A CLIENT CARE STUDY ON TYPHOID FEVER AT AJEGUNLE PRIMARY HEALTH CENTRE, LAGOS STATE

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Typhoid fever, caused by the bacterium Salmonella enterica serotype Typhi, remains a significant public health concern in many developing nations, including Nigeria. It is primarily transmitted through the ingestion of contaminated food or water and is prevalent in areas with poor sanitation and limited access to clean drinking water. According to the World Health Organization (WHO, 2021), over 11 million new cases of typhoid fever occur globally each year, with the highest incidence reported in South Asia, sub-Saharan Africa, and Southeast Asia. Nigeria is among the countries that face a high burden of this disease, particularly in urban and peri-urban areas where rapid population growth outpaces infrastructure development. Ajegunle, a densely populated area in Lagos State, exemplifies the types of environments where typhoid fever thrives. Ajegunle's inadequate sanitation, poor water supply, and limited healthcare services contribute to the frequent outbreaks of waterborne diseases, including typhoid fever (Olalekan et al., 2022). At Ajegunle Primary Health Centre, one of the few healthcare facilities available to the local population, the management of typhoid fever is critical.

The health centre is often overwhelmed by the number of cases it receives, which affects the quality of care provided to patients. The impact of typhoid fever on individuals and communities cannot be overstated. Prolonged illness often leads to school absenteeism, reduced productivity, and financial strain on households, especially those with limited access to healthcare. Furthermore, complications from untreated or inadequately managed typhoid fever, such as intestinal perforation or encephalopathy, can be fatal (Crump & Mintz, 2018). Therefore, the need for effective case management, including proper diagnosis, treatment, and client care, is critical in mitigating the impact of the disease.

Client care in healthcare refers to the holistic approach to managing patients, addressing not only their medical needs but also their emotional and psychological well-being. In the context of managing typhoid fever at Ajegunle Primary Health Centre, client care involves ensuring that patients receive prompt and accurate diagnosis, appropriate medical interventions, and adequate follow-up care. However, several challenges exist in achieving these goals, including inadequate staffing, limited resources, and a lack of awareness among patients about the importance of completing prescribed treatment regimens (Ibrahim, 2019).

Typhoid fever, if detected early and treated adequately, is curable. However, many patients in low-resource settings delay seeking care due to financial constraints, limited access to healthcare facilities, or the belief in alternative treatments. This delay often leads to severe complications, making the role of primary healthcare centres even more critical. Ajegunle Primary Health Centre, like many public health facilities in Nigeria, faces significant operational challenges. The facility is often understaffed, lacks essential diagnostic tools, and struggles with irregular supplies of necessary medications (Bashir & Lawal, 2021). These limitations hinder the provision of optimal care for patients with typhoid fever.

In response to these challenges, the Nigerian government has initiated various programs aimed at improving healthcare delivery and reducing the incidence of typhoid fever. One such initiative is the National Typhoid Control Programme, which seeks to strengthen the capacity of primary health centres to manage typhoid fever cases effectively. However, the success of these programs largely depends on the extent to which local health centres, like the Ajegunle Primary Health Centre, are equipped to implement them (Adeyemi, 2020).

This study focuses on evaluating the client care practices for typhoid fever at Ajegunle Primary Health Centre in Lagos State. By examining the current state of care, including the challenges faced by healthcare providers and the experiences of patients, this research aims to identify gaps in service delivery and propose strategies for improving the management of typhoid fever in this context.

 

1.2 Statement of the Problem

Typhoid fever remains a significant cause of morbidity and mortality in Nigeria, particularly in densely populated urban areas like Ajegunle. Despite the availability of Ajegunle Primary Health Centre as a frontline healthcare facility, the incidence of typhoid fever in the community remains high. This raises concerns about the adequacy of care provided at the centre and the factors contributing to the persistent spread of the disease. Several challenges have been identified in managing typhoid fever at the primary healthcare level. These include delayed diagnosis, inadequate laboratory facilities, a shortage of healthcare personnel, and inconsistent availability of essential medications (Ifeagwazi et al., 2019). Furthermore, the socio-economic conditions in Ajegunle, such as poor sanitation, overcrowding, and low health literacy, exacerbate the spread of the disease and hinder effective management. The problem of suboptimal client care at Ajegunle Primary Health Centre not only affects the recovery of patients but also contributes to the continued transmission of typhoid fever in the community. Without proper management, patients risk experiencing severe complications, and the health centre may become overburdened, limiting its ability to address other health concerns. Therefore, there is an urgent need to assess the quality of client care provided to typhoid fever patients at this facility, identify the challenges healthcare providers face, and explore strategies for improving the situation.

 

1.3 Research Objectives

The objectives of this study are to:

1. Assess the quality of client care provided to typhoid fever patients at Ajegunle Primary Health Centre.

2. Identify the challenges faced by healthcare providers in managing typhoid fever cases.

3. Propose recommendations for improving the management of typhoid fever at the primary healthcare level.

 

1.4 Research Questions

The following research questions guide this study:

1. What is the quality of client care provided to typhoid fever patients at Ajegunle Primary Health Centre?

2. What challenges do healthcare providers face in managing typhoid fever cases?

3. What strategies can be implemented to improve the management of typhoid fever at the primary healthcare level?

 

1.5 Significance of the Study

This study is significant for several reasons. First, it provides insight into the current state of client care for typhoid fever at Ajegunle Primary Health Centre, highlighting the strengths and weaknesses of existing practices. Second, the findings will contribute to the broader body of knowledge on managing typhoid fever in low-resource settings, particularly in urban areas where the disease burden is high. Third, the study will offer practical recommendations for healthcare providers, policymakers, and the Nigerian government on improving the management of typhoid fever at the primary healthcare level, ultimately contributing to better health outcomes for affected communities.

 

1.6 Scope of the Study

This study focuses on the client care practices for managing typhoid fever at Ajegunle Primary Health Centre, Lagos State. It will assess the quality of care provided, explore the challenges healthcare providers face, and identify potential areas for improvement. The study will involve healthcare personnel working at the centre, as well as patients diagnosed with typhoid fever. The time frame for the study will cover a period of six months, during which data will be collected and analysed.

 

1.7 Definition of Terms

Typhoid fever: A bacterial infection caused by Salmonella enterica serotype Typhi, characterized by high fever, weakness, stomach pain, headache, and loss of appetite.

Client care: The holistic approach to treating and managing patients, including addressing their medical, emotional, and psychological needs.

Primary healthcare centre: A facility that provides basic healthcare services to a community, focusing on preventive, curative, and rehabilitative care.

Ajegunle: A densely populated area in Lagos State, Nigeria, known for its socio-economic challenges, including poor sanitation and inadequate access to healthcare services.