-Based Health

Workers (VBHW) who a r e t ra ined to search out vict ims,

give them first a i d treatment and repor t casea t o NIGEP

through the monthly surveil lance and report ing handbook.

About 7,000 VBHWs were t ra ined by UNICEF. Also involved

a r e nGuinea Worm Corpers" (members of the National Youth

Service Corps mobilized and t ra ined f o r t h a t purpose)

and the American Peace Corps Volunteers. Their a c t i v i t i e r

a r e supervised by the Primary Health Coordinator (PWC) at

the l o c a l government level . The monthly survei l lance

repor t s a re compiled and published annually by NIGEP.

The ul t imate goal of the in tervent ion component i s

t o provide potable water sources f o r endemic v i l l ages .

I n addit ion, VBHw,coordinators and o thers a r e required

t o t r e a t and educate infected persons on how t o care f o r

t h e i r sores, hold hea l th education t a l k s a t v i l l age

gatherings and d i s t r i b u t e monofilane nylon f i l t e r s and

water treatment chemicals t o households.

1.2 Statement of the Problem

The Nigeria Guinea Worm Eradication Programme

Monthly Surveil lance Report (1996) shows that Nigeria

achieved 98 per cent eradicat ion of the guinea worm

disease between 1987 and 1996, l a rge ly through the

e f f o r t s of NIGEP. Data from the repor t show t h a t i n the

1987/88 repor t period, a t o t a l of 653,620 cases were

recorded, while t o t a l cases i n 1996 was only 12, 282.

Also i n the 1987/88 period, a t o t a l of 5,872 v i l l ages

were described a s endemic, while 1996 had 1,360 endemic

v i l l ages .

This study assumes t h a t the campaign t o eradicate

t he guinea worm disease has been a success. I n the

campaign, NIGEP made e f fec t ive use of mass communication

i n the dissemination of the message on guinea worm disease.

Could the communication media have been instrumental t o

the change i n knowledge, a t t i t u d e and behaviour, leading

t o t he adoption of new p rac t i ce s f o r the prevention o f

guinea worm disease i n endemic areas? (as suggested by

Lazarsfeld and Menzel: 1963 and Rogers, 1969: 1 24-1 45) . 1.3 Purpose of the Study

The eminent anthropologist , A.R. Radcliff-Brown, i n

h i s seminal work, A Natural Science of Society (l957),

assigned two tasks t o s tudents of society. They a r e t o

f ind out:

( a ) how s o c i a l systems perpetuate themselves

by maintaining t h e i r s t ruc ture , and

(b) how social systems change t h e i r structure.

T h i s study proceeds from the second task. It is t o

f ind explanation t o the change-agent success i n the near

eradication of guinea worm disease i n Nigeria. It w i l l

consider the long-term mass communication pol ic ies and

practices supporting the guinea worm eradication

programme.

Specifically, t h i s study i s to :

ident i fy the modes of communication used t o

disseminate the message on guinea wora disease;

review the contents of the message on guinea

worm disease;

es tab l i sh the leve l of exposure t o the message

on guinea worm disease by people i n %he

endemic vi l lages;

analyse the impact of the channels used i n the

campaign f o r change i n knowledge, a t t i t ude and

behaviour of the people i n the guinea worm

endemic vil lages.

1.4 Theoretical Framework

The innovation decision process i s a mental process

through which the uni t of adoption - individual o r

s o c i a l system - passes i n making the decis ion (see

Rogers, 1983: 5 and Kaufman, 1987:332-338). Considering

t h i s process and the nature of d i f fus ion , general ly,

t h i s study in tends t o use the multi-step flow model as

a system f o r understanding the s t r a t e g i e s used by NIGEP

t o disseminate the message on- guinea worm disease.

Proposed by Menzel and Katz (1 955:337-352) the

multi-step flow theory i s based on the s e r i e s of sequen-

t i a l transmissions of information t h a t seem t o take

place i n most communication s i tua t ions . Proceeding from

the two-step flow theory, the multiple-step flow admits

more p o s s i b i l i t i e s ; research has shown t h a t the ul t imate

number of re lays between the media and f i n a l receivers

i s variable ( L i t t l e john, 1992:351) . In the adoption of an innovation, Rogers and

Shoemaker (1 971 : 209) elaborate:

Some members w i l l obtain the message d i r e c t l y through channels from the source, while o thers may be severa l times removed from the message origin. The exact number of s teps i n t h i s process depends on the in ten t ion of the source, the a v a i l a b i l i t y of mass media and the extent of audience exposure; the nature of the message, and the sa l ience of the message t o the receiving audience.

1.5 Signi f icance of t h e Study

If the s t a t e d ob jec t ives of t h i s s tudy i s achieved,

it w i l l throw more l i g h t on t h e e f f e c t i v e use of mass

communication i n s o c i a l development programmes. A s a

study of change agen t s ' success , l e s sons l e a r n t here

could be used i n designing f u t u r e campaigns.

This i s more p e r t i n e n t i n t h e face of inc reas ing

spread of such d i s e a s e s as HIV/AIDS, tube rcu los i s , yellow

f e v e r and malaria i n developing count r ies . Reports have

i t t h a t 17 mi l l ion people a r e in fec ted wi th H I V , a t t h e

r a t e of 8,000 d a i l y , wi th 80 p e r c e n t l i v i n g i n develop-

i n g coun t r i e s , while TB i s believed t o k i l l t h r e e m i l l i o n

people each year , wi th 98 p e r cen t of dea ths taking p lace

i n developing c o u n t r i e s (~wakei : 1995).

I n add i t ion , a study of t h i s campaign t h a t worked

w i l l be of i n t e r e s t t o a d v e r t i s i n g and pub l i c r e l a t i o n s

s t r a t e g i s t s , a s w e l l as t o s tuden t s and resea rcher s i n

communication and s o c i a l change.

Not l e a s t , t h i s s tudy w i l l se rve t o extend knowledge

i n the a r e a of d i f f u s i o n research and t h e concomitant

multi-step f l.ow theory.

1.6 Research Ques t ions

This study w i l l be guided by t h e following questions:

(a) What i s the content of the message on

guinea worm d i sease?

( b ) What a r e the dominant communication channels

used by t h e people i n guinea worm endemic

v i l l a g e s ?

( c ) What a r e the modee of communication used by

NIGEP t o disseminate t h e message on guinea

worm d i sease?

(d) Were t h e people i n the guinea worm endemic

v i l l a g e s exposed t o t h e message on guinea

worm disease?

( e ) Did exposure t o the message on guinea worn

d i s e a s e cause t h e people i n t h e endemic v i l l age :

t o adopt p r a c t i c e s designed t o prevent t h e

d i sease?

( f ) What i s t h e r e l a t i o n s h i p between the l e v e l of

exposure t o the message on guinea worm d i sease

and t h e r a t e of adoption of new h a b i t s ?

1.7 Def in i t ion of Concepts

For t h e purpose of c l a r i t y , the fol lowing terms/

concepts i n t h e s tudy have t h e following opera t iona l

d e f i n i t i o n s :

(a) Content - t h e substance of t h e message of guinea

worm d i s e a s e i n terms of meaning.

Mode of Communication - i d e n t i f i a b l e long-term pol icy

pe r t a in ing t o the way o r manner of t r ansmi t t ing

information,

Channels of Communication - physica l , t echn ica l , and

s o c i a l r o u t e s o r pa ths through which information i s

t r ansmi t t ed , t o guinea worm endemic v i l l a g e s .

Exposure - percept ion of information pe r t a in ing t o

t h e guinea worm disease .

Channel use - t h e a c t of l i s t e n i n g t o r ad io , watching

t e l e v i s i o n o r f i l m , reading newspapers and magazines,

o r o t h e r mass communication channels as a matter

of hab i t .

Adoption - t ak ing up new h a b i t s aimed a t preventing

the spread of guinea worm d i sease .

Level of exposure - i n q u a n t i f i a b l e terms, t h i s

means those who saw, read o r heard t h e message on

guinea worm disease .

Rate of adopt ion - quan t i f i ed number of people who

took up new h a b i t s .

P r a c t i c e - hygienic behaviour prescr ibed by the

message on guinea worm disease .

CHAPTER TWO - LITERATURE REVIEN

2.1 The Direction of the Review

The mass media were, i n the context of development, general ly used t o support development i n i t i a t i v e s by the dissemination of message8 t h a t encourage the public t o support development-oriented p-EO j e c t s . . . t he usual pa t t e rn f o r broadcasting and the p re s s has been predominantly the same: informing the population about p ro jec t s , i l l u s t r a t i n g advan- tages of these p ro jec t s , and reco- mmending t h a t they be supported ( ~ e r v a e s , 1991:73).

This study i s on the modes of communication employed

i n t he long-term, t o transmit messages on g u i ~ e a worm

eradicat ion. It i s a study on the process of d i f fu s ion

of innovation on health-care and the influence of mass

conunmication on the adoption of new hab i t s r e e e s s a r j for

guinea worm eradicat ion. Flris review w i l l focus an the

diffusion-adoption model, t he use of media i n d i f fu s ion

of innovation and on the multi-step flow i n t he

d i f fu s ion process.

2.2 The Diffuion-Adoption Model

The most prominent among the scholars who have worked

on the diffusion-adoption model a r e , probably, Bryce Ryan

and Niel Gross (1 943). Llihu Katz (1 957) and Everet t M.

Kogers (1 983) . The Ryan and Gross study which i s

regarded as t h e most i n f l u e n t i a l of a l l time, d e a l t wi th

t h e d i f f u s i o n of hybrid seed corn among Iowa (United

S t a t e s ) farmers. The seed corn which was introduced i n

1928, r e s u l t e d i n a g r i c u l t u r a l innovat ions spanning over

two decades a n d . g r e a t l y increased farm product iv i ty .

I n t h e s tudy, Ryan and Gross interviewed 229 farmers

t o a s c e r t a i n when and how they adopted the hybrid corn

and t o ob ta in information about them and t h e i r farm

operat ions. The r a t e of adoption was p l o t t e d over time - r e s u l t i n g i n t h e S-curve, now popular i n d i f f u s i o n

research. Next, t h e farmers were assigned t o adopter

c a t e g o r i e s based on time of adoption of t h e innovation.

F ina l ly , var ious communication channels were i d e n t i f i e d

a s playing d i f f e r e n t r o l e s i n the innovation-decision

process. This study yielded the c l a s s i c a l d i f f u s i o n

paradigm (see ch. 1 .I . I ) .

I n 1957, Katz examined how medical doc to r s i n f o u r

midwestern c i t i e s i n Anerica made dec i s ions t o adopt new

drugs. Severin and Tankard (1 988: 199) r e p o r t t h a t :

Besides t h e usual demographic d a t a (age, medical school a t tended, e t c ) and d a t a about a t t i t u d e s , prescr ip- t i o n of drugs, exposure t o information sources and inf luence and o t h e r d e t a i l s , t h e doc to r s were asked t o name the t h r e e col leagues they were

most a p t t o t a l k wi th about cases , the t h r e e they were most a p t t o seek information and advice from, and t h e th ree they were most l i k e l y t o s o c i a l i z e with.

The quest ions pe r t a in ing t o a d o c t o r ' s i n t e r a c t i o n s

with col leagues allowed t h e researcher t o ''mapM the

in te rpe r sona l r e l a t i o n s i n the- medical community. It

w a s i n f e r r e d t h a t t h e p a t t e r n of s o c i a l r e l a t i o n s was

i n f l u e n t i a l i n t h e decision-making: e a r l y adopters of

new drugs were l i k e l y t o a t t e n d out-to-town medical

meetings i n t h e i r s p e c i a l t i e s .

Evere t t Rogers i s , perhaps, t h e best-known and most

quoted researcher i n d i f f u s i o n l i t e r a t u r e . H i s book

Dif fus ion of Innovations (1983), now a t i t s f o u r t h

e d i t i o n , examines more than 2,000 empir ica l research

r e p o r t s and over 3,000 publ ica t ions . It i s aimed t o

r e v i s e e a r l i e r theory about t h e innovation dec i s ion

process , as a r e s u l t of t h e increase i n d i f f u s i o n

resea rch i n r ecen t years (Severin and Tankard: p.123).

Among o the r conclusions, Rogers suggests t h a t communi-

c a t i o n channels i n t h e d i f f u s i o n of innovat ions may be

in te rpe r sona l o r mass media i n na ture ( p a 198) , and

t h a t t h e mass media serve pr imar i ly t o inform, whereas

in te rpe r sona l channels a r e most important a t persuad-

i n g people t o change a t t i t u d e s .

2.2 The Innovation-diffusion Process

According t o Rogers (1 983: 121 -1 49) t h e adoption

u n i t passes through f i v e s t ages in t h e dec i s ion t o adopt

o r r e j e c t t h e innovation:

Knowledge - t h i s i s t h e - s t a g e when t h e u n i t of

adoption is exposed t o the new idea , obJect o r

p r a c t i c e and when it acqui res understanding of how

it funct ions. A t t h i s s tage , r e sea rcher s usua l ly

want t o know where o r from whom t h e ind iv idua l

received information about t h e innovation.

Persuasion - t h i s i s t h e s t age of formation of

a t t i t u d e toward t h e innovation. The a t t i t u d e could

be negat ive o r p o s i t i v e . Researchers8 i n t e r e s t a t

t h i s s t age i s t o know who o r what convinced t h e

ind iv idua l o r s o c i a l system t o adopt o r r e j e c t t h e

innovation.

Decision - t h e adoption u n i t makes t h e choice t o

adopt o r r e j e c t t h e innovation a f t e r c a r e f u l evalua-

t i o n .

Implementation - t h e uni t p u t s t h e innovat ion i n t o

use, even i f on a t r i a l bas is ; using t h e knowledge

acquired i n t h e first instance.

( e ) Confirmation - t h e t r i a l of t h e innovat ion e i t h e r

makes t h e adoption u n i t t o r e in fo rce o r reverse t h e

dec is ion . Researchers ' i n t e r e s t a t t h i s s t age i s t o

know t h e source of f u r t h e r information with which

t h e ind iv idua l o r s o c i e t y r e i n f o r c e s o r r eve r ses t h e

dec is ion .

It should be noted t h a t these f i v e s t a g e s do no t

always occur i n t h i s sequence; some of t h e s t a g e s may be

skipped, e s p e c i a l l y t h e t r i a l s tage . Also, t h e process

does not always end with adoption; the u n i t of adoption

may seek f u r t h e r information t o r e in fo rce t h e dec is ion ,

o r may switch from adoption t o r e j e c t i o n owing t o t h e

experience with t h e innovation o r due t o t h e inf luence of

in te rpe r sona l communication (Rogers and Shoemaker, 1971:

2.4 Media Use i n t h e Diffusion of Innovations

Torsten Hagerstrand (1 972: 174-1 77) ouklined two

major approaches used i n d i f f u s i o n s tud ies . One approach

focuses on t h e c h a r a c t e r i s t i c s of *he ind iv idua l and h i s

r e l a t i o n s t o h i s immediate environment. The oQher

focuses on t h e s o c i a l system as a whole. Being i n the

t r a d i t i o n of c u l t u r a l h i s t o r y , and c u l t u r a l geography,

the second approach t a k e s i n t o cons idera t ion such

macroconcepts a s growth p a t t e r n , c e n t r e s of innovat ion

and c e n t r e s of spread, c h a ~ e l s of d i f f u s i o n , b a r r i e r s

t o d i f f u s i o n , c u l t u r a l boundaries, and r e c e p t i v i t y

f a c t o r s .

On t h e na tu re of diffusion channels, Hagerstrand

(p.176) suggests t h a t "personal communication between

p a i r s of ind iv idua l s and d i r e c t observat ion a r e s t i l l t h e

bas ic instruments f o r t h e d i f f u s i o n of innovationn. The

reason, a s he put it, i s t h a t new t h i n g s and i d e a s o f t e n

look complicated t o t h e u n i t of adoption; people have t o

be ab le t o ask quest ions, t ake th ings i n t h e i r hands,

t r y them, and g e t a f e e l i n g f o r them i n order t o f u l l y

understand and adopt.

Schneider and F e t t (1978: 494-500) s tudied the

q u a n t i t a t i v e and q u a l i t a t i v e na tu re of the flow of messages

about recommended a g r i c u l t u r a l p r a c t i c e s introduced v i a

t h e mass media i n a small farm a r e a i n Southern Brazi l .

The r o l e of opinion l e a d e r s i n message flow was explored

and a number of hypotheses r e l a t i n g socio-economic

f a c t o r s t o t h e amount of the messages received and

remembered by respondents were t e s t ed .

The resea rcher s hypothesized t h a t f a c t o r s such as

23

educat ion, change agent con tac t , mass media contac t and

frequency of con tac t with f r i e n d s and neighbours, were

p o s i t i v e l y r e l a t e d t o the amount of +he message respon-

d e n t s would remember having received. They a l s o hypo-

thes ized t h a t messages advocating p r a c t i c e s which conform

t o group norms, and messages wi th high u t i l i t y o r

relevance would spread more extens ive ly than t h e i r

opposi te . From t h e 327 heads of households interviewed

two weeks a f t e r t h e t h r e e s tudy messages were run i n t h e

l o c a l p r i n t and broadcast media, during a r e g u l a r r a d i o

farm extension programme, it was i n f e r r e d t h a t r ad io was

more e f f e c t i v e i n t h e spread of the message. It was

a l s o concluded t h a t seven socio-economic f a c t o r s were

p o s i t i v e l y r e l a t e d t o t h e amount of information received

and remembered by t h e respondents.

I n h i s ltCommunication S t r a t e g i e s f o r Population

P o l i c i e s N , Onuora Nwuneli (1 985: 210-21 9) reviewed

var ious paradigms i n communication and s o c i a l change and

suggested the use of t h e mass media t o c r e a t e awareness

and information on var ious innovat ive programmes. He

suggested a s t r a t e g y of information r e d i s t r i b u t i o n t o

r e f l e c t t h e soc io -cu l tu ra l norms of r u r a l and urban

audiences. Nwuneli emphasized t h e use of a combination agu;wi'f ,Y' - - - a

OF-7 n?W'-- - .*.:::

of t h e e l e c t r o n i c media ( e s p e c i a l l y t h e r a d i o ) , f o l k

media, f e s t i v a l s , drama, songs, shows, competit ions, and

in te rpe r sona l channels t h a t allow a two-way exchange of

information. According t o h i m , personal communication

i s very o f t e n accompanied by t h e flow of personal

inf luence from persons who represent s a l i e n t reference

groups t o which the p o t e n t i a l adopter belongs.

While t h e preponderance of d i f f u s i o n s t u d i e s have

been on t h e channels of spread, l e s s has focussed on t h e

dominant channels of information used by t h e u n i t s of

adoption. Yet, we know t h a t a s o c i a l system is n o t

always bound t o use t h e channels of spread used by change

agents. Hence, Donald Roberts and Chr i s t ine Bechen

(1982:52) s t r e s s t h e need t o adopt t h e communication

components of change e f f o r t s t o t h e r e a l i t i e s of t h e

s o c i a l s t r u c t u r e i n which change is t o be achieved.

They emphasized t h a t t h i s i s a c e n t r a l i s s u e t o the

cu r ren t e f f o r t s a t a reassessmenk of t h e r o l e of communi-

c a t i o n i n economic and s o c i a l development.

The most empir ica l study on t h e use of media

channels as ttdominantu and nlesstt sources of information

was, perhaps, done by Alex Ede l s t e in (1974). Pie

focussed on how ind iv idua l s i n S e a t t l e (uni ted S t a t e s )

and i n two c i t i e s i n Yugoslavia (Belgrade and LjublJana)

use in te rpe r sona l and mass communications t o understand

t h e na ture of s o c i a l problems and t o decide what should

be done about them.

Ede l s t e in found t h a t people i n S e a t t l e usedte levis ion ,

r a d i o and o t h e r mass channels more a s dominant sources

of information about l o c a l problems than t h e people i n

Belgrade and i n Ljubljana. He a l s o found that i n S e a t t l e ,

i n t e r p e r s o n a l channels, def ined as f r i e n d s , family members

and l o c a l meetings were used more as sources of informa-

t i o n than i n Belgrade and Ljubljana. Ede l s t e in conBludes

t h a t having s o l u t i o n s t o s o c i a l problems was assoc ia ted

wi th g r e a t e r use of mass media channels and t h a t access i -

b i l i t y t o mul t ip le sources of information accentuated

such knowledge, which was demonstrated as extens ive and

q u a l i t a t i v e (pp . 1 98, 209) . I n 1975, Hubbard, DeFleur, and Defleur s t u d i e s n o t

only t h e s o c i a l problems presented i n t h e media and

pub l i c conception o f those problems, but a l s o o f f i c i a l

s t a t i s t i c s about t h e same problems. Their r e s u l t s

suggest that, e s p e c i a l l y i n t h e emergence phase of a

s o c i a l problem, t h e news media may p lay a r o l e i n shaping

conceptions about t h e importance of t h e problem. Publ ic

b e l i e f s of t h e prevalence of t h e problem, on t h e o t h e r

hand, p a r a l l e l agency s t a t i s t i c s , presumably because

agency s t a t i s t i c s a r e usua l ly regarded by the s o c i e t y as

a r e f l e c t i o n of the r e a l i t y on t h e mgroundn - both a r e

products of t h e genera l c u l t u r e of t h e American soc ie ty .

S imi la r ly , Naroldsen and Harvey (1 979: 771 -775)

s tudied t h e p a t t e r n of d i f f u s i o n of I1shockingW good news,

using the announcement i n 1978 by the Mormon Church i n

U S that blacks, who were h i t h e r t o precluded from holding

pr iesthood, could f i n a l l y hold priesthood. O f t h e 245

heads of households interviewed over a period of f o u r

days beginning from the Monday following t h e Friday a f t e r

t h e announcement, 94 p e r c e n t heard t h e announcement, 53

per cen t of which heard t h e news from i n t e r p e r s o n a l

sources. O f t he 113 respondents who first heard t h e news

through the mass media, 54 per cent heard it on t e l e v i -

s ion , 38 per cent read it i n newspapers. O f t h e 129

who first heard it through in te rpe r sona l channels, 54

pe r cent heard it from c lose a s soc ia tes , f r i e n d s o r

r e l a t i v e s outs ide the immediate family.

The Mormon Church s tudy is s i g n i f i c a n t i n a t l e a s t

two ways: it confirms the inportance of

conununication in the diffusion of news,

interpersonal

leading Melvin

Defleur to "celebraten eight years after, that "the

oral tradition is alive and well in the information

societyl1 (1 987: 189). Secondly, the Mormon Church study

confirms the dependence on mass media channels for

information; indeed, respondents believed the mass media

to be more credible than interpersonal influence.

But caution should be exercised in extrapolating

the conclusions of theHaro3.dsenand Harvey to the

circumstances of innovation diffusion, owing to the

marked distinction of information on nimportant eventsn

from information on "innovationsn, or what Rogers and

Shoemaker (1971 ) called the "how tott and nprinciplesn

knowledge. Robinson (1972) also provides an effective

typology for classifying information.

In Nigeria, Ebeze (1 992) studied the roles of 1 modem

and traditional communications in the adoption of the

Expanded Programme on Immunization (EPI) - an innovation in child care. He concluded that media use among the

people of Ezioka community in Awka, cuts across charmela:

radio formed the dominant channel of information on

EPI, followed by jhe market-place channel, the town c r i e r

and pr iva te v i s i t s i n t h a t order, A s much as 90.5 per

cent of the people are aware of EPI through a combination

of modern and t r a d i t i o n a l channels,

~ l s o , Igboeli (1997) suggests t h a t women i n Anambra

S t a t e r e l y mostly on in terpersonal sources - hospi ta l /

hea l th centre/waternity workers - f o r information on the

Oral Rehydration Therapy (oRT), While as much as 84 per

cent of the women polled r e l i e d on these channels, as'

l i t t l e a s 3,3 per cent reported the p r i n t and e lec t ron ic

media t o be t h e i r dominant Sources of information on

OHT, Igboe l i ' s conclusions f ind corroborations i n the

works of Anekwe (1 988) and Elaeruwa (?988), a l l ORT

s tudies . What can be sa id on t h i s i s t h a t s ince ORT is

an innovation t h a t requires technical knowledge i n

preparation and administration, it i s no surpr ise t h a t

mothers r e l i ed on the exper t ise of hea l th workers.

Oweka (1 992) studied the influence of aocio-economic

s t a t u s on the adoption of chi ld survival p rac t ices - ORT and EPI - i n Nigeria. H e concluded that the r a t e

of adoption of the two innovations was very high among

people with high education and people with low education,

though t h e r a t e is s l i g h t l y higher i n t h e former group

owing t o t h e i r more use of t h e mass media. There is a

s i g n i f i c a n t r e l a t i o n s h i p between awareness of t h e

programmes and t h e i r adoption (see a l s o Emenyeonu: 1986).

On t h e dominant media of information and awareness,

Oweka suggests that r a d i o is most a p t (38 per c e n t ) ,

owing t o t h e d e a r t h of i n f r a s t r u c t u r e and f a c i l i t i e s i n

most r u r a l a reas , while in te rpe r sona l communication

(defined a s government h e a l t h worker) se rves a s "a l te rna-

t i v e ' means of information.

Eni (1993) a l s o found t h a t t h e awareness of an

overwhelming nwnber of people on sex-re la ted problems was

boosted by t h e adver t i s ing campaign on safe sex and

family planning, through t h e use of condom. According

t o him, the campaign served, among o the r s t o inform

consumers about i s s u e s r e l a t e d t o sexual ly t ransmi t ted

d i s e a s e s (STD) , unwanted pregnancy and family planning;

a s i g n i f i c a n t major i ty of respondents (57 p e r cen t )

repor ted the use of condom as a r e s u l t of being exposed

t o adver ts ing on it, while a s i g n i f i c a n t minori ty

(35.5 per c e n t ) denied use.

On the most i n f l u e n t i a l appeal, among the categories

of " sa fe tyN, "contraceptivew, ncomfortw and "nothing*,

Eni concludes t h a t most people who used condom were

influenced by the "safetyn appeal; only a neg l ig ib le

number of people were motivated-by the ncomfortm appeal.

2. 5 Multiple-step Flow i n the Difussion Process

The f indings of ea r ly d i f fus ion researchers on the

influence of in terpersonal soc i a l r e l a t i o n s i n the t rans-

mission of information, influence and innovations, led

i n i t i a l l y t o the conceptualization of the two-step flow

theory. It resul ted la rge ly from the discovery by

Lazarsfeld, Berelson, and Gaudet (1944), t h a t personal

contacts were more frequent and e f fec t ive i n influencing

voting decisions during the U S p res iden t ia l e lec t ions .

Among the conclusions from the now, famous Er ie

County, Ohio, study a r e t h a t very few voters changed t h e i r

minds during the campaign in. s p i t e of t he barrage of mass

communication, and t h a t those who changed t h e i r vote

in ten t ions reported t h a t o ther people, r a t h e r than the

mass media had influenced them. "The mass media were held

t o reach widely dispersed opinion leaders, who then

passed on what they had learned t o those f o r whom they

were i n f luent ia l I1 ( Katz, 1972!3:179).

More recen t ly , however, research has shown t h e two-

s t e p flow model t o be too s i m p l i s t i c ; f o r example, i n

t h e adoption of innovat ion, c e r t a i n ind iv idua l s w i l l

h e a r about i t d i r e c t l y from mass media sources, whereas

o t h e r s w i l l be many s t e p s removed ( L i t t l e j o h n , 1992:351).

This led t o the conception of the mul t i s tep flow theory.

A c l e a r conception of t h e mult iple-s tep flow theory

was done by Menzel and Katz (1955). It incorpora tes t h e

two-step flow model and t h e hypodermic theory. It does

no% spec i fy any p a r t i c u l a r number of s t e p s , n e i t h e r does

it spec i fy t h a t t h e message must emanate from t h e mass

media. Most important, t h e focus of research as Katz

(p.180) c l a r i f i e d , h a s s h i f t e d from a conception of

i n t e r p e r s o n a l inf luence a s simply a channel of communi-

c a t i o n bearing on ind iv idua l dec is ions , t o conception

of in te rpe r sona l r e l a t i o n s a s "networks of communication

through which inf luence and innovation spread through

t h e s o c i a l system".

The conclusion of Robinson (1972: 71-93) is that

t h e exact process whereby information flows through

t h e s o c i a l networks i s n o t we l l understood; t h a t

overwhelming evidence suggest t h a t " interpersonal mean:

a re more persuasive than mass media appeals owing t o

g rea te r c r e d i b i l i t y and understandabil i tyw. According

t o him, the e a r l i e r hypothesis of the two-step flow

d i s t o r t s the nature and complexity of the information

d.i.ffusion process. ~ o b i n s o n writes: Itto be sure, one

would almost define media information which f a i l s t o

exc i t e in terpersonal discussion i n the public a s having

the same impact a s the philosophical t r e e f a l l i n g i n

the wildernessv.

Cit ing the var ie ty of '"media forumsv1 i n Canada,

India , Africa, China, I t a l y and Latin America, t h a t haw

worked out well i n pract ice (Rogers and Shoemaker: 1971

Robinson sees the d i f fus ion l i t e r a t u r e a s f a r more

valuable i n suggesting an approach whereby media can

exp lo i t the powers of in terpersonal communication.

2.6 Summary of L i te ra tu re

Evidence from avai lable l i t e r a t u r e on d i f fus ion

s tud ies acknowledge the influence of the mass media i n '!

the spread of innovations. The innovation decision

process i t s e l f ii a mental process through which the I

po ten t i a l adopter passes. While t he mass media may be

of the ascribed influence i n t h a t process, overwhelming

evidence suggest t h a t interpersonal communication i s

of prime influence.

In a dominantly o r a l cu l tu re l i k e Nigeria, i n t e r -

personal communication could be pa r t i cu l a r ly e f fec t ive

i n the spread of innovative 'ideas such a s the message

on guinea worn disease , This spread may take various

pat terns ; some people w i l l l e a rn of it d i r e c t l y through

the mass media while others w i l l l ea rn about it through

other p e ~ p l e .

CHAPTER T r n E

Ml3THODOLOGY

3.1 The Method o f Research

The survey research method was used i n t h i s study;

a simple survey method was used t o genera te t h e

dominant d a t a f o r answers t o research ques t ions (b ) and

(d) t o ( f ) . These ques t ions a r e explora tory i n nature.

The sample survey i s most s u i t a b l e f o r answering ques t lor

about how a l a r g e number of sub jec t s f e e l , behave o r

a r e , e s p e c i a l l y with regard t o v a r i a b l e s t h a t change

over time (Severin and Tankard, 1988:17, Shoemaker and

McCombs, 1989:151).

3.2 Population of the Study

The universe of t h i s study i s t h e guinea worm

endemic v i l l a g e s i n Nigeria. But t h e t a r g e t population

i s t h e people in t h e endemic v i l l a g e s of Enugu and

Ebonyi s t a t e s . For convenience and owing t o l i m i t e d

funds, and time a v a i l a b l e f o r t h i s s tudy, t h r e e of such

v i l l a g e s were sampled. Two of t h e v i l l a g e s were sampled

i n Ebonyi. They a r e Nkomoro, i n t h e Abakaliki Local

Government Area, and Effium Urban i n t h e Ohaukwu Local

Government Area. I n Enugu S t a t e , Emene Owo i n t h e

Nkanu-East Local Government Area was sampled. Each of

the three vi l lages has an estimated population of

below 3,000. This apparent bias i n the number of

v i l lages from the two s t a t e s i s based on the f a c t tha t

Ebonyi State i s more endemic than Enugu State , and i n

f a c t i s one of the "highly endemicN s t a t e s (see NIGEP,

1 992: 6-7) . 3.3 Sample Size

A total. of 200 people were administered the '

research questionnaire. Out of t h i s 120 came from

Ebonyi and 80 from Enugu State. Two key o f f i c i a l s of

NIGEP i n the two s t a t e s were,in addition,inverviewed

ora l ly , using mostly an hs t ruc tu red interview schedule,

f o r answers t o research questions (a) and ( c ) . The

UNICEF representative i n Nigeria replied i n wriOing

through the head, Health Section.

3.4 Sampling Procedure

Samples were drawn using the multi-stage c lus te r

sampling method. In the f i r s t stage, purposive sampling

was applied. The three endemic vi l lages were selected

a r b i t r a r i l y from the l is t contained i n the NIGEP - Monthly Surveillance Report, January - December, 1992

which i s readily available t o the researcher.

The use of t h i s method i s s i g n i f i c a n t as p r a c t i c a l

cons idera t ion precludes the use of p r o b a b i l i t y sampling

a t t h i s s tage. Moreover, t h e researcher be l ieves t h a t

poss ib le e r r o r s i n sampling w i l l n o t be s e r i o u s (Blil ler ,

1970:56). It i s a l s o h i s convict ion that these v i l l a g e s

a r e t r u l y r ep resen ta t ive of t h e e n t i r e universe,

e s p e c i a l l y a s personal knowledge of t h e populat ion i s

necessary i n t h i s type of sampling (Ackoff, l953:124).

During t h e r e p o r t per iod , Nkomoro repor ted 57 guinea worm

cases , Effium urban reported 36 cases , while Emene Owo

repor ted 1 4 cases .

In the second s t age , elements i n t h e sample were

generated through t h e take-part sampling as a g a i n s t the

t a k e - a l l method. Using t h e v i l l a g e map obtained from t h e

Primary Health Care department of t h e l o c a l government,

the v i l l a g e was divided i n t o s i x c l u s t e r s of r e s i d e n t i a l

bui ld ings t o form t h e Primary Sampling Units (PSUS).

F i n a l l y , t h e two u n i t s sampled were chosen by b a l l o t .

Once i n t h e u n i t , t he houses were sampled a l t e r n a t e l y .

However, n o t more than f i v e a d u l t s of a t l e a s t 18 years

o ld were sampled i n a house. The essence of a l l t h i s i s

t o s e l e c t subsamples propor t ionate i n s i z e t o t h e

s i g n i f i c a n t c h a r a c t e r i s t i c s of t h e t o t a l population and

thereby increase the chances of approaching a truly

representative sample (Miller: p.56).

3.5 Research Instruments

Since the @itus of this study is the field, two

methods were used in collecting data. Primary data

were generated using the questionnaire, while the secon-

dary, supportive data were gathered through documentary

sources and personal interviews. The questionnaire

contains structured and unstructured questions, while

the oral interview schedule, which dwells on the

communication policy component of the guinea worm eradi-

cation programme, contains mostly unstructured questions,

3.6 Method of Data Analysis

Quantitative data for this study were. analysed

using the simple mathematical and statistical tables

and graphs, so as to bring out the underlying features,

characteristics, trends and relationships inherent in

the body of the data (Obikeze , 1990: 89), On the other hand, those data which do not lend

themselves to quantification were analysed using a

combination of analytic induction and data specific

analytic methods, partiaularly as in data from indepth

interviews. A s Obikeze (pp. 76, 79) p u t s it, i n t h e

a n a l y t i c induct ion method, the researcher a t tempts t o

provide a general ized explanat ion t o problem o r i s s u e s

t h a t have come t o prominence from t h e information

obtained o r observat ions made during the f i e l d work,

While i n t h e a n a l y s i s of indepth in terv iew d a t a ,

personal i n s i g h t and imagination a r e used t o i d e n t i f y

and s e l e c t key concepts i n the d a t a f o r u l t ima te

comparison and i n t e g r a t i o n , Research ques t ions (a) and

(c) e s p e c i a l l y c a l l f o r t h i s method of ana lys i s .

CHAPTER FOUR

DATA PRESENTATION AND ANALYSIS

4.1 Frame-work of Analysis

Analyses i n t h i s ehapter f a l l i n t e three rnajer

franewmks. The firs* part reviews %he message on the

guinea werm disease and the sacis-eoonenic cha rac t e r i s t i c s

of the survey pepulation. The secmd p a r t shews the

dominant channels of maas commmication i n .the endemic

v i l l ages . The t h i r d p a r t i s on the major sources of

information on the guinea worm disease and adherence t o

the new methods of hygiene and drinking water habits

advocated i n the message on guinea worn disease.

Lc.2 The Message on t h e Guinea W o n Disease

The message on the guinea worm disease i s contained

i n Facts f o r Life , a booklek i n s e r i e s t h a t contains

information about the disease and other i s sues partainiaad:

t o women and chi ld survival . The message on guinea warn

disease reads:

(1) Guinea worm comes from drinking water from

ponds and streams contaminated by the guinea

worm larvae.

(2 ) Infected persons (with b l i s t e r s o r opea aores)

should not come i n contact with the source

of dr inking water.

A s good ci-kizens, aeighboura should he lp

those with guimea worm by fe tch ing wa%er

f o r them.

All dr inking water from unsafe sources should

be f i l t e r e d o r boiled.

Provis ion of safe dr inking water sources

(deep wel l , boreholes o r t a p water) i s t h e

long-term s o l u t i o n t o guinea worm.

(See Appendix 11).

4.3 Sample C h a r a c t e r i s t i c s of the Population

(a ) Age Bracket

The age of t h e respondents ranged from 18 years t o

52 years and above. They were grouped into f i v e , a t an

i n t e r v a l of e i g h t yea r s t o conserve space and make

coding easy. The h ighes t number of resporademts were

recorded among people.between.35 and 42. This category

accounts f o r 32 pe r penL(64) of t h e respondents, while

those between 26 and 34 made up 23 per cent (46) of t h e

respondents. The lowest number of response was recorded

from people of 52 years and above. Only '1 4 pqr, cent ' ,

(28) responde,d in that category as showv i n Table 4.1

below.

41

Table 4.1: Age Distribution of Sample Population

Code

a

b

C

d

e - I

Category

18 - 25

26 - 34

35 - 42

43 - 51

52 and above

Total

(b) - Educational Attainment

A s much as 45.5 per cent (91) of those surveyed had

no formal education, while 27 per cent (54) a t ta ined

the leve l of F i r s t School Leaving Cer t i f ica te (FSLC) only.

Significantly, those who claimed t o have studied up t o

the HMD and degree leve l were higher (14 o r 7 per cent)

than those tha t claimed t o have at tained the OND/MCE

leve l who made up 6 per cent (12). See Table 4.2 below.

T a b l e 4.2 : Educational Distribution of Sample Population

(c ) Income Bracket of Samples

A greater percentage of the respondents can be

described as very low income earners, with as much as

48 per cent (96) earning below W18,000.00 per atmum. -is

is about Wl,5OO.OO molathly. On the other hand, only 1.5

per cent (3) earned N50,000.00 and above as shown i n

Table 4.3.

%

27

Code - a

e No formal education 9 1 I 45.5

Category

FSLC

f

54

43

Table 4.3: Income Brackets of Sample Population

Code Category

Less than W18,000.00

N18,OOO.OO - W25,OOO.OO

W26,OOO.OO - N33,OOO.OO

W34,OOO.OO - W41,OOO.OO

W42,OOO.OO - W49,OOO.OO

N50,000.00 and above

(d ) Occupational Dis t r ibut ion of Samples

More than half of the survey population (108 o r 54

per cent) were farmers while 46 (23 per cent) were self-

employed a s technicians, a r t i s a n s o r t raders .

See Table 4.4 below.

Table 4.4 f Occupational Distr ibu%ion of Sample Population.

Code Category

C i v i l servant

Se l f employed

Farmer

Student

Others

Total

In the gender category, 56 per cent (112) of those

surveyed were female while 44 per cent (88) were male . Care

4.4

was taken t o ensure tha t a l l indicated t h e i r gender.

Dominant Communication Channels Used by the People i n Guinea Worm Enderiic Villages

A l l questions in Section I1 (6-12) of the

questionnaire were ta i lored toward answering research

question (6). The question dwells on the dominant mass

communication channels used by the people i n guinea worm

endemic vil lages.

Beginning from t h e i r usage of specif ic mass

communication channels, a preponderance of the respondents

(135 o r 67.5 per cent) claimed they l is tened t o radio

as a habit. Only 65 (32.5 per cent) agreed they do not

l i s t e n t o the radio. Television viewership was indeed

very low. Only 22 (11 per cent) of the respondents

reported watching te levis ion habitually. One hundred

and seventy-eight (89 per cent) reported they did not

watch television. I n the same measure, p r in t media

readership was equally very low with 84 per cent (168)

of the respondents reporting t h a t they did not read

e i the r newspapers and/or magazines. Only 16 per cent

(32) claimed t o be regular readers of newspapers and/or

magazines . On t h e channels of communication r e l i e d on most

f o r information, a s i g n i f i c a n t major i ty (94 o r 47 per

c e n t ) claimed t h a t r a d i o was t h e i r maJor source of

information. Seventy-two (36 per c e n t ) r e l i e d on t h e

o r a l face-to-face channel which-was def ined t o include

in te rpe r sona l dialogue wi th f r i e n d s , r e l a t i o n s , and o t h e r

people. Newspapers ranked t h i r d i n t h e order of preference

as a major source of information. Nine pe r cent (18)

r e l i e d on newspapers as shown i n Table 4.5.

Table 4.5: Reliance on Channels of Mass Cornmicat ion

Code Category - - - -- - - - - - -- -

Radio

Televis ion

Newspapers

Magazines

Film

Oral (face-to-face)

Others

T o t a l

Asked t o indicate the reason for t h e i r preferences

among possible reasons such a s "provides more informa-

t ion", I1most educativet1, Itreadily available1', Itmore

entertainingN or "cheapest t o accessN, a s ignif icant

majority 52.5 per cent (105) of the respondents claimed

t h e i r preference was "readily available". Next, 19 per

cent (38) preferred t h e i r source because it was Itcheapest

t o accesstt while I1 per cent (22) preferred the Itmost

educativeIt channel. As much a s 21 (10.5 per cent) of the

respor1den.t~ preferred the "most entertainingH channel

while 10 (5 per cent) nvotesll f o r the channel tha t

"provid-es more informationN.

In s p i t e of t h e i r individual preferences, a

preponderance of the respondents said tha t the oral

face-to-face channel was the dominant channel of

information i n t h e i r vi l lages. Table 4.6 below shows

tha t 131 (65.5%) of the respondents believed t h a t the

o ra l channel was mostly used. Fif ty (25%) however

believed t h a t the radio predominated, while 19

(9.5 per cent) of the respondents claimed t h a t the town

c r i e r was mostly used t o disseminate information i n the

vil lage.

47

Table 4.6: Dominant Channel of Information Used i n Endemic Vil lages

Code Category

Newspapers

Magazines

Radio

Television

Film

Town Crier

Oral (face-to-face)

Others

Total

To shed more l i g h t on the use of communication

channels by the respondents, they were asked t o

ind ica te any of the following receiver se t o r material

they owned o r possessed: te levis ion, radio, newspapers,

o r magazines. They were allowed t o t i c k more than one

when applicable. A t o t a l of 108 respondents claimed they

owned radio receivers . Seventy-four owned newspapers,

46 had magazines, 47 had t e l ev i s ion s e t s , while only 25

indicated they did not have any of those th ings mentioned.

A t o t a l of 270 responses were recorded.

4.5 Modes of Communication Used t o Disseminate t h e Message on Guinea Worm Disease

The mass communication programme of t h e guinea worm

e rad ica t ion p r o j e c t has three broad ob jec t ives t h a t

t o s u s t a i n and increase commitment among

po l i cy and dec i s ion makers involved i n t h e

p r o j e c t ;

t o improve t h e knowledge, a t t i t u d e and p r a c t i c e s

of bas ic s e r v i c e providers and b e n e f i c i a r i e s ;

and

t o promote and s u s t a i n community p a r t i c i p a t i o n .

A s L. W. Nweke (1998;interview), t h e s e c r e t a r y t o

the Enugu S t a t e Task Force on Guinea Worm Eradica t ion

s a i d , t h e p r o j e c t recognizes - a b i n i t i o t h a t Nigeria has

a network of modern mass communication systems which a r e

no t used e f f e c t i v e l y f o r development programmes. Under

the advocacy and s o c i a l mobil izat ion components of t h e

guinea worm and o the r UNICEF country programmes of

cooperat ion t h e r e f o r e , t h e r e i s t h e recogni t ion of t h e

need t o s t rengthen the capac i ty of these systems t o

produce q u a l i t y programmes and increase pene t ra t ion i n t o

remote r u r a l households.

There a r e four p r o j e c t s i n t h e advocacy and s o c i a l

mobil izat ion components of UNICEF programmes. The

p r o j e c t s a re : advocacy, mass media capaci ty bui ld ing ,

comrnunity p a r t i c i p a t i o n and empowerment, and mobil izat ion

of non-governmental organiza t ions . Overal l , advocacy,

information and educat ion a r e t a rge ted a t a l l t h e a l l i e s - e s p e c i a l l y the government and N C O s - while media capac i ty

bui lding aims t o enhance t h e a b i l i t y of media personnel

t o produce q u a l i t y ma te r i a l s t o s t rengthen communication

a t d i f f e r e n t l e v e l s .

4.5.1 The Advocacy Pro jec t

S p e c i f i c a l l y , t h e advocacy p r o j e c t aims t o develop

p lans of a c t i o n t o c r e a t e and s u s t a i n awareness of c h i l d

s u r v i v a l , p ro tec t ion and development i s s u e s among p o l i c y

and decision-makers throughout t h e country. This is t o

ensure t h e continued a t t r a c t i o n of s u f f i c i e n t budgets

and admin i s t r a t ive resources t o reach s t a t e d t a r g e t s .

It a l s o aims t o ensure t h a t i s s u e s a f f e c t i n g women and

c h i l d r e n - including hea l th , water supply and s a n i t a t i o n ,

n u t r i t i o n , education f o r t h e g i r l c h i l d , c h i l d abuse

and neg lec t , e t c . , - remain i n t h e f o r e of media

coverage i n Nigeria .

The p r o j e c t s t r a t e g y involves f requent personal

con tac t s with p o l i t i c i a n s , pol icy- and decision-makers,

t r a d i t i o n a l and r e l i g i o u s l eader s , entrepreneurs , t h e

p r e s s and e l e c t r o n i c media, a r t i s t s , i n t e l l e c t u a l s ,

l o c a l and i n t e r n a t i o n a l N G O s and agencies. It a l s o

involves the production of p r in ted and audio-visual

advocacy mate r i a l s i n a t t r a c t i v e formats, simple language,

and f r i e n d l y tone t o dramatize t h e problems. These w i l l

be dissemina%ed t o t a rge ted audiences l o c a l l y and

i n t e r n a t i o n a l l y . 4.5.2 Mass Media Capacity Building Pro jec t

The essence of t h i s p r o j e c t i s t o increase t h e

knowledge, a t t i t u d e and p r a c t i c e s of t h e bas ic s e r v i c e s

providers and b e n e f i c i a r i e s i n t h e guinea worm eradica-

t i o n e f f o r t . It is a l s o t o promote and s u s t a i n community

p a r t i c i p a t i o n .

A s a background t o t h e mass communication po l i cy

of the guinea worm e r a d i c a t i o n programme and o t h e r

country programmes, the UNICEF/FGN Masterplan of

Operations 1991 -95 (1 991 : 275) took cognizance t h a t t h e

f e d e r a l government opera tes seven rad io s t a t i o n s loca ted

i n Abuja, Kaduna, Enugu and Ibadan, and t h a t most s t a t e

governments opera te r a d i o s t a t i o n s . It held t h a t about

75 per cent of urban and 45 p e r c e n t of r u r a l households

own rad io s e t s and t h a t r a d i o broadcasts r each 65.7

m i l l i o n people i n English, Pidgin and a t l e a s t 80 l o c a l

languages . Furthermore, it held t h a t - t h e r e were 22 n a t i o n a l

and I 7 state-owned t e l e v i s i o n s t a t i o n s each of which

t ransmi ts an average of 60 hours of proarammes weekly.

I t est imated t h a t viewership was 45 m i l l i o n i n 1988; and

reported a n a t i o n a l survey which pu t ownership of t e l e v i -

s i o n s e t s a t 37.7 per cent of urban and 1 3 pe r cent of

r u r a l households wi th an annual growth r a t e of n ine p e r

cent .

On t h e p ress , t h e masterplan pointed ou t t h a t it i s

p a r t l y owned by t h e p r i v a t e s e c t o r and serves a s an

important forum f o r t h e exchange of news and opinions on

n a t i o n a l development and s o c i a l i s sues . It held t h a t

t h e r e were a t l e a s t 18 d a i l y newspapers, f o u r evening

d a i l i e s , 20 Sunday newspapers, s i x weekly magazines and

t h r e e f i n a n c i a l weeklies. There were a l s o many publica-

t i o n s i n l o c a l languages a l l of which reach a s i g n i f i c a n t

number of people i n modern, formal s e c t o r of t h e economy.

Despite t h e modern channels t h e programme

comn~unication pol icy r e l i e s a s much on t r a d i t i o n a l and

r e l i g i o u s channels. It s t a t e s :

T r a d i t i o n a l networks have l o s t l i t t l e of t h e i r e f f i c a c y i n the f ace of r ap id modernization. T r a d i t i o n a l and r e l i - g ious l e a d e r s throughout t h e country use t h e i r charisma and a u t h o r i t y t o pub l i c i se information through town c r i e r s , counci l members, age groups and o t h e r s t r u c t u r e s , They c o n t r o l access t o t h e most powerful means of communication i n r u r a l communities. Rel igious l e a d e r s a l s o wield s i g n i f i - can t inf luence , Publ ic address systems i n churches, mosques, t a x i parks and market p laces cover wide audiences and have proved e f f e c t i v e f o r advocacy and mobi l iza t ion (p.275),

On the b a i s of a l l t hese , USICEF suppor ts t h e

t r a i n i n g and s k i l l s development of r a d i o and t e l e v i s i o n

producers and t echn ic ians with a view t o improve t h e i r

basic s e r v i c e s and t h e production of c h i l d su rv iva l -

r e l a t e d promarnmes. There i s a l s o t h e p o l i c y of r egu la r

sponsorship of newspaper supplements and r a d i o and

t e l e v i s i o n programmes aimed a t s t rengthening awareness

and adherence t o p r a c t i c e s espouced i n t h e message on

guinea worm d i s e a s e , The p r o j e c t a l s o supports a network

of communication and mobil izat ion coordina tors a t t h e

LGA l e v e l t o develop cos t -e f fec t ive systems f o r

p a r t i c i p a t o r y communication t h a t w i l l meet t h e s p e c i f i c

c u l t u r a l needs of t h e communities.

Spec i f i c annual t a r g e t s a r e s e t . For ins t ance ,

t h e 1 991 -1 995 media capac i ty bui lding pro j c c t aimed t o

increase by 100 per c e n t , r ad io and t e l e v i s i o n produc-

t i o n turned out during t h e 1986 - 90 period. It a l s o

aimed t o increase by 30 pe r cent t h e frequency of broad-

c a s t s and placements i n the media, and assist i n t r a i q i n g

500 producers, j o u r n a l i s t s and technic ians . Other

output t a r g e t s a r e t h e a s s i s t a n c e t o t r a i n 100 mainte-

nance t echn ic ians i n Nigeria and overseas; t h e support

f o r t h e establ ishment of a permanent audio-visual t r a i n -

ing scheme; a s s i s t a n c e i n t h e production of 25

documentaries, 50 video c l i p s and 500 j i n g l e s on c h i l d

s u r v i v a l and development (CSD) f o r t e l e v i s i o n ; support

f o r t h e production of 100 r a d i o documentaries, 500

j i n g l e s , 200 drama s e r i e s and ch i ld ren ' s programmes f o r

r a d i o and the establ ishment of permanent d a i l y CSD

j i n g l e s i n a t l e a s t 60 per c e n t of a l l r a d i o and t e l e v i -

s i o n s t a t i o n s (UNICJZF/FGN 1991 : 287-288) . To monitor and evalua te t h e programme, s t u d i e s

were conducted i n 1992 and 1995 t o update t h e knowledge

. - c

of programme o f f i c e r s about mass media capc i ty and

impact; t o a s s e s s t h e needs and preferences of d i f f e r e n t

audiences, and t o evaluate t h e ex ten t of exposure t o

educat ional messages.

4 . 5 . 3 Cornmuni t y P a r t i c i p a t i o n and Empowerment

The ob jec t ive of t h e commhity p a r t i c i p a t i o n and

empowerment p r o j e c t i s t o s t rengthen l o c a l governments

t o support and s t rengthen community-based communication

systems. The p r o j e c t supports wi th in t h e PHC a profe-

s s i o n a l cadre of h e a l t h educators w i t h experience i n

communication and mobilizing communities. Apart from

h e a l t h education a c t i v i t i e s , t hese extension workers a r e

requi red t o mobilize t h e communities toward t h e provis ion

of a l t e r n a t i v e s a f e water supply and s to rage systems

which i s t h e u l t ima te g o a l of t h e whole programme.

Community e f f o r t s a r e enhanced by s t a t e , f e d e r a l govern-

ment and i n t e r n a t i o n a l organiza t ions involved i n t h e

programme.

4.5.4 Mobil izat ion of NGO

The programme recognizes non-governmental organiza-

t i o n s a s a p o t e n t i a l fo rce i n the promotion of h e a l t h

programmes. Their impact has been f e l t on such

programmes as t h e Oral Rehydration Therapy (oRT),

primary h e a l t h c a r e , and EPI. I n 1988, NCOs i n i t

t h e

i a t e d

the National Immunization Days (MID) which i s bel ieved

t o have r a p i d l y increased EPI coverage i n Nigeria.

Apart from funding, t h e programme mobilizes N C O s f o r

a systematic cooperat ion with government and p r i v a t e

h e a l t h agencies i n programme communication and mobiliza-

t i o n of communities. For example, t h e Rotary I n t e r n a t i o n a l

( R I ) has engaged i n t h e provis ion of s a f e water sources

f o r some endemic v i l l a g e s through i t s l o c a l d i s t r i c t

c lubs.

4.6 Exposure t o t h e Message on Guinea Worm Disease

Ques t ions 13-21 i n Sect ions I1 of t h e ques t ionnai re

were designed t o answer research ques t ion (d ) ; which

sought t o know i f t h e people of the guinea worm endemic

v i l l a g e s were exposed t o t h e message on dracculculiasis.

A l l t h e 200 respondents agreed t h a t they knew about

t h e d i sease with a s i g n i f i c a n t percentage (66 per cen t o r

132 respondents) claiming they heard about it mainly from

in te rpe r sona l (face-to-face) d i scuss ions o r personal

experience. Sixteen-point-f ive per cen t (33) claimed t o

have heard about guinea worm through t h e r a d i o while

t e l e v i s i o n was t h e major source of information f o r 5.5

pe r c e n t (11) of t h e respondents. Only t h r e e per cent

( s ix) ind ica ted newspapers a s t h e source of t h e i r

information, while none ind ica ted magazines. F i n a l l y ,

n ine pe r cen t (18) of t h e respondents ind ica ted o the r

sources no t included i n any of t h e spec i f i ed choices.

Their sources ranged from p o s t e r s and book drawings t o

b i l l boards.

On t h e prevalence of guinea worm i n t h e sampie

v i l l a g e s , n o t everyone believed t h e d i sease was prevalent

i n chei r v i l l a g e s . While a majori ty of 83 per cent

(166) agreed, 17 per cen t (34) of t h e respondents

disagreed.

An overwhelming number of respondents 173 (86.96)

claimed exposure t o t h e message on t h e guinea worm

d i sease . Only 27 (13.5%) respondents were no t aware of

t h e message as shown i n t h e t a b l e below.

To conPirin such knowledge among those who claimed

Table 4.7: Knowledge of t h e Message on the Guinea Worm Disease

exposure, a r e c a l l t e s t was adminis tered, whereby

respondents were requi red t o say a t l e a s t two f a c t s

Code

a

b ------

--

contained i n t h e message. O f t h e 173 respondents who

f

173

27

200

Category

Yes (aware)

No (not aware) - ---.---

Tota l

were exposed t o t h e message, 158 (79 pe r c e n t ) were a b l e

% ,

86.5

13.5

1 00

t o r e c a l l t h e minimum number. Fac t s commonly r e c a l l e d

were i n s t r u c t i o n s r equ i r ing them t o b o i l o r f i l t e r

dr inking water and t h a t persons with guinea worm sores

should no t g e t i n con tac t with dr inking water sources.

When shown some memory a i d however, a l l t h e 173 respon-

derlts acknowled.ged t h e contents of t h e message.

011 t h e i r sources of information on t h e message, a

s i g n i f i c a n t major i ty of those who were exposed - 62.43

pe r cen t o r 108 respondents claimed t h a t i n t e r p e r s o n a l

( face- to-face) channels were t h e i r sources of t h e message.

Radio served as t h e source of t h e message f o r 16.8

per cent (28) of t h e respondents, while 12.14 p e r cen t

(21) read from p o s t e r s and handbi l l s . Only 5.20 per

cen t (9) read about the message i n newspapers as shown

i n Table 4.8.

Table 4.8: Source of Information on t h e Message on Guinea Worm f o r 173 Respondents who were

Exposed

Code

a

b

C

d

e

f

g

h

Category

Radio

Newspapers

~ o s t e r / H a n d b i l l s

In te rpe r sona l (face-to-face) channels

Film

Televis ion

Magazine

Others

Do t h e people i n t h e endemic v i l l a g e s know about

t h e messenger NICEP? F i f ty -e igh t per cen t (116) said

yes, while 42 pe r cent (84) s a i d they d id not know.

Furthermore, only 47.5 per cent (95) who were though

i n the majori ty knew t h e p rec i se a c t i v i t y of NIGEP which

i s engaged i n combating t h e guinea worm d i sease . Eight-

poin t - f ive per c e n t (1'7) thought they suppl ied dr inking

water , while 1.5 pe r cent (3 ) thought they were medical

doctors . A s i g n i f i c a n t 42.5 pe r cen t (85) d i d n o t know

what NIGEP does. See Table 4.9. I 1

Table 4.9: Knowledge of the Ac t iv i ty of NIGEP

I Tota l

Code

a

b

c

d

e

f

People ' s opinion of the guinea worm d i sease was

d i v e r s e , t o say t h e l e a s t . A s a way of f u r t h e r asser -

tairi ing t h e i r awareness of t h e d i sease , respondents

were asked t h e i r opinion of the d isease . O f t h e 354

Category

Builds roads

Suppl ies water

Combats guinea worm d i s e a s e

Provides medical doctors

S e l l s f e r t i l i z e r s and agric. chemicals

I don't know what they do

reponses (some t i cked more than one response) , more than

50.28 pe r cent (178) were of t h e opinion t h a t guinea

worm comes from dr inking unsafe water. However, it is

i n s t r u c t i v e t h a t some respondents s t i l l believed t h a t

t h e d i s e a s e was caused by j u j u and wi tchc ra f t . See

Table 4.10,

Table 4.10: Respondents' Opinion of t h e Guinea Worm Disease ( t i c k i n g more than one)

Code Category

GW is caused by J u j u and wi tchc ra f t

GW i s caused by unsafe water

GW i s no t a d i sease

GW i s p a r t of l i f e i n my v i l l a g e

GW i s n o t curable

Tot a1

4.7 Adoption of Mew P r a c t i c e s Prescr ibed by t h e Message on Guinea Worm udsease

Ques t ions 22-30 were designed t o a s c e r t a i n whether

exposure t o t h e message on guinea worm was ins t rumenta l

t o adoption of new p r a c t i c e s t o prevent t h e d i sease .

T h i s i s t h e sub jec t of r e sea rch quest ion ( e ) .

Boi l ing and f i l t e r i n g of water a r e two prominent

p r a c t i c e s canvassed by t h e message. A s i g n i f i c a n t

percentage of respondents 69.5 per cent o r 139 - d i d n o t

b o i l o r f i l t e r t h e i r dr inking water. Only 30.5 pe r cent

(61) claimed they boi led o r f i l t e r e d t h e i r water.

O f t h e 61 respondents who -claimed t o b o i l o r f i l t e r

water , t h e i r reason was t o make water s a f e f o r dr inking ,

not; j u s t t o prevent guinea worm in fec t ion . Of 182

responses recorded as reasons f o r bo i l ing o r f i l t e r d n g

water , t h e major i ty of 31.87 per cent (58) d id it t o

make dr inking water sa fe . Only 23.08 pe r cen t (42) d id

it purposely t o prevent guinea worm in fec t ion . See

Table 4.11.

Table 4.11: Reason f o r Boil ing o r F i l t e r i n g of Water by

61 Respondents ( t i c k i n g more than one

Code

a

b

C

d

e

response) . Category

To prevent guinea worm i n f e c t i o n

I t i s prescr ibed by NIGEP o f f i c i a l s

My f r i e n d s and r e l a t i o n s do it

To make water s a f e f o r dr inking

I t is norn~al p r a c t i c e In my home

Tota l

The message a l s o exhor ts people i n endemic

v i l l a g e s t o a s s i s t guinea worm vict ims t o f e t c h water ,

so a s t o prevent them from en te r ing t h e source of water

s u p p l y , Again 54 per cen t (108) of t h e respondents had

never a s s i s t e d ally v ic t im, while 46 per cen t ( 9 2 ) claimed

they a s s i s t e d vict ims t o f e t c h water , Reasons f o r such

a s s i s t a n c e was n o t t o prevent the contamination of water

sources. Though t h e g r e a t e s t number (88 o r 3l.l@6)

assistecl vict ims t o prevent the contamination of water,

a s i g n i f i c a n t number (62 o r 21.91%) d i d i t out of more

sympathy f o r the vict ims as shown i n Table 4.12 below.

Table 4.12: Reason f o r Assistance t o Guinea Worm Victims

by 92 Respondents ( t i c k i n g more than one

- Code

a

b

C

d

e

Category

To avoid contamination of water source

It i s prescr ibed by NIGEP o f f i c i a l s

To prevent them from wetting t h e i r wounds

It i s t h e normal p r a c t i c e i n my v i l l a g e

I f e e l so r ry f o r them

Tota l

Asked i f they believed they had adopted t h e new

h a b i t s prescr ibed by the message on guinea worm d i s e a s e ,

only 36.5 pe r cen t ( 7 3 ) of the respondents agreed, while

a s i g n i f i c a n t major i ty of 61 p e r cen t (122) disagreed.

Two-point-five per cent (5) d id no t record any response.

This f ind ing i s p a r t i c u l a r l y s i g n i f i c a n t when placed

among o t h e r s on t h e l e v e l of awareness of t h e message,

and t h a t on t h e bo i l ing o r f i l t e r i n g of water and

a s s i s t a n c e t o guinea worm vict ims.

While 86.5 per cent of the respondents were exposed

t o t h e message, a major i ty (69.5%) n e i t h e r boi led nor

f i l t e r e d water and only 46 pe r cent repor ted a s s i s t a n c e

t o guinea worm vict ims. Awareness has no t r e a l l y t r ans -

l a t e d i n t o a c t i o n by way of adoption of t h e new prac t i ces .

The most common reason p re fe r red by t h e respondents

who repor ted adoption of new h a b i t s was t h a t they wanted

t o avoid t h e pains and discomfort a s soc ia ted wi th such

a f f l i c t i o n . Not a few (13 o r 17.81%) of adopters d i d so

t o prevent t h e I1shamefl associa ted wi th it. None of t h e

respondents mentioned t h e media as l i k e l y inf luence .

However, when asked pointedly i f t h e i r knowledge of t h e

message has inf luenced them, v i r t u a l l y a l l the adopters

(9'7.26 per cent o r 71 ) agreed while an inconsequent ial

2.74 per cent (2 ) disagreed.

An overwhelming majori ty of t h e respondents (164

o r 82%) encountered problems i n t r y i n g t o adopt p r a c t i c e s

prescr ibed by t he message. Only 18 per c e n t ( 3 6 ) claimed

they d i d no t encounter any problems. The nature of t h e

problem was mostly t h e lack of time f o r bo i l ing o r

f i l t e r i n g water a s repor ted by 28.5 pe r cent of t h e

respondents. See Table 4.1 3.

'Table 4.13: Problems Encountered i n Trying t o Adopt New

Habits f o r Guinea Worm Prevention - - -

Code -- a

b

C

d

e

f

g

--

Category

I t i s forbidden t o go c lose t o

people in fec ted by guinea worm

I d o n ' t usual ly have time t o f e t c h water f o r someone

Some vict ims do n o t accept people f e t c h i n g f o r them

Boil ing o r f i l t e r i n g water wastes time

My people abhors boi l ing o r f i l t e r i n g of water

Boil ing water consumes firewood o r kerosine t h a t could be used f o r cooking

No response

Tota l

Not a l l those surveyed believed t h a t guinea worm

can be t o t a l l y e rad ica ted from t h e i r v i l l a g e s , Though

an overwhelming percentage of 87.5 per cent (175) were

convinced of t h a t p o s s i b i l i t y , 12.5 p e r c e n t (25) d id

n o t see t h e p o s s i b i l i t y of t o t a l e r a d i c a t i o n of guinea

worm.

On t h e bes t method t o e rad ica te t h e d i s e a s e , a

s i g n i f i can- t percentage (72.5% o r 1 45 respondents)

believed t h a t t h e provis ion o f pipe borne water was . t h e

best . Eight per' cen t (16) of the respondents found f r e e

medical t reatment f o r t h e vict ims of t h e d i s e a s e as t h e

bes t method. Yet o t h e r s (7%) saw indiscr iminate t r e a t -

ment o f sources of water supply as t h e bes t s o l u t i o n

a s seen i n Table 4.14.

66

Table 4.1 4: Best Method t o Eradica te Guinea Worm as Suggested by Samples

Code

-

Category

Treatment of ponds and we l l s

Provis ion of pipe-borne water

bducation and enlightenment on t h e mode of t ransmission of guinea worm

Free medical t reatment f o r v ic t ims

El iminat ion of ponds and we l l s

Uuarantine of v ic t ims

Others ( spec i fy )

Tota l

I n t h e minds of the majori ty of those surveyed,

NIGEP had been e f f e c t i v e i n disseminat ing t h e message on

guinea worm disease . This was t h e view of 52.5 pe r cen t

(105) of t h e respondents. Thirty-seven pe r cen t (74)

d isagreed , while 10.5 per cent (21 ) had no opinion on

the programme.

4.8 Relat ionship Between Exposure Level and Adoption h a t e - Data f o r t h i s s tudy show t h a t though exposure t o

t h e message on t h e guinea w o r m d i s e a s e was h igh among

people i n endemic v i l l a g e s , t h e r a t e of adopt ion of

new p r a c t i c e s advanced i n the message was q u i t e low.

Whereas more than e i g h t i n 10 respondents (86.5%) were

exposed t o t h i s message, only three i n t e n persons

e i t h e r f i l t e r e d o r boi led t h e i r water. Equally, only

f o u r i n t e n persons claimed t o have a s s i s t e d vict ims of

guinea worm i n f e t c h i n g water f r b m wel ls o r streams as

the case may be.

I n answer t o research quest ion ( f ) t h e r e f o r e , t h e r e

i s no s i g n i f i c a n t r e l a t i o n s h i p between t h e l e v e l of

exposure t o t h e message and t h e l e v e l of adoption of

some p r a c t i c e s canvassed by t h e message.

CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATIONS

5.1 Summary

This study s e t s out t o a t t a i n two major object ives

which are:

( a ) t o review the mass communication p o l i c i e s

and p rac t i ce s i n the programme f o r the

eradicat ion of dracuncul ias is o r the guinea

worm disease i n Nigeria, and

( b ) t o explore the impact of such mass communication

t a c t i c s and s t r a t egy on t h e near-eradication

of the disease.

The main s t ra tegy i n the project i s t o promote the

exclusive use of c lean drinking water a t t h e household

and v i l l age leve l s . It depends on the e f f ec t ive coordina-

t i o n between hygiene and hea l th education a c t i v i t i e s and

the provision of safe water supply and storage systems

(UNICEF/FGN, 1991 : 196).

From the research da t a presented i n the las t

chapter the following inferences a r e drawn:

(a) The message on guinea worm disease informs

the v i l l a g e r s t h a t guinea worm i s caused by

drinking water contaminated by the guinea worm

l a r v a e and exhor t s them t o prevent

persons in fec ted by t h e d i s e a s e from coming

i n t o contac t with aources of dr inking water.

Neighbours werbe urged Oo he lp those wi th

t h e d i sease by fe tching water f o r them, and

t o b o i l o r f i l t e r water from unsafe sources.

I n t h e long-term however, t h e message s e e s

t h e provis ion of sa fe dr inking water sources

as t h e s o l u t i o n t o guinea worm i n f e s t a t i o n .

(b) The sample surveyed showed a f a i r d i s t r i b u t i o n

ac ross age brackets of between 1 8 and 52 years

and above, wi th those between 35 and 42 being

s l i g h t l y h igher a t 64 pe r cent . A s much as

45.5 per cen t had no formal education while

27 per cen t had very l i t t l e formal education.

Income d i s t r i b u t i o n was equal ly very low wi th

only 1.5 per c e n t earning up t o N50,000.00

per annum, o r s l i g h t l y above W4,166.00 monthly.

More than h a l f of the sample were farmers, of

t h e peasant , subsis tence l e v e l .

(c) Radio was t h e dominant modern channel of

mass communication r e l i e d on by t h e v i l l a g e r s

surveyed, with more than s i x i n t e n persons

claiming t o l i s t e n t o r ad io as a h a b i t . The

reason f o r t h e i r preference was ready ava i l a -

b i l i t y . I n s p i t e of ind iv idua l preferences ,

more than 65 pe r cent believed t h a t the o r a l

(face-to-face) channel was most dominant i n

t h e i r v i l l a g e s . The most probable explanat ion

t o t h i s l o g i c a l inconsis tency i s provided by

Ede l s t e ins (p .234), t h a t i n d i v i d u a l s wi th '

d i f f e r e n t c a p a c i t i e s t o use information use

d i f f e r e n t media channels f o r t h e i r information

and t h a t s o c i a l c r i t e r i a such as age,

educat ion, sex r o l e and income r o l e a r e

p red ic t ive o f such colrlrnunication behaviour.

Being predominantly r u r a l , subs is tence farmers

and o f low income, and o f low educat ion, t h i s

p a r t i c u l a r communication behaviour of these

v i l l a g e r s a r e understandable.

NICEP adopted a d e f i n i t e mass communication

po l i cy t h a t focused on t h e modern and t r a d i t i o n a l

channels under t h e advocacy and s o c i a l mobili-

za t ion component of the programme. The

ob jec t ive of t h i s component inc lude g r a s s r o o t s

mobilizatiol? of b e n e f i c i a r i e s , community

hea l th educati-on, mobil izat ion of N G O s ,

i n t e r v e n t i o n i n water supply and s a n i t a t i o n ,

and monitoring and evalua t ion of programme

a c t i v i t i e s .

(e) Knowledge about the guinea worm d i s e a s e was very

high among t h e sample. A l l t he 200 respondents

claimed knowledge about t h e d i s e a s e , wi th 66

per cent c i t i n g in te rpe r sona l sources a n d .

personal experience as t h e i r sources of such

knowledge. Exposure t o the message on the

disease (knowledge i s d i f f e r e n t from exposure

a s c l a r i f i e d by Oskamp, 1977: 99-100) was

equal ly high. A s much as 86.5 pe r cen t were

exposed, 62 per cent of which c i t e d i n t e r -

personal (face-to-face) channels a s t h e sources

of t h e i r exposure.

Adoption of p r a c t i c e s prescr ibed by t h e

message on guinea worm d i sease i s a d i f f e r e n t

b a l l game. Only t h r e e i n t e n persons claimed

t o b o i l o r f i l t e r dr inking water a s prescr ibed

by t h e message, while more than f o u r i n t e n

persons rendered a s s i s t a n c e t o guinea worm

vict ims t o f e t c h water. Therefore, t h e r e

i s no marked r e l a t i o n s h i p between exposure

t o t h e message of guinea worm d i s e a s e and

t h e r a t e of adoption of new h a b i t s designed

t o combat t h e d isease . Are we t o conclude

hereby t h a t t h e mass communication component ?

of t h e e r a d i c a t i o n p r o j e c t has been a waste? I

The answer is: No.

5.2 Provis ion of Safe Water Sources

The response by a s i g n i f i c a n t majori ty ' of t h e

population t h a t the bes t s o l u t i o n t o guinea worm e rad i -

c a t i o n was the provis ion of s a f e dr inking water sources

is t h e tu rn ing point i n discovering t h e p i l l a r of khe

success of t h e programme. Nearly e i g h t i n t e n respon-

d e n t s believed t h a t the s o l u t i o n t o the d i sease l a y i n

the provis ion of s a f e dr inking water sources more than

anything else. This response is s i g n i f i c a n t i n more

ways than one:

(1) it shows t h a t t h e people i n t h e endemic

a r e a s know the r e a l cause of t h e guinea

worm d i s e a s e , i r r e s p e c t i v e of what may be

t h e i r ind iv idua l a t t i t u d e s o r opinions on

t he d i sease ;

(2) it i n d i c a t e s t h a t t h e i r views on t h e u l t imate

s o l u t i o n t o the s o c i a l problem f i n d a coal-

escence with t h e v iew of NIGEP t h a t "the

long-term s o l u t i o n t o guinea worm" i s the

provis ion of safe dr inking water sources;

(3 ) f i n a l l y , i t lends credence t o t h e f ind ings

of some scho la r s such a s Maccoby and Alexander

(1979,1980) which conceptual ize communication

as necessary but n o t s u f f i c i e n t t o engender

meaninglul change and a s such advocates f o r

what they c a l l "community-basedt1 in te rven t ion

i n change campaigns.

Indeed, such i n t e r v e n t i o n is p a r t of t h e e n t i r e

pl loject . For ins t ance , Effium Urban has two hand-dug

wel ls and t h r e e manually operated water pumps while

Emene Owo has two water pumps, through t h e a s s i s t a n c e of

UNICEF and o the r o rgan iza t io l~s . Also Nkomoro has two

pumps. I t musc be noted t h a t some of these f a c i l i t i e s

were not func t iona l during the per iod of t h i s study.

These are i n a d d i t i o n t o d i s t r i b u t i o n of water t reatment

chemicals such as abate and pe r iod ic t rea tment of ponds,

we l l s and streams i n t h e t h r e e v i l l a g e s .

The emphasis of t h e programme on ncommunity-based~

in te rven t ion r e f l e c t s t h e b e l i e f t h a t change occurs

wi th in a s o c i a l s t r u c t u r e and t h a t c h a r a c t e r i s t i c s of

t h a t s t r u c t u r e f a c i l i t a t e o r impede change independent

of the communication aspec t s of t h e campaign (Roberts

and Bachen, 1982: 52). I n t h e case of t h e guinea worm

e r a d i c a t i o n programme t h e s e i n t e r v e n t i o n i s t v a r i a b l e s

have helped make t h e campaign successfu l .

5.3 Conclusion

The l e s sons t o be drawn from t h e success of t h e

Nigerian guinea worm e rad ica t ion p r o j e c t i s t h a t mass

cornrnunica-tion and by extension the mass media possess

t h e p o t e n t i a l t o educate and mobilize people a t t h e grass-

r o o t s t o support urgent t a s k s of s o c i a l and economic

development. But they a r e hardly e f f e c t i v e i n changing

es tab l i shed family and s o c i a l p a t t e r n s and behaviours.

As Pool (1966) noted, the t r u t h is t h a t t h e mass media

alone, unlinked t o word-of-mouth communication ( p a r t of

community-based i n t e r v e n t i o n ) , f a i l i n producing a c t i o n ,

but do c r e a t e information. Indeed, people i n the

guinea worm endemic v i l l a g e s l e a r n t about t h e message

on the d i sease and what they were expected t o do. But

t h e c o n s t r a i n t s of c u l t u r a l p r a c t i c e s , convenience

and economic r e a l i t i e s prevented them from adhering t o

some of t h e p r a c t i c e s . The key t o t h e success remains

t h e g r a s s r o o t s p o l i t i c a l organiza t ion t h a t provided

t h e word-of-mouth support f o r t h e messages i n t h e

rnedia and mobilized t h e v i l l a g e r s towards t h e provis ion

of a l t e r n a t i v e s a f e water sources ( ~ o o l : 1 3 3 ) . I !

5.4 Hecommendat ions

It should be noted t h a t t h i s s tudy at tempt$ t o

f i n d out t h e r o l e mass communication pol icy and

p r a c t i c e s i n t h e success of t h e guinea worm e r a d i c a t i o n

p r o j e c t i n Nigeria using j u s t 200 samples drawn from

th ree endemic v i l l a g e s of Enugu and Ebonyi S t a t e s .

A s an opportuni ty f o r f u r t h e r research , t h i s researcher

recommends t h a t a l o n g i t u d i n a l design be employed t o

a s c e r t a i n the impact of t h i s d i f f u s i o n message. Such

study should a l s o be spread i n t h e var ious f o u r zones

of t h e programme. This would f u r t h e r e l iminate t h e

sample b ias as well a s r e f l e c t the var ious socio-

c u l t u r a l v a r i a b l e s l i k e l y t o impinge on the outcome of

a s t u d y of t h i s nature. A s Hubbard, e t a1 (1 975) put -- it, i d e a l t e s t of hypothesis about t h e r e l a t i o n s h i p

between s o c i e t y and t h e mass media would e n t a i l such

l o n g i t u d i n a l design t o make accurate explanat ion t o

such r e l a t i o n s h i p .

Secondly, t h e r e i s t h e need t o a s c e r t a i n t h e

empir ica l reasons f o r t h e d i s p a r i t y i n adopt ion of

p r a c t i c e s be tween t h e o r a l Rehydration Therapy (ORT)

and the E;xpalu.led Programme on Immunization (EPI) on t h e

olle lland and water f i l t e r i n g o r boi l ing a s prescr ibed

by t h e message 011 guinea worm d i sease , a l l programmes

in t h e c h i l d s u r v i v a l ancl development (cSD) p r o j e c t s i n

t h e primary h e a l t h care . A s Igboel i (1997) repor ted ,

ilulovative p r a c t i c e s i n ORT and EPI campaigns have been

widely adopted ( a l s o see UNICEF/FGN: 278).

F i n a l l y , it i s recomrnencled t h a t a h i s t o r i c a l /

a n t ~ ~ r o p o l o g i c a l study be c a r r i e d out t o a s c e r t a i n t h e

att icucle arid behaviour of people i n endemic a r e a s p r i o r

t o the campaign and now. This before-and-after approach

w i l l h e lp t o exp la in t h e cu r ren t resurgence of the

d i sease as reported by Oyeleye (1 998:33).

The s t r a t e g y of NIGEP i n hea l th communication i s

s i ~ n i f i c a n t t o the e n t i r e hea l th ca re d e l i v e r y system

i n Nigeria . It can be adopted i n designing a compre-

hensive h e a l t h care p o l i c y f o r t h e nat ion; one t h a t

emphasizes prevent ive measures t o educate people about

bas ic precaut ions they must take t o avoid i l l n e s s .

A s --- The . Guardian - ( 1 9 9 6 : ~ l + ) puts i t , an enl ightened

ca~npaign rooted i n our c u l t u r a l r e a l i t i e s i s cheaper

and more e f f i c i e n t than g i g a n t i c s t r u c t u r e s and

expensive medication.

This approach i s even more r e l e v a n t i n the present

campaign aga ins t HPV/AIUS i n f e c t i o n . A s - Time

I n t e r n a t i o i ~ a l (1 996: 12) repor ted , a s a f e sex campaign -- ai~riecl a t p r o s t i t u t e s has worked i n Thailand, home' of

olle of Lhe world ' s f a s t e s t growing AIDS epidemic. The

r a t e 01 i l l fec t ion of H l V among young men dropped by

ha l f s ince 1991 when the government unleashed a media

b l i t z and began providing condoms i n bro the ls .

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APPENDIX 1

QUESTIONNAIFE

UNIVERSITY O F NIGERIA, NSUKKA

DEPARTWNT OF MASS COMMUNICATTON

Uear Six./~adam,

I wish t o s o l i c i t your help i n completing t h i s

ques t ionnai re .

I am a postgraduate s tudent i n the above-named ' '

department. I am conducting a research on NCommunication

S t r a t e g y and Adoption of New P r a c t i c e s i n t h e Nigerian

Guinea Worm Eradica t ion Programmet1.

T h i s study i s pure ly f o r academic purposes and

I assure you t h a t your anonymity i s guaranteed.

Thanks f o r your co-operation.

Yours s i n c e r e l y ,

Nna ji , Ndubuisi.

SECTION I

Please i n d i c a t e your response by t i c k i n g ( ) i n t h e box provided.

1 . What i s your age bracket?

(a) ,18-20 - (d) 44-60 /-7 ( b ) 26-34 ( e ) 61 and above - /7 (4 35-43 17

2 . What i s your l e v e l of formal education?

( a ) F.S.L.C. /-7 (d) HND/BA/B.SC. /-7 (b) WASC/SSCE (e ) No formal educat ion 0 ( c ) OND/NCE a

3 . What i s the l e v e l of your income per annwn?

(a ) Less than W18,000 - f f (b) N18,000 - W25,000 /-7 ( c ) N26,OOO - N B 3 , O O O

(d ) N34,000 - N41,000 - /-7 ( e ) ~ 4 2 , 0 0 0 - P149,OOO - /7 ( f ) W50,000 and above - /-7

4. What i s your occupation?

( a ) C i v i l servant (d) Student /7 - (b) S e l f employed (e) Others (specify)

( c ) Farmer /-7 - 5. What i s your sex?

( a ) Male /-7 (b) Female - /-7

SECTION I1

7. Do you watch t e l e v i s i o n ?

(4 'yes L/ (b) No L7

8. Do you read newspapers and magazines?

9. Which of tile following channels of communication do you 1-ely on most f o r your information? . .

(a] Radio - /7 ( b ) Televis ion /7 - ( c ) Magazine - /7 ( d ) Film - /T ( e ) Newspapers - ( f ) Oral (face-to-face) channels /-7 ( ) Others ( spec i fy )

10. Could you say the reason why you p r e f e r your choice of channel? Because i t / t h e y :

( a ) provides more information f f - ( b ) i s l a r e most educat ive /-7 ( c ) i s / a r e r e a d i l y a v a i l a b l e - /17 (d ) i s / a r e more e n t e r t a i n i n g /7 (e) i s / a r e cheapest t o access a

111 your own assessment which communica-tion i s mostly used (a) Film /-7 ( 4 ( b ) Newspapers /-7 ( f ) (c ) Magazines - /7 ( g )

Which of t h e following i tems

( a ) Televis ion - /-7 ( b ) Radio / ( c ) Newspapers - /7 (d) Magazines /-7

of these channels of i n your v i l l a g e ? Televis ion /-7 Town c r i e r Oral ( face- to-face) channel 0 Others ( spec i fy)

do you own?

(You can t i c k more than one).

SECTION I11

Nave you ever heard about t h e guinea worm disease?

(4 Yes - r7 (b) No /-7 If you have, what i s t h e major source of your information?

(a ) Newspapers - /7 ( b ) Radio (c) Magazine

(d) Televis ion (e) In te rpe r sona l (face-to-face) d i scuss ion ( f ) Film - /-7 ( g ) Others ( spec i fy)

Do you th ink t h a t t h e guinea worm d i s e a s e is prevalent i n your v i l l age?

Do you know about t he message on guinea worm d i s e a s e ?

(4 Yes 7 (b) No /7 If you know about the message on guinea worm d i s e a s e , what does it say?

Through what channel of cornnuxication d i d you hear message on guinea worm d i sease?

Radio

Newspapers - /7 Tel-evision - /7 Magazines - r7 ~ o s t e r / ~ a n d b i l l s /-7 In te rpe r sona l (face-to-face) d i scuss ion - f f Film - /7 Others ( spec i fy )

Do you know about the Nigeria Guinea Worm Eradica t ion Programme (NIGEP)?

(4 Yes - r 7 (b) No /-7 If you know about NIGEP, What does it do?

(a) Builds roads /-7 - ( b ) Supplies dr inking water - /7 ( c ) Combats t h e guinea worm d i s e a s e /-7 (d) Provides medical doctors D, ( e ) S e l l s f e r t i l i z e r s and a g r i c u l t u r a l chemicals ( f ) I don ' t know what it does /-7 -

21. Which of t h e following s tatements i s l i k e l y t o r ep resen t your opinion of t h e guinea worm d i sease? ( a ) Guinea worm i s caused by j u j u and wi tchc ra f t

L7 (b) Guinea worm i s a d i sease caused by dr inking

unsafe water - /17 ( c ) Guinea worm i s not a d l s e a s e - /--7 (d) Guinea worm i s p a r t of l i f e i n my v i l l a g e - /7 ( e ) Guinea worm i s not curable /7

(YOU can t i c k more than one).

2%. D o you b o i l o r f i l t e r your dr inking water before dr inking? ( a ) yes (b) N O D

23. What could be t h e reasons f o r your response t o ques t ion (22)?

(a) To prevent guinea worm i n f e c t i o n

(b ) I t i s prescr ibed by NIGEP o f f i c i a l s /-7 ( c ) My f r i e n d s and r e l a t i o n s do i t /1 (d) To make water s a f e f o r d r ink ing /-7 ( e ) It i s normal p r a c t i c e i n my home - /-7

24. Do you he lp those with guinea worm s o r e s t o f e t c h water i n t h e stream o r from t h e we l l o r stream?

(4 Yes - /-7 (b) No r;T 25. S t a t e the reason f o r your response t o ques t ion (24 )?

(a) To avoid contamination of water source /7 ( b ) It i s prescr ibed by NIGEP o f f i c i c i a l s - /17 ( c ) To prevent them from wett ing t h e i r wounds /-7 - ( d ) I t i s the normal p r a c t i c e i n my v i l l a g e /-7 - ( e ) I f e e l s o r r y f o r them

Have you adopted t h e p r a c t i c e s prescr ibed by t h e message on guinea worm d i sease?

( 3 ) Yes /-/ (b) No /-7 What can you say has influenced you t o adopt t h e p r a c t i c e s prescr ibed by t h e message on guinea worm d i sease?

Do you th ink your knowledge of t h e message on guinea worm d i s e a s e inf luenced you t o adopt t h e h a b i t s prescr ibed by t h e message on guinea worm d i sease?

( 4 Yes /7 (b) No 17 ( c ) Don't know /7 Do you encounter any problem i n t r y i n g t o adopt p r a c t i c e s prescr ibed by t h e message on guinea worm d i sease?

(4 Yes (b) No /7 I f you encounter any problems, what a r e they?

I t i s forbidden t o go c l o s e t o people i n f e c t e d by guinea worm r / I d o n ' t u sua l ly have time t o f e t c h water f o r someone /7 - Some vict ims do no t accept people f e t c h i n g f o r them /17 - Boil ing o r f i l t e r i n g water wastes time /T My people abhors boi l ing o r f i l t e r i n g of water /-7 - Boi l ing water consumes firewood o r kerosine t h a t could be used f o r cooking - /7

I n your opinion, do you th ink t h a t guinea worm can be t o t a l l y e rad ica ted i n your v i l l a g e ?

(4 Yes /7 (b) No L/

32. I n your opinion, what is t h e bes t way t o e r a d i c a t e guinea worm i n your v i l l a g e ?

( a ) Treatment of ponds and we l l s /-7 (b) Provision of pipe-borne water /-7 ( c ) Education and enlightenment on t h e mode of

t ransmiss ion of guinea worm /-7 (d) Free medical t reatment f o r v ic t ims - /17 (el Elirrlination of ponds-and wel ls - /7 ( f ) Quarant ine of vict ims

( g ) Others ( spec i fy )

3 3 . Tn your opinion, do you th ink t h a t NIGEP has been e f f e c t i v e i n disseminat ing t h e message on guinea worm disease?

(4 Yes - r-7 (b) No /-7

34. Through what o ther channels do you th ink t h e message on guinea worm d i sease could be disseminated?

ORAL INTERVIEW SCHEDULE

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COMMUNICATION POLICY COMPONENT OF THE GUINEA WORM -. ERADICATION PROGRAMME

What i s t h e p o l i c y gu id ing t h e gu inea worm e r a d i - c a t i o n programme as it p e r t a i n s t o your organiza- -tion?

Docs your o rgan iza t ion have any s p e c i f i c p o l i c y approach t o mass communication b u i l t i n t o t h e gu inea worm e r a d i c a t i o n programme?

Could you d e s c r i b e t h e con ten t of such p o l i c y i f th.ere i s anyr?

What f a c t o r s informed t h e communication p o l i c y of NIGEP i n guinea worm e r a d i c a t i o n programme?

Has the p o l i c y undergone any review i n t h e l a s t e igh t years?

Do you f e e l t h a t any a spec t of t h e communication po l i cy should be reviewed? P lease , s t a t e reasons f o r your response.

What f a c t o r s would you in t roduce , o r remove i f you a r e i n a p o s i t i o n t o review t h e communication p o l i c y of t h e programme?

Give a g e n e r a l comment on th'e programme, e s p e c i a l l y a s it r e l a t e s t o t h e use of mass communication and mass media i n t h e programme.

. APPENDIX I1

STOP GUINEA WORM NOW Guinea Worm comes from

drinking unsafe water

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