EXAMINING THE ROLE OF NURSES IN THE PREVENTION AND MANAGEMENT OF NON-COMMUNICABLE DISEASES IN NIGERIA (A CASE STUDY OF WARRI METROPOLIS)

CHAPTER ONE

INTRODUCTION

1.1   Background to the Study

Africa is currently facing a double challenge related to epidemiological change (Oni & Unwin, 2015; Haileamlak, 2018). This transition entails the emergence of chronic diseases in an environment where infectious diseases continue to predominate (Haileamlak, 2018). Factors include changes in health habits such as tobacco and alcohol use, as well as economic development and urbanization. According to Oni and Unwin (2015) and Haileamlak (2018), the increasing prevalence of chronic diseases has a significant impact on health outcomes and the healthcare system. The hallmark of non-communicable diseases (NCDs), also known as chronic diseases, is that they are non-communicable and last for three months or more (Bernell & Howard, 2016). The World Health Organization (WHO) defines noncommunicable diseases as diseases that are not transmitted from person to person and typically have a long duration of illness with slow progression (World Health Organization, 2014). The main types of noncommunicable diseases include cardiovascular disease, cancer, chronic respiratory disease and diabetes, with neurological disorders and mental health problems often falling into this category. Annually, chronic diseases are responsible for the deaths of 41 million people worldwide, accounting for approximately 71% of global deaths, with three-quarters of these deaths (31.4 million) occurring in low- and middle-income countries, particularly in Africa (World Health Organization). , 2021; Hay et al., 2017).
Non-communicable diseases, including cardiovascular diseases, diabetes, chronic respiratory diseases and cancer, account for a significant proportion of mortality and morbidity in Nigeria (WHO, 2022). The prevalence of noncommunicable diseases has increased due to urbanization, lifestyle changes and inadequate access to health services (Akinmoladun et al., 2023).

In order to achieve the 2030 universal health coverage target, the World Health Organization (WHO) recognizes the vital role nurses may play in managing chronic diseases (Mechcatie, 2018; UN, 2021; UN, 2023). Physicians and nurses need to work together using task shifting techniques to manage chronic diseases in a safe and efficient manner (World Health Organization et al., 2007; Maier & Aiken, 2016). In Nigeria, where noncommunicable diseases (NCDs) are placing increasing pressure on the health system, nurses are crucial in both the prevention and treatment of these diseases. As frontline healthcare professionals with a strong commitment to patients and the community, nurses play a critical role in the prevention and treatment of these diseases through patient education, early detection and chronic disease management.
In addition, nurses are promoting healthier lifestyles through community outreach programs and public health activities and studying risk factors associated with noncommunicable diseases (NCDs) as part of their prevention efforts (Ojo et al., 2021) and in a country with serious health problems, their role extends beyond the clinic to include advocacy and health promotion (Nwachukwu et al., 2023). By participating in these programs that promote early intervention and management of chronic diseases, nurses help bridge the gap between the community and healthcare professionals, however, the lack of resources and infrastructure in the Nigerian health system is one of its major problems, affecting how effectively NCDs are managed (Adeyemi et al., 2022). In settings where access to state-of-the-art medical equipment and therapies is frequently restricted, nurses must concentrate on practical and reasonably priced ways to treat illness. In these circumstances, their capacity to inform patients about self-management techniques, disease prevention, and treatment compliance is essential to reducing the impact of NCDs (Ezeh et al., 2022). In addition, nurses also play a role in the treatment of noncommunicable diseases influenced by their ongoing education and training. Afolabi and Oyediran (2023) assert that nurses can participate in ongoing professional development to stay current on the latest recommendations and best practices for the management of noncommunicable illnesses. Their effectiveness in prevention and treatment can be enhanced through training programs tailored to the unique needs of the Nigerian healthcare system. This also ensures that they are prepared for the challenges of dealing with chronic illness (Ibrahim et al., 2024).

1.2   Statement of the Problem

In Nigeria, non-communicable diseases (NCDs) such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers have emerged as leading causes of morbidity and mortality, imposing a significant burden on the healthcare system (WHO, 2022). Despite the growing prevalence of these conditions, there is a noticeable gap in the effective utilization of nursing resources for their prevention and management. Nurses, who are pivotal in frontline healthcare delivery, often face challenges such as limited training in NCD management, inadequate resources, and an overstretched healthcare infrastructure, which hampers their ability to deliver optimal care (Adeyemi et al., 2022; Ezeh et al., 2022). This situation is exacerbated by the lack of comprehensive policies and support systems that can enhance their role in combating these diseases (Akinmoladun et al., 2023).

The problem is compounded by the rapid urbanization and lifestyle changes that contribute to the rising incidence of NCDs, coupled with an insufficient emphasis on preventive care within the Nigerian healthcare framework (Nwachukwu et al., 2023). Nurses are in a strategic position to address these issues through community education, early detection, and management of chronic conditions; however, their effectiveness is often undermined by systemic limitations and insufficient professional development opportunities (Afolabi & Oyediran, 2023; Ibrahim et al., 2024). Addressing these challenges requires a thorough examination of the current roles and responsibilities of nurses, as well as an evaluation of the barriers they face in the prevention and management of NCDs in Nigeria (Onyema et al., 2024).Top of Form

1.3 Objectives of the Study

The main objective of the study is to examine Examining the Role of Nurses in the Prevention and Management of Non-Communicable Diseases in Nigeria. Specific objectives of the study are:

1. To assess the Current Knowledge and Practices of Nurses in Non-Communicable Disease (NCD) Prevention and Management
2. To evaluate the Barriers and Challenges Faced by Nurses in NCD Prevention and Management
3. To explore Strategies to Enhance Nurses' Role in NCD Prevention and Management

1.4 Research Questions

To guide the study and achieve the objectives of the study, the following research questions were formulated:

1. What is the level of awareness and understanding of nurses in Nigeria regarding the prevalence, risk factors and consequences of NCDs?
2. What are the primary barriers and challenges faced by nurses in implementing NCD prevention and management programs in Nigerian healthcare settings?
3. What are the most effective strategies for improving nurses' knowledge, skills and attitudes towards NCD prevention and management?

1.5 Research Hypothesis

The following research hypothesis was developed and tested for the study:

Ho: Nurses in Nigeria do not significantly influence the prevention and management of non-communicable diseases compared to other healthcare professionals.

1.6 Significance of the Study

The study is important for many reasons. The following are the major stakeholders this paper through its practical and theoretical implications and findings will be of great significance:

Firstly, the paper will benefit major stakeholders and policy makers in the Nursing Science sector. The various analysis, findings and discussions outlined in this paper will serve as a guide in enabling major positive changes in the industry and sub-sectors.

Secondly, the paper is also beneficial to the organizations used for the research. Since first hand data was gotten and analyzed from the organization, they stand a chance to benefit directly from the findings of the study in respect to their various organizations. These findings will fast track growth and enable productivity in the organizations used as a case study.

Finally, the paper will serve as a guide to other researchers willing to research further into the subject matter. Through the conclusions, limitations and gaps identified in the subject matter, other student and independent researchers can have a well laid foundation to conduct further studies.

1.7 Scope of the Study

The study is delimited to Warri Metropolis. Findings and recommendations from the study reflects the views and opinions of respondents sampled in the area. It may not reflect the entire picture in the population.

1.8 Limitations of the Study

The major limitations of the research study are time, financial constraints and delays from respondents. The researcher had difficulties combining lectures with field work. Financial constraints in form of getting adequate funds and sponsors to print questionnaires, hold Focus group discussions and logistics was recorded. Finally, respondents were a bit reluctant in filling questionnaires and submitting them on time. This delayed the project work a bit.

1.9 Organization of the Study

The study is made up of five (5) Chapters. Chapter one of the study gives a general introduction to the subject matter, background to the problem as well as a detailed problem statement of the research. This chapter also sets the objectives of the paper in motion detailing out the significance and scope of the paper.

Chapter Two of the paper entails the review of related literature with regards to corporate governance and integrated reporting. This chapter outlines the conceptual reviews, theoretical reviews and empirical reviews of the study.

Chapter Three centers on the methodologies applied in the study. A more detailed explanation of the research design, population of the study, sample size and technique, data collection method and analysis is discussed in this chapter.

Chapter Four highlights data analysis and interpretation giving the readers a thorough room for the discussion of the practical and theoretical implications of data analyzed in the study.

Chapter Five outlines the findings, conclusions and recommendations of the study. Based on objectives set out, the researcher concludes the paper by answering all research questions set out in the study.

1.10 Definition of Terms

1.  Non-Communicable Diseases (NCDs)

 Non-communicable diseases are chronic illnesses that are not caused by infectious agents and cannot be transmitted from one person to another. Examples include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. They often result from a combination of genetic, physiological, environmental, and lifestyle factors.

2.  Primary Prevention

 Primary prevention refers to measures taken to prevent the onset of disease before it occurs. In the context of NCDs, this includes activities such as health education, lifestyle modifications (e.g., diet and exercise), and vaccination to reduce risk factors and prevent disease development.

3.  Secondary Prevention

 Secondary prevention involves early detection and prompt intervention to reduce the severity and impact of a disease once it has begun. For NCDs, this includes regular screenings, early diagnosis, and timely treatment to manage the disease effectively and prevent complications.

4.  Tertiary Prevention

 Tertiary prevention focuses on managing and reducing the impact of an already established disease to prevent further deterioration and enhance the quality of life. This includes rehabilitation, ongoing treatment, and support services for individuals with chronic NCDs to improve their functional status and prevent complications.

5.    Promotion

Health promotion encompasses strategies and actions designed to improve overall health and well-being by encouraging healthy behaviors and lifestyles. In the realm of NCDs, this involves community outreach, public awareness campaigns, and educational programs to empower individuals to make informed health choices.

6.  Case Management

 Case management refers to a coordinated approach to delivering healthcare services that involves assessing, planning, and facilitating care for individuals with NCDs. Nurses play a crucial role in case management by ensuring that patients receive appropriate treatments, follow-up care, and support to manage their conditions effectively.

7.  Chronic Disease Management

Chronic disease management is an approach to healthcare that focuses on the long-term management of chronic conditions, such as NCDs. It includes strategies to improve patient adherence to treatment plans, monitor disease progression, and provide ongoing education and support to help patients manage their conditions and maintain a good quality of life.