Lagos State, Nigeria - Family Health International

In-Depth Assessment Report
5.8 Ethnographic Account
Ojo LGA, with headquarters at Ojo, was established in
October 1966. It has an estimated population of 875,990.
The LGA is located at the western part of Lagos State,
bounded on the north by Alimosho LGA, to the east by
Amuwo-Odofin LGA, to the south by the Lagoon and
Atlantic Ocean, to the west by Ologe Lagoon and Badagry
LGA/Ogun State. The topography is partly riverine and
dry land; 40 percent of the area is water, accessible only
through the Lagoon. As the host of a major international
electronic market in Nigeria, Ojo LGA attracts all ethnic
groups. Although Yoruba and Ibo are the leading ethnic
groups, the Awori-Yoruba are the real indigenes. The two
national religions, Christianity and Islam, are widely practised
in churches and mosques throughout the LGA.
There are also some adherents of traditional religion.
To facilitate primary health care, the LGA has divided sex
workers into different categories – including students of
secondary school and tertiary institutions trying to supplement
their allowance with the income from sex trade.
5.9 Community Leaders
Community leaders are well-respected; they range in age
from 51 to 80 years and they have lived in the community
between five and 80 years. The leaders have varied
influence over such community activities as building of
roads, toilets, town halls and schools, digging of wells,
donation of property for government projects, immunization,
sports, counseling and marriage guidance for youths.
They have mobilized people for environmental sanitation
activities, PHC and enlightenment programs on health
issues. However, they have never been involved in
HIV/AIDS programs except in condom distribution. They
did not see HIV/AIDS as a major health problem in the
community – rather they consider malaria, typhoid fever,
gonorrhea, yellow fever and malnutrition as their health
problems. Only three of the seven men interviewed have
ever known some one who died of AIDS; two mentioned
the late popular musician, Fela Anikulapo-Kuti.
There is no community-based NGO working on HIV/AIDS
but the leaders indicated that some religious groups, through
their sermons, discuss it. They agreed that enlightenment
campaigns would be a good way to make people understand
the risk of HIV/AIDS. Other methods mentioned are provision
of screening centers in LGA, inclusion of HIV/AIDS
messages in sermons in churches and mosques and school
clinics. The leaders are interested in initiating or expanding
HIV/AIDS services in the LGA; they are ready to spearhead
these activities if given the necessary information. They
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would like to be involved in mobilisation, enlightenment
campaigns, health talks and provision of land to safe HIV
screening centers. Some are ready to participate in caring for
people already infected with HIV in their communities. It is
believed that the community can be encouraged to identify
PLHA and provide support for them.
5.10 Care and Support
Political commitment to HIV/AIDS is certainly not a major priority
here. The few programs organised have basically targeted
preventive activities. School youths and artisans should be
reached. Little or no care and support activities are ongoing.
5.11 Medical Care / Counselling
The chest clinic in Ojo is the major provider of TB care in
the public sector. Directly Observed Therapy, Short-course
(DOTS) is not being practiced because of distance from the
facilities. TB patients are routinely tested for HIV at the
Mainland Hospital. Other services include medical management
of HIV/AIDS, counselling by nurses who – though
not trained specifically in HIV matters – provide both preand
post-test counselling to literate patients. Routine care
for HIV/AIDS patients without TB is provided.
The PHC, which is headed by a Chief Nursing Officer, has
not handled cases of HIV/AIDS. Private health care
providers, however, seem to be more active in the area of
care, with slightly more than one percent of admissions in
one facility due to HIV-related illnesses in the past two
years. Clinics see about five to 10 cases of AIDS- related
illness per month. Rapid tests for HIV are provided. ARV
is not used, but strong analgesics are occasionally given.
Preventive therapy for illnesses of HIV-positive people is
uncommon. When referrals are made to teaching hospitals,
there is little or no feedback.
Only one patient was treated for TB over the past three
years in the two private hospitals considered. STD treatment
is, however, very common, using clinical diagnosis.
Home-based care and nutritional supplementation are not
provided. None of the guidelines provided by the FMOH
is available in these clinics. No training has been done for
most care providers in this sector. Facilities claim to offer
pre- and post-counselling, though none of the staff has
been trained. Awareness about Mother to Child
Transmission of HIV/AIDS (MTCT) interventions is low.
Routine tests for pregnant women are provided in many
centers – but if positive, the women are not allowed to
deliver in the clinic and are not told the results of the test.
Socio-economic support and community involvement in
care and support is minimal.