Availability And Utilization Of Radio-diagnostic Centers In Nsukka Urban

The utilization and effect of radio-diagnostic services in Nsukka urban was review over a period of five (5) years at Bishops Shannahan Hospital, Nsukka Medical Center, Chinemelum Hospital, and Faith Foundation Hospital among the thirteen radio-diagnostic center therein.  A study of the particular examinations carried out at the four hospitals showed that the radiological services accessed are conventional radiography and ultrasound examination. In all the sample radio-diagnostic centers, it showed that both chest x-rays and obstetrics ultrasound have over 60% of the entire examinations.  The chest- x-rays was followed by examination of extremities ranging from shoulder to hand, femur to foot.  The obstetric ultrasound was followed by prostate scan, infertility and general abdominal scan.  The total number of patients referred annually for both ultrasound and conventional radiography ranges from 1500-1700 and above during the period of the study.  From this research study, one draws the inference that 75% of the available radio-diagnostic centers were adequately distributed. The utilization of the radiological services was seen with high referred rate of patients from the clinicians, which has improved the health standard of the community.  It was also inferred that a good number of the Nsukka urban dwellers were aware of radio-diagnostic centers hence utilization. Therefore, the government and private organizations are urged to encourage provision of radio-diagnostic services to improve their standard of living.

Title page - - - - - - - - - i

Approval page- - - - - - - - - ii

Dedication- - - - - - - - - - iii

Acknowledgment- - - - - - - - - iv

Abstract- - - - - - - - - - v

CHAPTER ONE

INTRODUCTION

1.1. Background of the Study - - - - - - 1

1.2. Statement of the problem- - - - - - 3

1.3. Purpose of the Study - - - - - - - 3

1.4. Significance of the Study- - - - - - 4

1.5. Scope of the Study- - - - - - - 4

1.6. Operational Definition of Terms. - - - - - 5

1.7. Related Literature Review- - - - - - 6

CHAPTER TWO

THEORETICAL BACKGROUND

2.1. Overview of Diagnostic X-Ray - - - - - 12

2.2. Meaning of X-Ray (Conventional Radiography) - - 12

2.3. Basic uses of X-Ray - - - - - - 13

2.4. Preparation of Patients for X-Ray Investigation  - - 14

2.5. Procedures of X-Ray Examination  - - - - 15

2.6. Risks Associated with X-Ray Examination  - - - 16

2.7. After care of Patient Undergoing X-Ray Investigation  - 16

2.8. Diagnostic Radiology a Neglected Essential Service  - 16

2.9. Diagnostic Radiography - - - - - - 17

2.9.1. Overview of ultrasound - - - - - - 18

2.9.2. Operations of ultrasonography  - - - - - 19

2.9.3. Obstetric Ultrasound Diagnosis  - - - - - 19

2.9.4. Diagnosis Ultrasound Examinations/Investigations - - 21

2.9.5. Ultrasound Aids in Theatre and Biopsy - - - 22

2.9.6. World health specifications for number ultrasound Recommendations - - - - - - - 23

2.9.7. Patient Preparation For An Ultrasound Examination  - 24

2.9.8. No preparation Required in these Areas of Exams - - 24

2.9.9. Risk Associated with Ultrasonography - - - - 25

2.9.9.1 The Radio-diagnostic Facilities and Services of Bishop Shannahan Hospital Nsukka. - - - - 26

CHAPTER THREE

RESEARCH METHODS

3.1 Research Design - - - - - - - 29

3.2   Sampling Method. - - - - - - - - 29

3.3 Sample Size- - - - - - - - - 29

3.4 Selection Criteria- - - - - - - - 30

3.5 Sources of Data. - - - - - - - - 30

3.5.1. Primary Source of Data. - - - - - - - 30

3.5.2. Secondary Source of Data. - - - - - - 31

3.6 Method of Data Collection. - - - - - - 31

CHAPTER FOUR

4.1 Data Analysis- - - - - - - - - 32

4.2 Data Presentation - - - - - - - - 33

CHAPTER FIVE

Discussion, Conclusion and Summary Of Findings

5.1. Discussion - - - - - - - - - 47

5.2 Summary of Findings- - - - - - - 49

5.3 Conclusions - - - - - - - - - 49

5.4 Limitations of the Study- - - - - - - 50

5.5 Recommendations - - - - - - - - 50

Recommended area for further studies  - - - - 51

References- - - - - - - - - - 52

Appendix - - - - - - - - - - 55

Table 1: Number and Distribution of Radio-diagnostic Centers in Nsukka Urban. - - - - - - - 33 

Table 2: Relative Distribution of x-ray Examinations done at Bishop Shannahan Hospital Nsukka  - - - - - 35

TABLE 3: Relative Distribution of Ultrasound Examinations done at Bishop Shannahan Hospital. - - - - - 36

Table 4: Relative Distribution of x-ray Examination done at Nsukka Medical Center - - - - - - - 37

Table 5: Relative Distribution of Ultrasound Examination done at Nsukka Medical Centre  - - - - - - 38

Table 6: The Frequency of x-ray Examination done at Chinemelum Hospital  - - - - - - - - 40

Table 7: The frequency of ultrasound examination done at Chinemelum Hospital  - - - - - - - - 41 

Table 8: The Frequency of x-ray Examination done at Faith Foundation Hospital  - - - - - - - - 42

Table 9: The Frequency of Ultrasound Examination done at Faith Foundation Hospital  - - - - - - 43

Table 10: The frequency of the level of awareness on the use of Radio-Diagnostic services in Nsukka Urban - - - - 44

TABLE 11: The Frequency of level/rate of Referrals for Radiological Services by Clinicians in Nsukka Urban - - - 45

TABLE 12: The Frequency Distributions on Utilization of Radiological Reports before Commencement of Treatments by Clinicians 46

Radio-diagnostic centre refers to a place where medical diagnostic service is given by using sophisticated equipment (such as x-ray equipment) to produce images of the internal structure of the body anatomy and physiological assessment in some cases.  Fundamentally any given radio-diagnostic centre is setup for diagnosis, screening and medical examination and may be established by government or private organizations.   Radio-diagnostic imaging is an aspect in health sector world wide that is continuously undergoing development.   For most primary health care and emergency services the key radio-diagnostic modalities are conventional radiography (x-ray) and diagnostic ultrasound1. These two imaging modalities together are able to meet over 90% of imaging needs of the population.

Availability of diagnostic imaging centers in any given community is critical to ensuring provision of effective diagnosis. Studies have shown that when these imaging modalities are available, they seem very few and as such may not be widely distributed in many areas thereby compelling patients in the need of the services to spend one or more weeks in wait of turn for radio-diagnosis.  These barriers result in delayed diagnosis resulting in an increased morbidity and mortality for many health conditions.  In addition, non-availability of these modalities may warrant long distance transportation for appropriate and efficient study which can significantly delay treatment of diseases and as well result in great cost considering cost of transportation.

Utilization of radio-diagnostic center in a given community refers to utility of imaging diagnostic service by the dwellers.  In the event of poor utility, it may mean low or lack of awareness of the existence of radio-diagnostic centers in the area.  Limited utilization of the services rendered by Radio-diagnostic center can make immediate treatment of certain cases impossible which may lead to complications and high mortality rate.

Nsukka urban is a city located in Enugu North senatorial district of Enugu state Nigeria that is characterized with relatively high population density. National Population commission (NPC) 2006, shown that the population density of Nsukka urban is over three hundred thousand (300,000) populace.  Nevertheless a good number of the dwellers in this community are illiterates which expose their ignorance and superstitious beliefs that sometimes hinder the patronage of radio-diagnostic centers even when the facilities are available.

This research work is specifically interested in assessing the availability and hence the utilization of radio-diagnostic services in the Nsukka urban using data obtained in a sample of Nsukka Urban Residents.