CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

The importance of a robust health-care delivery system for any population is self-evident and cannot be overstated. A healthy person is a great asset not just to himself, his family, and society as a whole.

The World Health Organization (WHO) defined health in 1948 as a condition of whole physical, mental, and social well-being, rather than simply the absence of sickness or infirmity. The World Health Organization (WHO) said in the Ottawa Charter for Health Promotion in 1986 that "health is a human right.""Not the goal of existence, but a resource for everyday life. Health is a positive notion that emphasizes social and personal resources in addition to physical abilities." Physical, mental, emotional, and social well-being are all important components of overall health.

To attain total health, we require health care delivery systems (HCDS) that can offer high-quality medical treatment while also being responsive to the health needs and expectations of the communities they serve.

Health care delivery, on the other hand, is the prevention, treatment, and management of sickness as well as the maintenance of mental and physical well-being through the services provided by the medical, nursing, pharmaceutical, dental, clinical laboratory sciences, and allied health professions (Wikipedia, 2009).

Health care delivery, according to WHO, encompasses all products and services aimed at promoting health, including "preventive, curative, and palliative treatments, whether directed at people or communities." A health care delivery system is a system that organizes the provision of such services. When phony medications are utilized in health care delivery, the fundamental goal of the system, which is to improve general health, is not met.

By examining the levels of health care delivery systems, the link between fake drug usage in the healthcare delivery system and how people view health care delivery systems will be better understood. Lunde (1990) identified four fundamental levels of care in all health-care systems:

1. Prioritize self-care.

2. Professional primary care.

3. Secondary care or general specialized care.

4. Tertiary care or super-specialist care.

There is also quaternary care, which is the fifth degree of care.

Self-care is defined by the World Health Organization as "actions that people, families, and communities engage in with the goal of improving health, avoiding disease, minimizing sickness, and restoring health." These activities are based on a combination of professional and non-professional knowledge and abilities. They are carried out by laypeople on their own behalf, either alone or in collaborative partnership with professionals.” The capacity to take appropriate action(s) to attain overall health will be manifested by an individual's self-care skills and knowledge. Knowing when to seek professional treatment, gathering information on what sort of care to seek, and knowing where to receive desired medical services are examples of such acts.

Media reports (print and electronic) and lay information about fake drug incidents and consequences might affect a person's decision on how to obtain health treatment. As a result, it's crucial to figure out the link between false drug use in HCDS and how it impacts people's perceptions of the disease.

Primary health care (PHC), as defined in the Alma-Ata Declaration (1978), is essential health care based on practical, scientifically sound, and socially acceptable methods and technology that is universally accessible to individuals and families in the community through their full participation and at a cost that the community and country can afford to maintain at every stage of their development in the community.

Promotive, preventive, and rehabilitative health care are all aspects of primary health care. Immunization against the primary infectious diseases: measles, whooping cough, diphtheria, polio, tetanus, and TB, as well as other components of National Health Policy, are included in PHC-based health care.

When false vaccinations are used and no immunity is imparted on the vaccinated, those who are inoculated are more likely to get the illness.

Secondary health care refers to services offered by medical experts who do not often see patients initially, such as cardiologists, urologists, and dermatologists. A physician may choose to confine his or her practice to secondary care by denying patients who have not visited a primary care provider first, or a physician may be forced to limit his or her practice in this fashion, generally through various payment arrangements (Wikipedia, 2009).

Tertiary health care is specialized consultation care provided by experts working in a center with people and facilities for specific investigation, diagnosis, and treatment, generally on recommendation from primary or secondary health care personnel ( Wikipedia, 2008).

Quaternary health care refers to the highest degree of medicine, which is highly specialized and not commonly used (Intota, 2009). It include providing medical treatment to patients in areas such as cardiac care, orthopedics, neurosciences, cancer, and renal care, among others.

Given the current state of affairs in Nigeria, the environment is extremely stressful, and nearly everyone's health is jeopardized in some manner. In times like these, our health-care system should give respite to Nigerians, who are constantly on edge (Adelusi-Adeluyi, 1995). Unfortunately, the use of phony medicines in our health-care delivery has exacerbated this unpleasant scenario. It's worth noting that judgments on the authenticity of the drugs one takes, as well as the suitability and competency of health-care facilities and people, need a lot of thought.

Because of Nigeria's unstable drug distribution, the risk of being a victim of counterfeit medications is quite high. After all, securing a property with over a thousand doors is more difficult than securing one or two doors. In Nigeria, there are a lot of handlers (intermediaries) involved in drug distribution. Each intermediary represents a possible entrance route for counterfeit medicines.

“A counterfeit medication is one that is purposefully and fraudulently mislabeled with regard to identification and/or source,” (WHO, 2006). Counterfeit products might include products with the proper ingredients or the incorrect components, products without active ingredients, products with inadequate active ingredients, or products with false packaging.”

1.2 STATEMENT OF THE PROBLEM

Drugs as we all know it are very delicate substances and if a wrong prescription is given, can have excruciating results on the patient. The alarming rate at which fake drugs are prescribed to the people of Anambra state is a cause for concern not just to the regulatory bodies overseeing the activities of these healthcare services but also to the government of Anambra state because these fake drugs have a huge negative impact on the residents of Anambra state and it may also affect their perspectives on the credibility of healthcare systems as their perspectives may cause them to lose trust totally in healthcare services and resort to self medication which is extremely dangerous and can be harmful to the people.

This study seeks to investigate the correlation between fake drugs and people’s perception of healthcare systems in Anambra state.

1.3 OBJECTIVE OF THE STUDY

The primary aim of this study is to determine the correlation between fake drugs and people’s perception of healthcare systems in Anambra state. Thus, the following are the specific objectives;

1. To determine the prevalence of fake drugs administration to patientsin Anambra.

2. To determine if the prevalence of fake drugs has a negative effect on the perception of consumers towards healthcare systems.

3. To determine the implication of fake drugs administration.

1.4 RESEARCH QUESTIONS

The following questions guide this research;

1. What is the prevalence of fake drugs administration to patientsin Anambra?

2. Does the prevalence of fake drugs have any negative effect on the perception of consumers towards healthcare systems.

3. What are the implication of fake drugs administration?

1.5 SIGNIFICANCE OF THE STUDY

This study will be significant as it will create awareness on the rate at and the extent to which fake drugs are prescribed to the residents of Anambra state. It will be a call to attention for medical practitioners and the necessary regulatory bodies of pharmaceuticals and healthcare centers to properly investigate on the type of drugs prescribed to people as it negatively affects the image of healthcare centers.

1.6 SCOPE OF THE STUDY

This study will only cover the correlation between fake drugs and peoples’ perceptions of healthcare systems. The effects of these perceptions will also be looked into as well as the extent to which fake drugs are administered to the people of Anambra state. This study will be limited to Residents in Onitsha, Anambra state.

1.7 LIMITATION OF THE STUDY

This study is limited to only the people in Anambra state as the study cannot focus on a wider sample size as gathering of data will be tedious. Also, during the course of this research, the researcher was limited by availability of essential funds needed to carry out this study in depth.

1.8 DEFINITION OF TERMS

1. DRUGS: A medicine or other substance which has a physiological effect when ingested or otherwise introduced into the body.

2. PERCEPTION: The way in which an individual understands or interprets a certain concept or view or thing.

3. HEALTHCARE SYSTEMS: The health care system refers to the institutions, people and resources involved in delivering health care to individuals

CHAPTER TWO

REVIEW OF LITERATURE

INTRODUCTION

Our focus in this chapter is to critically examine relevant literature that would assist in explaining the research problem and furthermore recognize the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps.

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