Attitude, Knowledge and Awareness of Malaria Prevention Practices Among At-Risk
Individuals in Apapa, Lagos State, Nigeria
Dissertation Proposal
Submitted to Northcentral University
Graduate Faculty of the School of Business Administration
in Partial Fulfillment of the
Requirements for the Degree of
DOCTOR OF PHILOSOPHY
y
OKECHUKWU AZUBUIKE AKANNO
San Diego, California
June 2017
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Table of Contents
Table of Contents………………………………………………………………………………13
Chapter 3: Research Methods
Introduction …………………………………………………………………………….14
Research Design………………………………………………………………………...15
Population……………………………………………………………………………….16
Materials/Instrumentations…………………………………………………………........16
Operational Definition of Variables……………………………………………………...18
Study Procedure………………………………………………………………………….20
Data Collection and Analysis…………………………………………………………….21
Assumptions……………………………………………………………………………...23
Limitations……………………………………………………………………………….23
Delimitations……………………………………………………………………………..24
Ethical
Assurances…………………………………………………………………………25
Summary…………………………………………………………………………………26
References………………………………………………………………………………………..28
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Chapter 3: Research Methods
This section of research paper describes the research design and methods used, including,
problem and purpose of the study, population, materials and instrumentations, operational
definition of variables (Quantitative/Mixed Method Studies), study procedures, data collection
and analysis, assumptions, limitations, delimitations, ethical assurances and summary. The
problem to be explored in this study is the relationship between attitude, knowledge, and
awareness of malaria prevention practices among pregnant women and nursing mothers of
children under five that attend Saseun Hospital and antenatal clinic in Apapa, Lagos State,
Nigeria. There are over one million malaria cases resulting in 429,000 deaths, worldwide, of
which, 92% are from the sub-Saharan desert of Africa, followed by 6% from South East Asia,
and 2% from Eastern Medite
anean regions (Nigerian Malaria Facts Sheet, 2014). Some of the
key statistics related to malaria in Nigeria show that over one hundred million cases of malaria
take place every year. This account for 60% hospital visits, 30% of hospitalizations, 25% of
children under one and 11% of pregnant women and nursing mothers demise (World Malaria
Report, 2016). Nigeria spends 172 billion naira ($797 million) on malaria treatments, such as,
drug administration, hospitalizations, doctor‟s office visits and absenteeism from work (Lagos
State Malaria Statistics, 2012).
The purpose of the study is to determine the relationships between attitude, knowledge,
and awareness of malaria prevention practices among at-risks individuals in Apapa, Lagos State,
Nigeria. The attitudinal behavior of these individuals towards utilization of malaria preventive
measures both at home and outdoor activities, knowledge of malaria symptoms and causation
and awareness of malaria preventive practices, such as, insecticide treated bed nets will be an
essential factor in formulating health care policies that will reduce, control, prevent and
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ultimately eliminate malaria infection in Nigeria.
In this chapter, the key points to be summarized are, attitude towards malaria prevention
practice, knowledge of malaria symptoms, causation, and awareness of malaria prevention
practice, malaria, insecticide treated nets, anti-malarial drug, residual indoor spray, at-risk
individuals, such as, pregnant women and nursing mothers of children under five.
Research Design
This is a quantitative, questionnaire-survey and interview and the researcher designed a
study specific questionnaire to survey demographic characteristics, attitude, knowledge and
awareness of malaria prevention practices among at-risk group of individuals. The study will
involve the use of a validated 20-item interviewer-administered questionnaire that has a
eliability coefficient of 0.74. Sample size will be determined by considering 85% power
computations that will account for a type 11 e
or with 95% confidence interval for a type 1 e
or
to give a minimum sample size of 42 and maximum sample size of 162 respondents adopting
Kadam and Bhalerao (2012) calculation methods. Use of quantitative methods will provide a
snapshot of the variables, like, attitude, knowledge and awareness of malaria prevention
practices, in addition to income, age, education, occupation, and marital status of the participants
in the study through a one on one questionnaire survey and interview that is relatively
inexpensive, less time consuming, and better structured than using the alternative, qualitative
design (Creswell, 2012). In as much as quantitative study has an advantage, there is also some
flaws, including, bias in the level of knowledge for malaria preventive practices, and attitudinal
ehavioral change in the application because of undue influence exerted by the first impression
of insecticide treated bed nets and long lasting treated bed nets (Creswell, 2012). The perception
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that treated bed nets are associated with chemicals that could be detrimental to their health has a
negative impact in the application (Vakalopoulos, 2010). Also, the belief by some that malaria is
a cause from “god” or witchcraft and in addition to their belief that
eeding bad air can have
negative impact on utilization of malaria preventive measures (Vakalopoulos, 2010).
Population
The area under study is a rural region of Apapa, Lagos State, Nigeria with population of
217,000 diverse people and the climatic condition is warm and humid with warm temperature
and tropical rain forests (Nigerian Malaria Fact Sheet, 2012) Apapa is located at Longitude 6
0
26
and Latitude 3
0
12, western part of Lagos lagoon and one of the main ports of Nigeria (NPC,
2013). Apapa consists of a multi-ethnic group of people with major inhabitants as being the
Yoruba, Ibo and Hausas, with the Yoruba as the dominant group consisting of 85% of the
population, followed by the Ibos with 10% and the Hausas with 5% (Lagos State Population
Commission, 2012). The study population will be 210 pregnant women and nursing mothers
ages 20-32 and have resided in Apapa local government area for at least one year and the sample
size will be a combination of 48 nursing mothers and 162 pregnant women obtained by adopting
Kadam and Bhalerao (2012) calculation formula that has 95% confidence interval and 1.96
significance level with a margin of e
or of + 5%.
Materials/Instrumentation
Since the questionnaire survey is created by the researcher and this is the first time it will
e applied in research, a pilot test is needed to establish content validity that will enhance the
questions in the instruments as related to format and scales. However, Crombach alpha 0.74 will
e adopted to compute for the reliability. Since this study is based on a questionnaire and
interview, answers will be scored by adopting a Likert scale of scoring, but the concern about
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data collection is the reliability of measurement, therefore, a reliability coefficients will be
adopted to demonstrate whether the test as designed by the researcher is co
ect in expecting data
collected to yield interpretable statements about individual differences in answers and internal
consistency of the instruments (Crombach, 2004) For example, when Crombach α > .9, the
internal consistency is excellent meaning that the individual scored 90% or above on all the
questionnaire and interview, 0.9 > α > 0.8, meaning that the individual score is between 90% and
80%, meaning good score, however, when the individual score is between 0.8 > α > 0.7, it is
within borderline, but acceptable. When measurement scale is between 0.7 > α > .06 the grade
esult is questionable, however, at 0.6 > α > 0.5, the grade result is poor and 0.5 > α is
unacceptable (Crombach, 2004), so, the study uses Crombach alpha 0.74 or 74% and above as
acceptable. Instruments used in this study will measure the level of knowledge in understanding
the causes, symptoms, and malaria prevention practice, awareness of malaria prevention methods
and applications available, and attitudinal behaviors towards utilization of malaria prevention
methods, such as, insecticide treated bed nets and long-lasting insecticide treated nets.
Measurement of the level of knowledge that relates to malaria causes, symptoms and
consequences of exposure will be used to identify malaria infection and poor malaria prevention
practice. Knowledge will be measured dichotomously and calculated statistically using a
weighted score of zero point for wrong answers and one point for co
ect answers and similarly,
attitudinal behavior towards malaria utilization of insecticide treated nets and long-lasting
insecticide treated nets as preventive methods will be measured by adopting a 4-part Likert scale.
In the questionnaire, the pregnant women and nursing mothers will be given a 4-part option of
Strongly agree, Agree, Disagree, and Strongly disagree regarding malaria prevention methods,
level of...