ASSESSMENT OF THE CONTRIBUTION OF THE RADIO AS A MEDIA TOWARDS PREVENTION OF HEPATITIS B INFECTION IN PATIKO SUBCOUNTY, GULU DISTRICT

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Price: 2000 Naira (BSC, MSC)

ABSTRACT

The communication Media (Radio).
Media is communication channels through which messages in term of news, entertainment, education, or data, are disseminated to a mass audience. Media are vehicles that carry information from the sender to the recipient. This study evaluates the impact of the radio on dissemination of community information about Hepatitis B infection.
Hepatitis B infection causes significant global burden of disease with 2 billion people exposed to the virus, more than 350 million of whom are chronic carriers. It is a cause of more than 600,000 deaths annually, Africa shares 25% of the total HBV burden, with 65 million chronic carriers (J.J Ott et al: 2012). In Uganda 10% (more than 3.5 million Ugandans) are living with chronic Hepatitis B infection. Region Hepatitis B prevalence: North East 21.7%, North Central 19.4%, West Nile 18.7%, Western 10%, Kampala Central 5.8%, while South West with 2.9% (National HIV/AIDS Sero-behavioural survey 2005).
The aim of the study: To investigate the impact of the radio on prevention of Hepatitis B infection and promotion of healthy behaviour, in Anyadwe village, Kal parish in Patiko Sub County.
Methods: A cross-sectional quantitative survey on 256 respondent was conducted in Patiko sub county Anyadwe village using both interview and self-administered questionnaire with questions on knowledge, attitudes, and practices regarding HBV. The data were analysed using both qualitative and qualitative method.
Results: Of the 264 interviewed, a total of 256 were completed questionnaire and analysed, with an overall response rate of 97.0% (256/264). Gender composition of 51% male and 49% female, with 70% being peasant farmers, and the majority 56% earning an average monthly income of less than 30,000/=. 46% attended secondary education, 32% Primary education meanwhile 15% tertiary level of education, only 7% where illiterate. Majority 100% (256/256) heard about HBV infection over the radio and 78.52% (201/256) correctly identify the cause being Viral. Majority 71% (182/256) completed HBV vaccination and only 29% (74/256) had not. Radio health program preference 73% Radio Mega, 11% Radio Rupiny, 10% other stations and 6% Gulu FM

CHAPTER ONE

INTRODUCTION

1. INTRODUCTION
1.1. Hepatitis B Infection.
Hepatitis means inflammation of the liver. The condition can be self-limiting or can progress to fibrosis (scarring), cirrhosis or liver cancer. Hepatitis viruses are the most common cause of hepatitis in the world other than other causes such as; infections, toxic substances (e.g. alcohol, certain drugs), and autoimmune diseases.
There are 5 main hepatitis viruses, classified as type A, B, C, D and E. Hepatitis B (HBV) a DNA-virus, according to the World Health Organization is the world’s most common liver infection disease. [WHO] (2012).
The routes of transmissions of hepatitis viral infection includes fecal-oral mode for Hepatitis A and E and parental or mucosal contact with infected body fluids for Hepatitis B and C.
Hepatitis B Virus (HBV) virus is highly contagious, 50 -100 times more infectious than HIV, and the most common ways of transmission are by sexual contact, the transfer of blood or serum through shared needles in drug abusers, accidental needle sticks with needles contaminated with infected blood, blood transfusions, hemodialysis, and by infected mothers to their newborns.
1.2 The Communication Media
Media is communication channels through which messages in term of news, entertainment, education, or data, are disseminated to a mass audience. Media are vehicles that carry information from the sender to the recipient. Media are communication outlets used to store, deliver information or data. It can either associated with communication media, or the specialized communication businesses such as: print media and the press, photography, advertising, cinema, broadcasting (radio and television), and/or publishing.
Media includes every broadcasting and narrowcasting medium such as newspapers, magazines, TV, radio, billboards, direct mail, telephone, fax, and internet.
According to the media historian, educator, author, and Expertise in the history of broadcasting, Mrs. Donna Halper, she explains that the word “media” did not come into common use until the late 1950s. Prior to that, it was generally called the “press.” There was mainly the print press (publications that were printed, and required you to know how to read newspapers, books, and magazines). But then, gradually, along came other forms of communication, in the late 1800s, there were recorded movies (which at first were silent, but you could watch them, and read the title cards). In 1920, along came radio; talking pictures were perfected by 1927; and by the late 1940s, there was television. Finally, by the early 1990s, wider access to the internet occurred (the precursor to the internet was ARPANET, a network used by the military in the late 1960s, but the average person had no access back then). Currently Print Media, Electronic media and digital or online media are the main forms of media in use.
2.1 Background
In Uganda, Radio was born in 1954 during the colonial times and named Radio Uganda. Initially, the colonial power (British) wanted to use radio to broadcast their program to their colony. The first broadcast was in English and the broadcast frequency would only cover 15 miles radius. In late 1950s, they introduced other languages like Luganda, Acoli, Ateso Lunyoro/Kitara and other regional languages so that messages would reach a larger audience. Later, Television came on board in 1963, a year after Uganda’s independence and named Uganda Television (UTV).
With the liberalization of the air-waves in the late 1980s by Uganda’s Government, most radios in Uganda are now Commercial Radios, a few Religious Radios, Community Radios and Public/Government Radios. Radios are many, cheap and provide information in different languages. The government has today resorted to using radios to quickly reach people with messages. Currently in Uganda, there are over 300 rural and urban Frequency Modulation (FM) radio stations and about 30 television stations but radio remains the most used communication media by both rural and urban dwellers.
Though today Uganda runs; Electronic Media, Print Media and the Internet (digital or online media), the most commonly used media in Uganda stills remains radios.
With the invention of the hand gadgets such as smart phones, laptops information access among people has increased and the social media platforms are becoming common communication channels.
After independence till the mid 1980’s, Uganda was faced with lots of economic hardships and as a result, many institutions including the national broadcaster suffered a general deterioration. It is with this background that the Ugandan Government saw the need to restructure the former Uganda Television (UTV) and Radio Uganda; as a result Parliament passed the Uganda Broadcasting Corporation Act that established the Uganda Broadcasting Corporation in 2005. This transformed the former UTV and Radio Uganda into one body, Uganda Broadcasting Corporation (UBC). The Corporation started its activities on 16th November, 2005.
STATEMENT OF PROBLEM
3.1 Epidemiological burden of Hepatitis.
The general knowledge about hepatitis B is very poor and yet the viral infection (HBV) causes significant global burden of disease with 2 billion people exposed to the virus, more than 350 million of whom are chronic carriers. It is a cause of more than 600,000 deaths annually, Africa shares 25% of the total HBV burden, with 65 million chronic carriers (J.J Ott et al: 2012).
Infection is highly endemic in Uganda 10% (more than 3.5 million Ugandans) are living with chronic Hepatitis B infection. Presently, by region Hepatitis B prevalence in Uganda is ranked as follows: North East 21.7%, North Central 19.4%, West Nile 18.7%, Western 10%, Kampala Central 5.8%, while South West with 2.9% (National HIV/AIDS Sero-behavioural survey 2005). The in-country distribution of the virus however varies from region to region. The highest prevalence is found in the Northern part of the country ranging from 19.4% in North West to 25% in the North east (Weinbaum C.M, et al: 2009, Ochola .E. et al; 2013). High burden of hepatitis B infection in Northern Uganda).
According to Dr. Richard Lukandwa a consultant physician at Nakasero hospital in Kampala, says, “Hepatitis B is a viral disease that’s highly infectious – much more than HIV, the B virus can survive outside the body for at least 7 days, during this time, the virus can still cause infection if it enters the body of a person who is not protected by the vaccine. The incubation period of the virus is 75 days on average, but can vary from 30 to 180 days. The virus may be detected within 30 to 60 days after infection and can persist and develop into chronic hepatitis B. It can also be transmitted sexually”. During the 4th annual World Hepatitis Day (WHD) commemorated in Adjumani District, on the 6th August 2014 held at Mayors Garden under the theme “Hepatitis; Think again”, presided over by the Minister of Sate of Health (Primary Health Care) Hon Sarah Opendi Ocieng. The Hon Minister reiterated the government’s commitment to ensure that test kits for testing Hepatitis are readily available at all health facilities and that phased accessibility of the monovalent Hepatitis B vaccine for the adult population is rolled out. In the same function the WHO Country Representative Dr Wondimagegnehu Alemu who was represented by the National Professional Officer/Accelerated Immunization Initiatives Mr. Andrew Bakainaga, called for focused attention on this disease which is now a major public health threat globally. On 3 July 2014, Hon Ababiku Jes¬sica, Woman MP Ad¬ju¬mani pe¬ti¬tioned par¬lia¬ment on the out¬break of He¬pati¬tis B (HBV) in Madi Sub re¬gion. It was in¬di¬cated that be¬tween April and July 2014 only 121 cases had been reg¬is¬tered in Ad¬ju¬mani hos¬pi¬tal alone.
In Uganda a study conducted in 2009 has documented that the Hepatitis B core Antibody (HBcAb) was present in 52.3% (95% CI: 51.0–53.6) of adults, and Hepatitis B surface Antigen (HBsAg) in 10.3% (9.5–11.1). By 15–19 years of age, 40.0% had been infected with the Hepatitis B virus (HBV). Based on these estimates, more than 1.4 million adults in Uganda are chronically infected with HBV (Rosamund F Lewis et al)
These high prevalence are attributed to lack of knowledge and awareness about the disease according to ‘Ochola .E. et al; (2013) and in Uganda over the last 25 years, the Northern region has been affected by civil strife and war which is known to have fueled the spread of the disease just like HIV infection. (WHO/Uganda report 2004: WHO activities in the North).
The 67th World Health Assembly (WHA) held in May 2014 reaffirmed the global commitment to prevent and control viral hepatitis by adopting resolution WHA 67.6 (1), which calls for raising public awareness, improving surveillance, strengthening prevention interventions, and increasing access to care and treatment services.
Several studies indicates that media contributes to the HBV prevention strategies by creating awareness to the community. A rapid assessment survey conducted in 10 households in Patiko Sub-county indicates that 100% of the household had radios, however only 30% of the 60 participants interviewed had access to educative information/program over the radio, as noted currently with the ongoing government engagement to fight the infection, Hepatitis B Viral infection is one of the key massages on most radio stations, therefore it is necessary to ascertain the contribution of the radio as one of the medium toward creating awareness on HBV prevention.
Figure: 1; (a) 1(b)
Figure 1(a): Human Viscera showing liver 1(b): Progress of hepatitis B infection.
(Source: Davidsons’ Principle and Practice of Medicine 20th Ed)
3.2 Purpose of the research.
The aim of the study was to assess the impact of Radio program towards creating community awareness and knowledge on hepatitis B infection and access to preventive methods.
3.3 Justification of the study.
In regards to Hepatitis B infection, no study on community awareness as a contribution of media was carried out in Patiko Sub-county despite of endemicity of the Hepatitis B in Gulu District. Therefore this study came in very handedly to be used as an inference to ascertain the contribution of radio media as means of behavior health change communication tool to promote community health in Gulu District.
3.4 The objective of the study
3.4.1 General objectives
To assess the contribution of radio programs in creating community awareness on HBV prevention and access to services in February 2017 in Patiko Sub-county.
3.4.2 Specific objective were:
a. To ascertain the effectiveness of the radio massages in relationship to hepatitis B infection prevention.
b. To ascertain factors that affect radio media campaign messages on Hepatitis B infection reaching the community.
c. To ascertain whether the media has attributed to prevention and control of Hepatitis B infection.
3.5 Research question
1. What is the level of knowledge about HBV infection among community members and the radio presenters?
2. Do Radio messages contribute to community awareness and preventive practices against HBV infection?
3. Is there any other source of information other than the radio that campions Hepatitis B infection awareness in the community?
Hypothesis
1. The community have high level of knowledge about HB infection.
2. The radio presenters have limited knowledge about HB infection.
3. Radio messages leads to community awareness and preventive practice against HBV infection
3.6 Scope of the study
The study will be geographically conducted in Gulu District covering the community of Patiko sub-county. It will ascertain the community level of awareness on Hepatitis B infection and through what form of communication source they have gain the knowledge from. Specifically the Radio is the only largest information dissemination medium in the region and at this particular time it has been abundantly used to pass on information in the region for various purposes following the post conflict, therefore it is necessary to ascertain its level of efficacy and efficiency in dissemination of health information.
The study will be conducted within a period of one month, the first week will be for community data collection and the second week will be analysis of collected data and the last weeks will be for report writing and submission.
3.7 Significance of the study
Communities’ knowledge and level of awareness about HBV infection is non uniform, very limited and therefore, it is important to carry out this study to investigate the effect and impact of Radio campaigns on creating awareness and ascertain communities’ knowledge about hepatitis B infection and practices of the community towards HBV prevention and including access to vaccination and utilization of the services offered.
Through the findings of this study, the result will provide insight and information for the radio station stakeholders and health professionals to blend their health education methods and supplement comprehensively the messaging on hepatitis B infection.
By the recommendation of this study, appropriate programme of intervention for primary prevention of this disease will be formulated and correct information about Hepatitis B disseminated through the most appropriate media (radio).
Given the endemicity of the infection it is important to increase the populations’ knowledge and levels of awareness with the right information about the disease without creating fear and anxiety to enable appropriate preventive health practices including accessing vaccination programs.
In Gulu district particularly, the community’s knowledge about HBV disease is average and there are few studies concerning knowledge, attitude and practice on disease in the region, although of recent following awareness campaigns there is a wide acceptability of the condition related to Hepatitis B in the community being reported and a number of private health facilities have been engaged in the campaign of voluntary for fee screening and provision of Hepatitis B Vaccines.
3.8 The conceptual and theoretical framework
In this study, knowledge and awareness is chosen as the theoretical concept that is seen as a promoter of prevention and health seeking behavior towards controlling the prevalence of Hepatitis B. Using the intermix of the traditional health promotion theories such as the Heath Belief Model, the Social Cognitive Theory and the Trans-theoretical Model, the pivot that enhances health promotional behavior amidst the three theories are belief and knowledge. These theories are used to predict why people decide, or do not decide, to control, prevent or screen for different illness conditions.
The Radio and other media campaign enhance the knowledge and belief that will result into perceived susceptibility, benefits, severity, barriers and cues to action and self-efficacy. Given the high contagiousness of HBV infection individual will perceived high susceptibility and possibility of suffering from the infection. Having perceived susceptibility individual will be aware of the severity of hepatitis B infection and its consequences. Believing in the efficacy of healthcare and advised action to attempt to reduce the risks or the impact’s seriousness will have impact on behavior change of the individual, as part of perceived benefits. For example, “the vaccine against hepatitis B is effective and safe”. Perceived barriers are about weighing concrete and emotional costs of following advised action, to return and get the vaccine a total of three times during 6 months. The individual will have certain cues to action, namely strategies to be provided with information and activate readiness, to take action, lay anxiety, strengthening confidence and adapting safer behavioral practices.

INDIVIDUAL PERCEPTIONS COMMUNICATION LIKELIHOOD OF
Access
availability
location
AND ENHANCING FACTORS CHANNELS ACTION
Services
Hepatitis B prevention
Through:-
Knowledge
Behavior change
Overcoming barriers
Media channel of message dissemination through
Radio
Television, press, etc
Language
level of literacy
Age
Gender
Individual
Content
Adequacy
frequency
Information
Figure 2. Knowledge and belief conceptual framework

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