EFFECT OF HEALTH EDUCATION ON STREET CHILDREN’S USE OF PSYCHOACTIVE SUBSTANCES IN KAJOLA LOCAL GOVERNMENT AREA OF OYO STATE

EFFECT OF HEALTH EDUCATION ON STREET CHILDREN’S USE OF PSYCHOACTIVE SUBSTANCES IN KAJOLA LOCAL GOVERNMENT AREA OF OYO STATE

Abstract

Introduction: The inherent dangers of street life, economic deprivation, the unrestrained exposure to the street and its associated lifestyles make the street child vulnerable to substance use. Despite this, the extent of this problem has yet to be investigated in rural areas where no documented intervention study has been instituted in Nigeria. This study set out to investigate the patterns and factors associated with psychoactive substance use among street children in the rural area of Kajola Local Government of Oyo State. It also determined the effect of health education on the knowledge and use of these substances among the study population.
Methodology: An interventional study method was used. A total sample of 360 was selected for the intervention and control groups from the cluster of street children using a total sampling technique. The baseline awareness, knowledge of and psychosocial correlates of substance use were assessed and the result used to plan and implement an interactive health education programme with a psycho-social component which the intervention group benefited from. An HIV/AIDS health education was however implemented for the control group.
Result: There was an attrition rate of 3.3% for the intervention group and 7.2% for the control group. The mean age of the respondents was 16 ± 1.2 for the intervention and 16 ± 1.3 for the control group. Fifty four percent of the respondents in the intervention group were males while 62.8% were males in the control group. Twenty six percent (26%) of the respondents in the intervention group were full time students while in the control group, 19.4% were full time students. In the intervention group, 15.6% had a low self esteem while in the control group, 26.1% had a low self-esteem. Awareness about substances was greatest for Kolanut in both groups with 91.7% in the control group, followed by tobacco with 82.2% and alcohol with 80.0% in the intervention group. At baseline, the mean knowledge scores
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were 8.6 ± 3.9 for the intervention and 8.0 ± 5.1 for the control group, while the maximum obtainable score was 20. The difference at baseline was not statistically significant. The ever use prevalence of substances in this study was 72.6% and 78.8% respectively in the intervention and control groups for street children who still attend school whereas it was higher recording 81.0% and 81.6% respectively in the intervention and control groups for street children that work full time. Ever use of substances was associated with length of stay on the streets, which was significant at the 5% level for only the control group. The current use prevalence of substance was 35.9% in the intervention group among street children that still school and 58.7% among street children that work fully. In the control group, current use prevalence was 47.1% among the street children that still school and 69.7% among street children that work full time. Males were also more likely to report current use of substances with 63.3% and 69.6% respectively in intervention and the control group. This observation was statistically significant at the 5% level. Not currently using substances was found to be associated with being a full time student, high school connectedness score, high mother connectedness score and high parental presence. These were significant at P<0.05. Although high self-esteem was associated with not currently using substances in the intervention group, it was not significant at the 5% level. Those with a general health status much worse than usual were only 0.6% for both groups while those with health status worse than usual were 1.7% in the intervention group and 4.4% in the control group
Post intervention evaluations were carried out at the immediate post intervention and 12 weeks post intervention. The common substances currently used by respondents were kolanut, tobacco, “sokudaye” and solvent with prevalence of 22.6%, 13.3%, 10.6% and 10.0% respectively in the intervention group and 36.1%, 28.3%, 14.4% and 8.3% respectively in the control group. The mean knowledge scores increased from the baseline scores of 8.6 ± 3.9 to 18.1 ± 3.5 at the immediate post intervention phase and reduced to 17.3 ± 2.9 at 12
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weeks post intervention in the intervention group. In the control group, the mean knowledge scores reduced from 8.0 ± 5.1 at baseline to 7.1 ± 6.3 at the immediate post intervention period before increasing to 8.7 ± 4.1 at the 12 weeks post intervention period. The differences observed in the knowledge scores of the two groups at both the intermediate and post intervention phases were significant at P<0.05. Following intervention, there was also a reduction in the prevalence of the current use of all substances except for stimulants that usage prevalence remained static. However, in the control group there was a general increase in the current use prevalence of the substances at the 12 weeks post intervention period except for cocaine and heroin that the usage prevalence remained at just one person.
Conclusion and Recommendation: Not currently using psychoactive substances was associated with some psychosocial factors. Also the significant improvement in knowledge and the reduction in psychoactive substance use in the intervention group are attributable to the health education given. It is therefore recommended that an interactive health education programme with a psychosocial component be instituted for street children especially in the rural areas. More research should be done to find effective ways to reduce stimulant use, which was unresponsive in this study.

EFFECT OF HEALTH EDUCATION ON STREET CHILDREN’S USE OF PSYCHOACTIVE SUBSTANCES IN KAJOLA LOCAL GOVERNMENT AREA OF OYO STATE

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