Você está na página 1de 68

ACCESS TO MICRO CREDIT AND HIV\AIDS

MANAGEMENT IN NIGERIA: AN EMPIRICAL

STUDY OF PEOPLE LIVING WITH HIV\AIDS

(PLWHA) IN SOKOTO METROPOLIS OF

NORTHERN NIGERIA.

BY

ABDULFATAI TOMORI
B. SC, MBF, MICE

A PROJECT SUBMITTED TO THE


POSTGRADUATE SCHOOL OF USMANU
DANFODIYO UNIVERSITY, SOKOTO STATE,
NIGERIA. IN PARTIAL FULFILLMENT FOR THE
AWARD OF MASTERS OF BANKING AND
FINANCE

FEBRUARY, 2008

1
CHAPTER ONE

Introduction

1.1. Background to the Study

Since the 1990s, many scholars including economists have been concerned with assessing

the effects of AIDS on households and by extension economy, more specifically, its

effects on national GDP growth (Casale and Whiteside, 2006). The economic impact of

AIDS is noticed in slower economic growth, a distortion in spending, increased inflows

of international assistance and changing demographic structure of the population

(Whiteside and Barnett, 2003). In African countries, it has been estimated that AIDS

caused between 19% and 53% of all government health employee deaths, just when the

need for healthcare services is increasing rapidly. Acquire Immune Deficiency Syndrome

(AIDS) epidemic was first discovered in the United States of America in July, 1981

(Scoeberlein, 2001; Crowe, 2003; Mafeni and Fajemisin, 2003; Whiteside and Barnett,

2003; Craddock, 2004; Olufemi, 2004; WHO, 2004; David et al, 2005 and Okunna and

Dunu, 2006). It was the Centre for Disease Control (CDC) in the United States of

America (USA) that received the report of two strange diseases, Pnenumostic Carinii

Pneumonia (PCP) and Kaposi’s Sarcoma (KS). Since then, HIV/AIDS menace is

becoming increasingly a global challenge. For instance, UNAIDS (2007), UNFPA (2007)

and DFID (2007) report that, about 42million people are infected with HIV/AIDS and

more than 20million have died from AIDS.

The latest global estimates show that Human Immunodeficiency Virus (HIV) prevalence

now stands at over 25% in some countries in sub-Saharan Africa and everyday there are

nearly 1,800 new infections and 1400 death from AIDS related illness among children

below the age of 15 (UNAIDS, 2007; UNFPA, 2007). Presently, the death rates from

2
AIDS already outweigh those from other killer diseases such as malaria (White and

Robinson, 2000; Attah, et. al, 2002; Mafeni and Fajemisin, 2003 and Okunna and Dunnu,

2006). There are many evidences that, the situation worldwide is going to get worse if

care is not taken. For example, the US government in recent time estimates that more

than 100million people will be infected with HIV by year 2010, with major outbreaks in

countries such as Nigeria, Ethiopia, Russia, China and India (Attah, et. al, 2002; Hunter,

2003 and Marlink and Kotin, 2004). More than 67 million will have died by that time and

the epidemic still not have peaked (Attah, et. al, 2002 and Marlink and Kotin, 2004). HIV

pandemic is the biggest obstacle to the achievement of the development goals agreed to at

the UN Millennium Summit in 2000 (Casale and Whiteside, 2006). 25 to 28 million of

the 34 to 46 million people globally infected live in Africa (Marlink and Kotin, 2004 and

Casale and Whiteside, 2006), where the number of cases is rising faster. Okunna and

Dunu (2006) report that, “of the estimated 40million people worldwide living with HIV,

28.5million (Approximately 70%) reside in Africa, with a great proportion of them being

Nigerians”. The UNAIDS/WHO (2006) reports on the global AIDS epidemic, shows that

Nigeria had 930,000 children orphaned by AIDS at the end of 2005. UNAIDS/WHO

further puts estimate of children orphaned by AIDS in Nigeria to 1.8-2million, that is, 1

in every 10 household provides care for an orphan.

AIDS is becoming widespread in Nigeria since 1986 when the first case was reported,

even though in 1988, the prevalence rate was just 1.8%. This rose to 5.8% in 2001; before

a slightly decline in 2003 to 5% and in 2004 to 4.4% (Attah, et. al, 2002 Mafeni and

Fajemisin, 2003 and UNAIDS/WHO, 2006). The UNAIDS/WHO (2006) research reports

reaffirm that no state or community is spared in this epidemic. It seems that, the Nigerian

government has since realized this and decided to support the effort of WHO’s objective,

3
by setting up first National Expert Advisory Committee on AIDS (NEACA) in 1986 and

similar state committees on AIDS were set up to alert the members of the public on the

existence of this epidemic and how to prevent it. This further facilitated the adoption of

first ever written HIV/AIDS policy in Nigeria, in 1997 under Federal Ministry of Health.

Furthermore, the Nigerian government has approved a policy that aims to bolster the

response to HIV/AIDS in the country's workforce, the policy aims at protecting the rights

of people living with and affected by HIV, as well as providing information about options

of recourse if they experience discrimination (Kaiser, 2007).

A number of evidences indicate that poverty as well as ignorance has been the major

factors accounted for the widespread of HIV/AIDS infections in Nigeria. (Attah, et. al,

2002; Mafeni and Fajemisin, 2003; Ezeanwu, 2004; David, et. al, 2005; Irefin and

Afolagbade, 2006 and Abdulrahim, 2007). It is also observed that the society tend to

avoid a person found to be HIV positive, by depriving such persons employment

opportunities and in case they are already employed they may likely to relieved of their

jobs on the basis that they would not want the virus to be extended to them. This

redundancy tends to contribute to their poverty circle and makes them spread the virus

among innocent people in order to alleviate their poverty, apart from stigmatization

problem. It is against this background that this current study attempts to empirically

investigate the relationship between access to micro credit and the management of

HIV/AIDS in Nigeria using Sokoto metropolis as a case study. The study is expected to

examine how people infected with HIV would be able to better manage the infection

when given access to credit by micro finance institutions operating in the metropolis.

1.2. Statement of the Problem

4
Today, the search for AIDS cure presents one of the greatest challenges to humanity

especially the contemporary medical health experts. Although, HIV/AIDS and their

menace had been in existence in Nigeria for some years, it was not until 1999 that a

serious national effort was made to tackle the problem. The then government of Olusegun

Obasanjo has placed high priority on prevention, treatment, care and support activities

(Atta et. al, 2002; Mafeni and Fajemisin, 2003 and WHO, 2004). It has established two

key institutions- the Presidential Committee on AIDS (PCA) and the National Agency for

Control of AIDS (NACA) to coordinate the various HIV/AIDS related cases in the

country (Attah, et. al, 2002 and WHO, 2004). Partners including the United Nation (UN)

System have provided increased technical and institutional support to strengthen NACA’s

efforts and enable the agency to better coordinate the National AIDS response. To this

end, an institutional support 2007 work plan has been developed for consolidated support

of the UN system, based on priorities areas identified by the NACA. The process of

scaling up towards universal access to HIV prevention, treatment, care and support by

2010 has begun. Similarly, a national and state road map as well as set targets have been

developed (Kaiser, 2007). The contribution of civil societies and Donor agencies in

setting and achieving the targets in line with the Paris Declaration and Global Task

Team’s recommendations have also been clearly identified (Kaiser, 2007).

Unfortunately, the intervention programs so far have not yielded very significant impact

in stemming the epidemic especially as the results from previous sentinel surveys show a

steady rise in the prevalence of HIV Sero-Positivity. Recent anecdotal reports indicate a

continuing rise in prevalence from selected populations and laboratory facilities around

the country. Those reported to be the most affected remain the youths and adolescents

(FMH and NACA, 2002; Mafeni and Fajemisin, 2003; WHO, 2004; Okunna and Dunnu,

5
2006; UNAIDS/WHO, 2006; Haruna, 2007 and Nwabueze, 2007). Despite the fact that,

there has been a steady increase in awareness of HIV/AIDS as indicated in a Survey

carried out by Federal Ministry of Health in 2003 and an increase in knowledge of

HIV/AIDS transmission modes as well as protective measures especially in the urban

areas (Okunna and Dunnu, 2006), still the issue of HIV/AIDS and their associated

problems such as poverty and stigmatization are in wide spread in the country.

Therefore, for the purpose of this research work the following research questions may be

relevant.

(i) To what extent is micro credit relevant in managing HIV/AIDS in Sokoto

Metropolis?

(ii) What is the income status of People Living with HIV/AIDS in the Metropolis?

(iii) Are micro finance institutions significant in managing HIV/AIDS in the

metropolis?

1.3. Objectives of the Study

The main objective of this research work is to examine the extent to which access to

micro credit is related to HIV/AIDS management in Sokoto metropolis.

However, the specific objectives of the study include:

i To identify the income status of People Living with HIV/AIDS in the metropolis.

ii To find out the impact of micro finance institutions on HIV/AIDS management in

the metropolis.

1.4. Significance of the Study

HIV/AIDS is no longer an exclusively health issue as it has been established that poverty

contributes to the spread of the diseases. As a result, the research findings of this study

are expected to assist government, policy makers as well as the management of

6
microfinance institutions in identifying the performance of their efforts and promoting

the best practices for the prevention and mitigation of HIV/AIDS in the country in

general and Sokoto metropolis in particular. The findings are also expected to provide a

framework for strengthening and supporting an expanded response to the HIV/AIDS

epidemic prevention activities through public-private partnership.

Similarly, the research findings are hoped to encourage the donor organizations, NGOs,

FBOs, CBOs etc in providing financial and technical assistance in the areas of alleviation

and reduction of vulnerability to HIV/AIDS. This in turn would provide an enabling

environment for people living with HIV to gain more access to micro credit in order to

reduce their poverty level and at the same time manage the disease effectively.

Furthermore, due to the fact that the research in this area of study is insufficient,

particularly in Nigeria where the available data on HIV/AIDS are often duplicated,

replicated and scanty as a result of poor funding, hoarding of research finding, lack of

specific focus and lack of effective co-ordination. The findings of this research will be

useful to the policy makers and other stakeholders in renewing their interests and efforts

on controlling the disease in the country especially considering labour loss and labour

productivity. Finally, the study will add to the existing literature in the field, which is now

receiving utmost attention from academicians, administrators and the general public

alike.

1.5. Scope and Limitations

As noted earlier, the main purpose of this research work is to establish a correlation

between access to micro credit and HIV/AIDS management in Sokoto Metropolis. The

study covers a period of 7 years i.e. between 1999 and 2006, this coincides with Obasanjo

regime. However, the research work is expected to be constrained by a number of

7
limitations. Some of these include time, data and financial constraints. These are

discussed below:

Time constraint is one of the limitations to this research work. The study is confined to

one year period and carried out together with the course work. To overcome this

constraint, the researcher decides to use lecture free period, week ends, and semester

break for writing the dissertation.

Another constraint faced by the research is that lack of adequate data. To source data for

the research work is not an easy task especially as data relating to the area under study is

not common in libraries located in Sokoto. Owing to this, the researcher resorts to

sourcing relevant data from electronic means such as internet in addition to those sourced

from the university libraries located both at main and city campuses. Likewise

questionnaire as an instrument of data collection will be used to source data from primary

source. This is just to ensure an unbiased study work. Incorrect information by the

PLWHA/respondents because of illiteracy and fear of exposing their status is another

problem. To solve this, the researcher employs the services of some research assistants

who are educated and familiar with the target respondent. Where necessary, the

questionnaires are translated to respondents so as to ease their responses.

There is also financial constraint as a limitation to this study. Any research work, which is

not properly and adequately funded, is likely going to fail just like moving a vehicle

without fueling. To overcome this problem, the researcher decides to rely heavily on

financial support from family and friends.

1.6. Research Hypotheses

Abimbola (1996) cited in Ijaiya (1997) defines hypothesis as a provisional or tentative

proposal for the explanation of phenomenon or situation that has some degree of

8
empirical substantiation or probability. In other words, it is a suggested solution to a

problem or a tentative explanation of the relationship between two or more variables.

There are two major types of hypothesis, the null and alternative hypothesis. However,

for the sake of this research work, the following hypotheses may be relevant.

Hi (a): there is significant positive relationship between access to credit and HIV/AIDS

management.

Hi (b): the higher the income status of people living with HIV/AIDS the better the

management of the infection.

1.7. Chapterization

This research work is proposed in five chapters. Chapter one, which is for introduction

covers background to the study, statement of the problem, objectives of the study,

significance of the study, scope and limitations of the study, research hypotheses and

organization of chapters.

Chapter two is for literature review. It reviews materials relating to concept of

HIV/AIDS, historical antecedence of HIV/AIDS, causes and factors contributing to the

spread of HIV/AIDS in Nigeria, impact of AIDS epidemic, concept of micro

finance/credit, brief overview of micro credit institutions in Nigeria, theoretical argument

on access to micro credit and HIV/AIDS management, empirical studies on access to

micro credit and HIV/AIDS management, HIV/AIDS trend in Sokoto state, and ends with

discourse on historical background of the study area.

Chapter three focuses on research design and methodology it discusses the organization

of the research work and procedures to be used. The chapter covers sampling techniques

and size, sources of data as well as techniques of data analysis. Chapter four, deals with

9
data collection and analysis of results. Finally, Chapter five, summaries, concludes and

draws recommendations based on research findings.

CHAPTER TWO Literature

Review2.1. Concept of HIV/AIDS

Although HIV and AIDS are related, actually they are two different things (Gilks, 1998;

Crowe, 2003 and Olufemi, 2004). The word HIV can be looked at literally where ‘H’

stands for Human, that is ‘man’ or ’human being’ ‘I’ connotes Immunodeficiency; which

means ‘human body inefficient’ and ‘V’ represents ‘virus’, that is the virus that caused

the inefficient of the body. AIDS too can be literally defined in the same perspective

where ‘A’ stands for Acquire; which means ‘to get’, ‘I’ on the other hand means Immune;

which means ‘protected’, ‘D’ stands for Deficiency; ‘lack of’ and ‘S’ represents

syndrome means; ‘a group of different signs of a disease’ (opportunistic infections).

Therefore, AIDS is a condition that develops from an HIV infected person. However,

there are two types of HIV; they are HIV-1 and HIV-2. The former is the earliest stage of

the disease where as the latter means the development of the disease into a full-blown

AIDS which may result in death (Richards and Leonon, 1986).

Schoeberlein (2001) observes that AIDS case definition includes all HIV-infected

adolescents and adults aged less than 13 years who have either (a) less than 200 CD4 + T-

lymphocytes per micro liter of blood (1/5000th of a teaspoon); (b) a CD4 + T-lymphocyte

percentage of total lymphocytes of less 14%; (c) any of the identified opportunistic

infections. To Appropriate Health Resources and Technologies Action Group (AHRTAG,

10
1997) AIDS is a disease characterized by progressive damage to the body’s immune

system, resulting in the development of a number of “Opportunistic” infections with fatal

outcomes. AHRTAG (1997) further explains that the virus attacks the body’s defense

mechanism, preventing it from effectively fighting certain infections or illness. AHRTAG

(1997) concludes that, the viruscan only live inside human body and it only survives for a

short time outside the body. According to Mujinja and Over (1993) HIV is a disease

which destroys the body’s immune system leaving the body opens to infections to the

extent that it cannot fight in the normal way. They add that when this happens the

infected person is said to be suffering with AIDS.

Gilks (1998) on the other hand sees AIDS as a chronic disease that is ultimately fatal but

individuals diagnosed as HIV positive, may live with the virus for a number of years. He

laments that the virus is associated with the body fluids such as blood, blood products,

saliva, tears, breast milk and particularly semen and virginal secretions. Gilks (1998)

further confirms that AIDS is caused by a virus called HIV which is very small living

organism that causes many different diseases in humans, animals and plants. He laments

that the viruses are so small that even if millions are put together, they cannot be seen

with eyes. The World Health Organization (2004) adds that the viruses are among the

smallest and simplest living things, they cannot reproduce on their own rather they

depend on the animals or humans they infected to act as host.

Akinkugbe and Falase (2000) discover that the virus (HIV) reproduces in certain cells in

human blood called White Blood Cells (WBCs) which are very important part to human

immune system that defends the body from infections. They add that when a person

becomes infected with HIV, the virus begins to live and reproduce in the White Blood

Cells (WBCs) and continue to multiply until there are millions of viruses present. While

11
AIDS on the other hand, is the terminal manifestation of this Viruses (HIV) infection.

Finally, Bennet (1990) has summarily described the disease in three dimensions. Firstly, it

is the epidemic or the silent epidemic which is largely hidden and spreading rapidly

throughout the world. Secondly, AIDS epidemic is the visible consequences of invisible

virus called ‘HIV’ and thirdly the epidemic moves beyond the medical to the social,

which refers to the denial, blame, stigmatization, prejudice and discrimination that is

prevalent in every country with HIV/AIDS.

2.2. Historical Antecedent of HIV/AIDS

The story of HIV/AIDS emerged in 1979 and 1980 when doctors in the US observed

clusters of previously extremely unusual diseases. These included a type of pneumonia

carried by birds (Pneumocystics Carinii) and a cancer called Kaposi’s sarcoma

(Whiteside and Barnett, 2003). The phenomenon was first reported in the Morbidity and

Mortality Weekly Report (MMWR) of 5 June 1981 published by the US Center for

Disease control in Atlanta (Crowe, 2003; Mafeni and Fajemisin, 2003; Whiteside and

Barnett, 2003; Olufemi, 2004; WHO, 2004; David et al, 2005 and Okunna and Dunu,

2006). The MMWR recorded five cases of Pneumocystics Carinii in Atlanta and

clustering of Pneumocystics Carinii in New York in a month later (Crowe, 2003 and

Whiteside and Barnett, 2003). Available evidence shows that AIDS epidemics began to

take root among heterosexual men, women and children in sub Saharan Africa shortly

after its detection in the United States (Crowe, 2003 and Whiteside and Barnett, 2003).

In the US, about 40,000 new infections occur each year and more than 30 per cent of

these infections occur in women and 60% in ethnic minorities (Okunna and Dunu, 2006).

The disease has since reached alarming rates to the extent that the United Nation Report

in 2003 warned that unless richer countries of the world intervened, 70 million people

12
would die of AIDS by the year 2020. The report further revealed that; of the 3 million

people who died of AIDS in 2001; 2.2 million of them were from Sub Saharan Africa that

makes Africa the most affected continent with HIV/AIDS globally. The World Health

Organization (2004) reported that the first case of AIDS in Africa was discovered in

Central Africa in 1982 with less than 0.3% cases. This estimation has risen as far as 1.7

million (1.4 - 2.4 million) new HIV infections in 2007. Similarly, an estimated 22.5

million (20.9 - 24.3 million) people living with HIV, or 68% of the global total, are in

sub-Saharan Africa (UNAIDS, 2007). In West Africa though HIV affect relatively less

but prevalence rates in some countries are increasing, especially in countries such as

Cameroon, Cote d’Ivoire and Nigeria (Cohen, 1998; Mutangandura, 2000 and Hunter,

2003). The onset of the HIV epidemic in West Africa began in 1985 with reported cases

in Cote d’Ivoire, Benin and Mali. Nigeria, Burkina Faso, Ghana, Cameroon, Senegal and

Liberia followed in 1986. While Sierra Leone, Togo and Niger in 1987, Mauritania in

1988; in 1989, the incidence emerged in The Gambia, Guinea-Bissau and Guinea and

finally in 1990 was the turn of Cape Verde (Hunter, 2003 and Craddock, 2004).

The first AIDS case was reported in Nigeria in 1986 in a sexually active 13 years old girl

(FMH and NACA, 2002; NCGHHR, 2002; Hunter, 2003; Mafeni and Fajemisin, 2003;

Craddock, 2004; Malink and Kotin, 2004; Irefin and Afolagbade, 2006 and Okunna and

Dunu, 2006). As at that time the response was to deny the fact that this was a significant

problem (NCGHHR, 2002 and Mafeni and Fajemisin, 2003). Though a National Expert

Advisory Committee on AIDS (NEACA) was established in the same year, little else was

done. No concerted attempt was initiated to prevent the spread of the epidemic

(NCGHHR, 2002 and Mafeni and Fajemisin, 2003). The main perception was that

HIV/AIDS is a disease of the western world associated with men who had sex with men

13
(NCGHHR, 2002). The first sentinel survey conducted in 1991 showed HIV prevalence

to be 1.8%, because there was very little visible evidence of AIDS, the country took only

a few essentially cosmetic actions. Public enlightenment campaigns attempted to scare

people into adopting safer sexual practices but these were narrow and fell on the deaf ears

of a largely disbelieving public (Attah, et al, 2002; Mafeni and Fajemisin, 2003; Irefin

and Afolagbade, 2006 and Nwabueze, 2007).

Unfortunately, it is now realized that this scare mongering led to the high levels of stigma

and discrimination towards those living with HIV/AIDS that became so common (Attah,

et al, 2002; Mafeni and Fajemisin, 2003; Craddock, 2004; Malink and Kotin, 2004; and

Irefin and Afolagbade, 2006). For instance, the HIV prevalence in the country rose from

1.8% in 1988 to 5.8% in 2001 (Nwabueze, 2007). Since 1991, the Federal Ministry of

Health has carried out a National HIV/Syphilis Sentinel Sero-prevalence Survey every

two years (NCGHHR, 2002 and Mafeni and Fajemisin, 2003). Meanwhile, the 2003

Survey estimated that there were 3,300,000 adults living with HIV/AIDS in Nigeria and

1,900,000 (57%) of these were women. In addition, the 2003 survey revealed that, the

prevalence rates varied from as low as 1.2% in Osun State to as high as 12% in Cross

River State (UNAIDS/WHO, 2006). Overall, 13 of Nigeria’s 36 states had HIV

prevalence over 5%. These figures, according to the report, give support to the claim that

there are explosive, localized epidemic in some states. Meanwhile, in 2005 it was

estimated that there were 220,000 deaths from AIDS and 930,000 AIDS orphans living in

Nigeria (Okunna and Dunu, 2006). There has been also an alarming increase in the

number of HIV positive children in recent years, 90% of which contact the virus through

their mothers. Presently, Nigeria is reported to be the second largest HIV prevalence in

Africa after South Africa (Attah, et al, 2002; NCGHHR, 2002; Mafeni and Fajemisin,

14
2003; Craddock, 2004; Malink and Kotin, 2004 and Haruna, 2007). Now the question is:

why the widespread of the disease in the country? This is explained below:

2.3. Causes and Factors Contributing to the Spread of HIV/AIDS in Nigeria

According to report placed on avert.com, some 80% of HIV infections in Nigeria are

transmitted by heterosexual sex. Factors contributing to this, according to the report,

include low levels of condom use and high levels of sexually transmitted infections

(STIs) such as Chlamydia and Gonorrhea, which make it easier for the virus to be

transmitted (avert.com, 2007). Blood transfusions are responsible for about 10% of all

HIV infections. The remaining 10% of HIV infections are acquired through other routes

such as, (according to avert.com) mother-to-child transmission, homosexual sex and

injecting drug use. Other factors are: lack of sexual health information; stigma and

discrimination; poor health services; gender and inequality; poverty; harmful marriage

and cultural affiliation and prostitution. Some of these are discussed below.

Up until recently, there was little or no sexual health education for young people and this

has been a major barrier to reducing rates of HIV and other STIs thereby increasing

transmission rates as well as stigma and discrimination towards people living with

HIV/AIDS. Stigma and discrimination is another problem, where both Christians and

Muslims see immoral behavior as being the cause of the HIV/AIDS epidemic (Okunna

and Dunnu, 2005). This according to Ali-Dinar (2007) affects attitudes towards PLWHA

and HIV prevention adversely. PLWHA often lose their jobs or are denied health care

services because of the ignorance about HIV/AIDS. The recent pronouncement by a

Chancellor of a private University in Nigeria that Certificate award to graduating students

of the institution will be based on HIV/AIDS test is a living witness. Though, this has

generated a lot of reactions from stakeholders in the war against stigmatization and

15
discrimination of PLWHA. While, due to the stigma admitting to HIV infections, some

individuals choose to continue to engage in unsafe sexual practices which thus, spread

HIV to new sexual partners. Poor health care services in no means have also contributed

a lot in spreading HIV/IADS in Nigeria (Haruna, 2007).

It has been discovered that there is indeed a direct correlation between women's low

status, the violation of their human rights and HIV transmission (Haruna, 2007). The

reason that AIDS has escalated into a pandemic is simply because of inequality between

women and men continues to be pervasive and persistent (Long and Ankhrah, 1996;

Lather and Smithies, 1997; Baylies and Bujra, 2000 and Nnaka, 2004). The report of

socio-economic status of PLWHA in Sokoto metropolis also attest to this claim, where

females are more infected than male by margin of 22% (Abdulrahim, 2007). In the light

of this, leaders across the world have agreed that women are more infected; more affected

and took the burden of the HIV/AIDS epidemic, yet little progress has been made in the

area of addressing the rights of women affected with HIV/AIDS (Haruna, 2007). There

are other reasons why women are more vulnerable than men to HIV/AIDS, according to

Walker (2002) cited in Irefin and Afolagbade (2006) they include female physiology,

women’s lack of power to negotiate sexual relationships with male partners especially in

marriage, and the gendered nature of poverty, with poor women particularly vulnerable.

He further asserts that inequalities in gender run parallel to inequities in income and

assets. Finally, he concludes that women are vulnerable not only to HIV/AIDS infection

but also to the economic impact of HIV/AIDS.

Harmful marriage practices according to Yamanchi (2007) also make women to be prone

to HIV/AIDS than men. In Nigeria for instance, there is no legal minimum age for

marriage and early marriage is still the norm in many rural areas. Parents see it as a way

16
of protecting young girls from the outside world and maintaining their chastity. Many

girls get married between the ages of 12 to 13 and there is usually a large age gap

between husband and wife (Haruna, 2007). As a result, young married girls are at risk of

contracting HIV from their husbands as it is common for men to have sexual partners

outside marriage (avert.com, 2007). Female circumcision/female genital mutilation

(FGM) is another reason why women are more prone to HIV/AIDS than men FGM is a

cultural practice whereby all or part of the external female genitalia is removed by cutting

(avert.com, 2007). For instance in 2000, a percentage of about 60 of all Nigeria women

experience FGM and it is most common in the Southern Nigeria, where up to 85% of

women undergo it at some point in their lives (Okunna and Dunnu, 2006). FGM puts

women and girls at risk of contracting HIV from un-sterilized instruments, such as knives

and broken glass that are used during the procedure. Although, prostitution is illegal in

Nigeria, there are more than a million female sex workers in the country (WHO, 2004).

HIV infection rates among sex workers have been estimated to be as high as 3% in some

areas (WHO, 2004).

Lugalla et al (1992) linked the AIDS epidemic with the years of economic crisis in the

early 1980s that saw the scarcity of essential commodities. These economic hardships

intensified poverty, destabilized families, and increased people’s movements between

countries. The situation widened the web of sex networking, and in this way facilitated

the early rapid spread of HIV. HIV/AIDS too intensifies poverty, leads to its persistence

and over time generates a culture of poverty. When parents are sick and die from AIDS-

related complications, little or no transfer of skills and knowledge to the younger

generation. The circle of poverty is likely to repeat itself and felt over generations (Casale

and Whiteside, 2006). Interventions to mitigate the effects of the pandemic on the rising

17
generations are needed. HIV/AIDS appears to interact strongly with poverty and has

increased the depth of vulnerability of those households already vulnerable to shocks

(Barnett and Whiteside, 1992). HIV/AIDS has acted to intensify the disadvantages

imposed on the poor households and communities (Singhal and Rogers, 2003). Some of

the impacts of the AIDS epidemic are explained below.

2.4 IMPACT OF AIDS EPIDEMIC.

The epidemic has both economic and social impacts as seen below.

2.4.1. Economic Impact of AIDS

In countries where a full-blown AIDS epidemic has taken hold as in Nigeria, public

resources are diverted from active development to crisis management, productivity of the

work force is reduced as it becomes depleted, traditional family and community

structures may break down, and there may be risks to political stability and the rule of

law. HIV/AIDS leads to lower levels of health arise because of the costs of caring for

family members with HIV, funeral expenses and the premature mortality among younger

adult members which potentially constitute the loss of an earring member of a household,

coupled with a lack of adequate mechanisms to cope with these financial shocks (Bechu,

1998; Alban, 1999; Magill, 2002 and Parker, 2002). Therefore, the actual cost of dealing

with HIV/AIDS at the family, community, company and national levels constitute the

total expenses. The expenses comprise both the direct and indirect costs. The direct costs

are expenses incurred in dealing with disease. These costs related to healthcare can be

easily estimated from the time a person is first tested HIV positive to the point when he

dies, a measurable amount of money will be spent on his health care (Ibrahim, 1999).

This cost may be borne by the individual, the family/relatives, employers, insurance

compares, medical aids societies or the public health system (Abdulrahim, 2007).

18
Similarly, AIDS infected households might spend increasing proportion of their income

on medical treatment. However if the treatment is unnecessarily delayed, inappropriate

and/or ineffective, the expensive might be wasted completely (Abdulrahim, 2007). The

principal economic impacts experienced by affected households include: loss of available

income, as working adults falling ill or dying or having to stop work to look after

children and/or the ill; additional expenditure on health care and funerals (Bollinger et. al

1999; Booysen et. al, 2002 and Parker, 2002).

2.4.2. Social Impact of AIDS

HIV/AIDS epidemic has devastated families in both emotionally, socially and financially

in Nigeria (David et al, 2005 and Abdulrahim, 2007). In addition to the expenses incurred

by individuals, each affected family must bear the physic costs associated with the death

and illness of a family member, the breakdown in family structure and the stigma

associated with HIV. In 2000 for instance, the UN Security Council identified HIV/AIDS

as a global security risk as well as a human security issue (Mathins, 2005). The high

attrition caused by AIDS deaths, countries risks exacerbating instability and the spread of

HIV can increase, as armies with highly HIV prevalence are involved in peacekeeping

activities in other countries. The epidemic’s influence on household living conditions

derives in great part from the virus’s specific demographic effects (Broombery et al, 1997

and Nampanya, 2000).

HIV/AIDS changes the structure of the population; it is distinct from other diseases

because it strikes prime-aged adults, the most productive segment of the economy

(Barnett and Whiteside, 1992). Thus the breadwinners are falling ill and dying,

destroying much-needed skills and depriving children of their parents. The repeated

impact of HIV/AIDS is most evident in the continent’s orphan crisis (Wilson, 2001 and

19
Germann, 2004). Approximately, 12 million children in sub-Saharan Africa are estimated

to be orphaned by relatives including especially grand mothers, but the capacity of the

extended family to cope with this burden is stretched very thin and is, in places,

collapsing (Ainsworth and Dayton, 2001 and Wyse, 2007). This may be the reason why

UNICEF and other international agencies consider a scaled up response to Africa’s

orphan crisis a humanitarian priority. Other impacts of the disease are considered below.

2.4.3. Impact of AIDS on Agriculture and Food Security

AIDS is often one of the serious factors aggravating an already difficult situation in

agricultural activities (Loewenson and Chikumbirike, 2005). In Southern Africa,

HIV/AIDS is considered to be a critical factor conditioning rural economic development,

exacerbating already difficult problems with climatic variability and poverty (Whiteside,

1994). A lot of countries are witnessing a systematic erosion of the productive capacity of

whole communities stemming from the HIV/AIDS pandemic (Yamano and Jayne, 2002).

Consequently, between year 2002 - 2003 at least 14 million people were deemed food

insecure and in need of food assistance (UNAIDS/WHO, 2006). Increased morbidity and

mortality of the prime-age adult population may lead to fewer agricultural workers and a

reduced amount of food produced and made available, as well as a smaller variety of

crops grown. At the same time, those living with the epidemic have a more acute need for

good nutrition (UNAIDS/WHO, 2006).

Off-farm income is substantially affected by the death of the male head of household, but

not that of other adult members. The loss of income from the cultivation of traditional

cash crops is mainly from death of males, which is a major source of hardship for the

households. In developing countries where HIV/AIDS epidemics are well-established in

20
the general population, subsistence agriculture is an important source of livelihood for the

majority of the population and a significant economic sector (Yamano and Jayne, 2002).

2.4.4. Impact of AIDS on Rural Households and Communities

AIDS-affected households are those where household members are not infected, but have

been affected by HIV/ AIDS, for example, through the diversion of household resources

to support AIDS-afflicted households. While, unaffected households are those in which

no member is ill or has died from AIDS and which has not been affected by the illness or

death of a member of any related household (Jill, et al, 2001). These terms are now

common parlance in the field of HIV/AIDS work, and implicitly broaden the scope of

analysis through their recognition of the impact of HIV/AIDS beyond individual

households where a member has been afflicted (Whiteside and Wood, 1995 and Jill, et al,

2001).

Households also experience a loss of financial assets in several areas owing to AIDS

infection. Labour may be diverted from economically productive activities such as paid

employment or cash-crop production to care for the sick individual, and money is needed

for medication and to pay funeral costs after the inevitable death. Even if a single AIDS-

related death has a similar impact on a household as a death from other causes, the large

number of deaths due to the epidemic may cause disproportionate harm to a household or

community at large (Ainsworth and Dayton, 2001; Wilson, 2001; Parker, 2002 and Wyss

et al, 2004). As a result of all these impact and others not mentioned in this section the

need for the intervention of the Microfinance Institutions through the provision of proper

access to micro credit for People Living with HIV/AIDS is necessary to alleviate their

poverty and by extension assist in the management of the disease.

2.5. Concept of Micro Finance/Micro Credit

21
According to Otero (1999) cited in Cornford (2000) micro finance is “the provision of

financial services to low-income poor and very poor self-employed people”. These

financial services according to Mathins (2003) generally include savings and credit but

can also include other financial services such as insurance and payment services.

Cornford (2000) on the other hand, sees microfinance as “the attempt to improve access

to small deposits and small loans for poor households neglected by the traditional banks”.

Therefore, microfinance involves the provision of financial services such as savings,

loans and insurance to poor people living in both urban and rural areas who are unable to

obtain such services from the formal financial sector. However, Conford (2000) further

observes that the demand for microfinance services usually comes from ‘micro

entrepreneurs’; people who survive by generating income for themselves in very small

business activities. Micro credit on the other hand, is the extension of very small (micro

loans) to unemployed, to poor entrepreneurs and others living in poverty that is not

considered bankable. These individuals, according to Liew (1997) lack collateral, steady

employment and a verifiable credit history and therefore cannot meet even the most

minimal qualifications to gain access to traditional (finance) credit.

Microfinance is also defined by Karlan and Zinman (2006) as the provision of relevant

and affordable financial services to poor households that do not have access to the

services offered by ‘traditional’ financial institutions. They add that the 'micro' prefix

refers to the size of the financial transactions; it does not imply that the MFIs themselves

are small. Although, microfinance is primarily concerned with credit and savings, in

recent times, allied services such as insurance, leasing, payment transfers and remittances

are being introduced to the mix of services. Ganyaza-Twalo and Seager (2005) consider

micro credit as a part of microfinance, which provide financial services to the very poor;

22
apart from loans, it includes (money) savings, micro insurance and other financial

innovations. Mathins (2003) describes micro credit as a financial innovation, which

originated in developing countries where it has successfully enabled extremely

impoverished people to engage in self-employment projects that allow them to generate

an income and, in many cases, begins to build wealth and exit poverty.

In most of African countries and indeed Nigeria, the use of micro finance programmes as

a poverty alleviation tool has not been very successful (Akanji, 2001). However, it is

important to note that the differentiated levels of success archived by micro finance

programmes in different countries, like in any other industry, depend mainly on

competitive pricing, efficient and effective delivery of products and services, innovation

continues improvement of the products and offered, management skills, commitment and

focus by all actors, good governance, accountability and transparency. In addition,

experience has also shown that while continuous, dependable and long-term sustainable

funding is so essential for successful microfinance programmes, more often than not, lack

of focus; business acumen and skills; limited outreach; poor banking culture-willful

default poor governance of MFIs/MF banks and government supported social

programmes that out rightly contravene market forces, affect the success of micro finance

programmes. At this juncture, it is important to take a look at micro finance institutions in

Nigeria, as below:

2.6. Brief Overview of Micro Finance Institutions in Nigeria

Micro financing is not a new phenomenon in the Nigerian society as evidenced by some

cultural economic activities such as “Esusu”, “Ajo”, “Adashi”, “Otataye” etc, practiced to

provide funds for producers in the rural communities (Ehigiamuosoe, 2005 and

Enechukwu, 2005). Over the years, successive governments in Nigeria have made several

23
attempts to address the issue of access to finance amongst poorer Nigerians to allow them

partake in micro and small scale economic activities (Okonjo-Iweala, 2005). Efforts so

far include Agricultural Development Programmes (ADP), Rural Banking Schemes, the

National Economic Reconstruction Fund (NERF), National Directorate of Food, Roads

and Rural Infrastructure (DIFRRI), Better Life for Rural Women (BLRW), Family

Economic Advancement Programme (FEAP) as well as National Poverty Eradication

Programme (NAPEP). In addition, several Development Financial Institutions which

could amongst other functions provide additional funding for institutions engaged in

micro finance have been established. These include the Nigeria Industrial Development

Bank (NIDB), the Nigerian Bank for Commerce and Industry (NACB), Nigerian

Agricultural and Cooperative Bank (NACB) and the Federal Mortgage Bank (FMB).

Most recently, the Small and Medium Industries Equity Investment Scheme (SMIEIS)

was created to provide equity resources for small and medium industries. Currently there

are 177 micro finance institutions in Nigeria. Some of these are as follows:

People’s Bank of Nigeria

People’s Bank of Nigeria was established by the Federal Government in 1989 with initial

capital of #30 million. Specifically, the bank is to meet the credit need of small borrowers

who cannot satisfy the stringent collateral requirements normally demanded by

commercial banks. Initially, it granted loans in the lower range of #50 to N 5,000 or as

higher as N 20,000 depending on how large the trade is and it is performances. The loans

given require no or little collateral and it did not attract much interest in the pay back.

The beneficiary will only be charged a small proportion of the loan to enable the bank

covered administrative costs.

Community Banks of Nigeria

24
A community bank in Nigeria is self sustaining financial institution owned and managed

by a community to provide banking and financial service to that community. The

National Board for Community Banks (NBCB) processes application for the

establishment of community banks. The first community bank commenced operation in

1990. Since then NBCB has issued final licenses by the CBN after operating for two

years. Currently there are about 502 community banks legally operating in Nigeria.

Nigeria Agriculture, Cooperative and Rural Development Bank (NACRDB)

The Nigerian Agriculture, Cooperative and Rural Bank Limited (NACRDB) established

in 2000. This is as a result of the merging of the then Agricultural Bank, Peoples Bank of

Nigeria and Family Economic Advancement Programme. It was created precisely to

redress the weakness of existing system whish was saddle with myriads of lack of

appropriate skill to mobilize identify the poor and cannot therefore provide the essential

remedy in sustainable way.

Federal Mortgage Finance Limited (FMFL)

FMFL commenced operations in 1990 as a direct Federal Government intervention to

accelerate its housing delivery programme. The FMFL is expected to expand and

coordinate mortgage lending on a nation-wide basis, using resources from deposits

mobilized and equity contributions by the Federal Government and CBN at rates of

interest below the market rates. The Federal Mortgage Bank of Nigeria (FMBN) served

as regulatory body for FMFL. FMBN also expected to provide long-term credit facilities

to mortgage institutions in Nigeria to enable them grant comparable facilities to

individuals desiring to acquire houses of their own; encourage and promote the

emergence and growth of Primary Mortgage Institutions (PMIs) to serve the need of

25
housing delivery in all parts of Nigeria; and to collect, manage and administer

contributions to the National Housing Fund (NHF).

Unfortunately, most of these programmes have at best recorded little success in securing

wide access to sustainable micro credit as a critical instrument for growth and poverty

reduction (Adelaja, 2005 and Kimotha, 2005). For instances, a CBN survey of in 2001

identified 1600 MFIs in which their operation have not grown much in term of size,

branch expansion, staffing, saving and credit levels (Kimotha, 2005 and Kpakol, 2005).

The reports conclude that MFIs in Nigeria are still continue to constrain by weak access

to funding sources; operating cost; lack of re-financing facilities; repayment problems;

inadequate experienced of credit staff and client apathy (Ehigiamouse, 2005). Meanwhile,

it has been suggested that for micro finance institutions to ease poverty and contribute to

the economic development of the country there is the need for them to resolve the

problems of unavailability of credit facilities; fostering the spirit of community

ownership of banks on a sustainable basis; promoting rural development by inculcating

saving habit in the rural people (Adelaja, 2005 and Kpakol, 2005). Below are some

theoretical arguments on micro credit and the management of HIV/AIDS.

2.7. Theoretical Argument on Access to Micro Credit and HIV/AIDS Management.

There is no gain denying the fact that poverty is major causer of HIV/AIDS in most of

the third world countries (Otim, 2006). Poverty is both a cause and a consequence of

HIV/AIDS. It increases the risk of contracting HIV/AIDS (Shisana and Simbayi, 2002

and Singhal and Rogers, 2003). In many developing countries, the most disfavored

people are also those who are mostly affected by infectious diseases. Therefore, by

redressing economic vulnerability of people living with the virus through micro credit

programs and the infected households would regain their autonomy and authority. The

26
need for more micro credit for PLWHA in order to alleviate their poverty and manage the

HIV problem is inevitable (Abdulrahim, 2007). Otero (1999) cited in Cornford (2000)

and Frances et al (2004) illustrates the various ways in which “access to micro credit

combats poverty and by extension AIDS epidemic”. Both agreed that microfinance

creates access to productive capital for the poor especially PLWHA, which together with

human capital help in addressing poverty through education and training. By providing

material capital to a poor people, their sense of dignity is strengthened and this can help

to empower such persons to participate in the economy and society. This is important as

women in Africa produce 80 percent of the food, but receive only 10 percent of the credit

made available for agriculture (Ganyaza-Twalo and Seager, 2005). Micro Credit projects

are thus regarded as an alternative source of credit for women and poor families

(Mathins, 2003).

Therefore, it has been maintained that, without proper access to credit, PLWHA are often

stuck in the cycle of poverty with no opportunities to improve their lives or those of their

children (Ehigiamusoe, 2005). By incorporating HIV/AIDS education, testing, access to

anti-retroviral drugs, and care/support into female-only micro credit groups, women are

more likely to get the information they need. As a result of the income earned through

micro credit projects, women are better positioned to care for family members infected

with HIV/AIDS, to send their children to school, and to have the financial stability that

will help them to avoid high-risk sexual behavior. When HIV/AIDS is devastating the

little income that women have, just a few dollars in loans can make a life-changing

difference (Baylies and Bujra, 2000).

Some evidences however have debunked the claimed that access to micro credit could

solve poverty and AIDS epidemic. For example, Durban Project HIV of Kolkata, India in

27
2007 assisted some sex workers to develop an alternative sources of income, they were

provided with loan of 700 rupees, so that they can stabilize themselves and their families,

unfortunately the sex workers continued with their normal sex work not minding the

money given. One of the beneficiaries (sex workers) declares that, throwing money on

them can not make them stop what they are doing, she concludes, ‘it is about our self-

esteem as women, we get honor from earning our own money through commercial sex

work’ (DFID, 2007). Also, scholars have argued that forcing clients to borrow for micro

entrepreneurial activities in order to gain access to credit does not address the needs of

low-income clients (Conford, 2000). Instead, clients may be forced to ‘invent’ a micro

enterprise plan in order to access sums of money which they can repay but which may not

necessarily be used for any income- generating purpose (Mathins, 2003).

Focusing on the Pacific, Liew (1997) notes that, in rural communities and especially

among the disadvantaged (mostly PLWHA), the demand for cash is primarily to meet

emergencies, for schooling of their children, to meet traditional and religious obligations

and for other basic necessities, rather than treatment of diseases like AIDS. He maintains

that the demand for cash is rarely for starting a micro-enterprise or income earning

activity, especially, where there is no access to markets and/or business opportunities,

then low-income clients are likely to find micro credit of little use. He further stresses

that, in many cases, very poor people are risk-averse; they do not want to go into debt and

fear losing what little they have in the event of their micro enterprise activity failing to

generate sufficient income to repay their loan. For them, access to savings services may

be perceived as far more useful (Liew, 1997). The growing number of clients accessing

voluntary savings services indicates that it is the ability to access safe, flexible savings

28
services to ‘smooth’ unexpected or seasonal cash requirements which many poor clients

value.

By and large, the connection between poverty and AIDS epidemic is indeed considered

straightforward and since there is currently no vaccine available to effectively prevent the

spread of HIV there is the need for an alternative which is the access to micro credit. This

may be the reason why Opportunity International, a non governmental organization has

expressed the challenge of MFI in a paper released in 2000 that, "if AIDS awareness has

not reduced the rate of infection, there is the need for the alternative mode of managing

the menace i.e. micro credit” (ICAD, 2001). To further appreciate this development,

below are some of the empirical studies on access to micro credit and the management of

HIV/AIDS.

2.8. Some Empirical Studies on Access to Micro Credit and HIV/AIDS Management

Schuler and Hashemi (1994) cited in Carolyn (2003) illustrates how GHESKIO Center

and the ACME Association that manage PLWHA in Haiti have impacted positively on

their beneficiaries. The beneficiaries (PLWHA) were given a loan of between €30 and

€500, with an interest rate of 2% per month. The loan was given for various commercial

activities (selling clothes, food products, hardware goods, cloths, warm food, etc.). The

first result was encouraging as 77 participants accessed the loan facilities and more than

40 of them were able to cross over the poverty line and manage their AIDS disease

effectively. Similarly, the Rodolphe Mérieux Foundation in Haiti had initiated a micro

credit program that takes part in validating a multi-factorial approach to the fight against

AIDS, and more considerably to helping development. The results of the foundation’s

effort show that about 52% of the clients (PLWHA) cross over the poverty line within 6

months.

29
Romanns (2006) study also shows how access to micro credit is used to manage AIDS

epidemic in Ghana. The study evaluates the impact of the micro-credits on the

beneficiary (PLWHA) based on three indicators: economic (the capacity to live on their

own, to pay for their childrens’ school fees, to generate commercial activity), social (the

integration and relations with their family and neighborhood, the capacity to recruit other

micro credit beneficiaries), and medical (state of health, clinic consultation and adherence

to the AVR treatment). The findings of the study was encouraging as for instance, in the

area of economic indicator 95% were able to buy food, 92% bought new clothes and 40%

have the possibility to pay their rent compared to 46%, 3% and 23% respectively for non

beneficiary group. While social indicator result reveals that, there is a reduction of the

discrimination/ stigmatization phenomenon among the beneficiary to the extent that, 76%

feel more autonomous and 92% affirming to be accepted in their surroundings after

receiving loan. Also, results from medical indicator disclosed that, the beneficiary (96%)

were able to take the responsibility of their wellbeing in terms of good medical treatment.

Latifee (2003) surveys 510 microfinance clients which include PLWHA conducted in

Nepal and the findings of his study reveals that access to micro financial services was

effective in increasing income, improving nutrition, providing better food intake,

housing, consumption and clothing, health care and access to education for children

(especially the orphans by HIV/AIDS), lowering child mortality, and birth rate, higher

adoption of family planning practices, etc. among clients compared to non-client

households. His study discloses that the clients of micro credit used the facility, both for

production (66%) and consumption (34%) purposes as well as concludes that about 56%

clients experienced significant improvement of income upon receiving microfinance

services. Magill (2002) on the other hand described a program in Bangladesh where rural

30
credit scheme was used to increase the status and level of PLWHA in order to increase

their mobility, economic security, freedom to make purchases on their own, freedom from

domination and violence within their family, and increase their awareness especially on

the rights of citizenship. The result of their findings revealed that 87% of the beneficiaries

were better off after receiving small loan.

In Nigeria, for example, Irefin and Afolagbade (2006) have discovered that, about 20,000

ladies are engaged in commercial sex activities in Brono state, with at least 75% citing

economic reasons for their involvement. Uninterestingly, none of the respondents

disclosed their HIV status, mostly stating that it is not their primary concern whether they

have it or not but the most important thing for them are school fees, child care, food and

shelters. However, the very high vulnerability of this people to HIV/AIDS is not

disputable and therefore the vicious circle continues. HIV/AIDS worsens poverty among

households already living below the poverty line in Sokoto state of Nigeria as the result

of a study indicates that in 2007, spending habit of affected households is 35% higher

than that of unaffected households (Abdulrahim, 2007). Similar a study carried out in two

states of Nigeria: Oyo and Plateau revealed that, HIV/AIDS imposes a greater burden on

health spending on affected households in both states. Indeed, according to the findings,

the households spending on treatment are greater (22%) and (11%) in Oyo and Plateau

state respectively, compared to 13.6% and 9.4% amongst unaffected households both

states respectively (David et. al, 2005).

2.9. Brief on HIV/AIDS Situation in Sokoto StateAlthough there are not reliable

data on when first HIV/AIDS case had been discovered in Sokoto state and the current

statistics of people living with the disease in the state, it was reported that HIV/AIDS in

the state were first discovered in 1990 with only four cases. The blood samples of the

31
affected persons had been taken to the University of Maiduguri Teaching Hospital for

confirmation and they were found positive. Since the number of people living with

HIV/AIDS has been mysteriously increasing in the state (Akintunde, 2004). It is perhaps

against this background that in April 2004, the Society for Family Health (SFH) in

Sokoto state a Non Governmental Organization brought together a group of people living

with HIV/AIDS to form an association known as “NASIHA” support group (Akintunde,

2004).

The association of PLWHA popularly known as NASIHA group emanated as a result of

efforts that brought about members’ easy access to drugs and ability to update their

knowledge on the disease through series of lectures they have received and still receiving

from the experts on HIV and AIDS (Abdulrahim, 2007). The information they are having

as members of the group enable them to develop confidence that they could have a

healthy live in spite of the disease. This goes to further prove that information is power as

it emancipates people from ignorance-the biggest disease (Abdulrahim, 2007). The

consequences of joining NASIHA group had raised their hope to live a good life as for

instance; a recent survey sponsored by UNDP in Sokoto revealed that, 42% and 34% of

NASIHA members are eventually happy and very happy respectively. While, 20%

claimed to be happy for being a member of NASIHA group, only 2% expressed been

depressed and sad. In a nut shell, “the state of mind of most respondents had been from

sadness to joy, before and after joining the NASIHA group as a PLWHA” (Abdulrahim,

2007).

Presently, there are two Voluntary Confidential Counseling and HIV Testing (VCCT)

centers in the metropolis; while one is located within the Specialist Hospital; the other

one is situated inside the Usmanu Danfodiyo Teaching Hospital. Specialized personnel on

32
HIVAIDS counseling and medical experts were positioned in these two centers to attend

to people who may either come for counseling or HIV test. It has been observed that the

majority of those who are patronizing these centers were from the metropolis this might

be as a result of the awareness and easy access to the centers compare to people from

other Local Government Area within the state.

2.10. Historical Background of the Study AreaSokoto Stateis one of the 36 states in

the Federation of Nigeria. It was created in 1976 during General Murtala Muhammed’s

administration. The state is located within Northern Sudan Savannah zone, it is traversed

partly by latitude 120' 000 N and Longitude 040' 300 'E to the extreme Northwest corner

of the Federal Republic of Nigeria. It is bordered to the North by the Republic of Niger,

flanked by Kebbi State to the West and Zamfara State by East (Sokoto State Government,

2005). In 2006 it had a population of 3, 696, 999 people. The state has a land mass of 26,

827.43 square kilometers and a population density of 97.7 person per square kilometer.

The state currently has 23 Local Government Areas. Its headquarters is based in Sokoto

town, the capital of the erstwhile Sokoto Caliphate which was established in the early

19th century following the successful execution of the Sokoto Jihad of 1804 led by Shehu

Usmanu Danfodiyo (Yaqub and Yandaki, 2000).

Therefore, Sokoto metropolis remains not only the seat of the Caliphate but also the

centre of Islamic culture, history and tradition. The town occupies a unique place in the

history of Nigeria. It is from there that the legendary Islamic scholar, Uthman Dan Fodio

launched the Jihad in 1804, introducing Islam to most parts of Northern Nigeria. Sokoto

metropolis has a commendable interest abound: these sites include Sultan Palace, ancient

Sokoto market, Central Mosque and tombs of founders of the caliphate. Historical

materials such as collections of artifacts from the caliphate are available in the state's

33
History Bureau located within Sokoto North LGA. Agriculture and craft has been the

mainstay of the people in the state, the former is the largest employer of labour in the

state with 80 per cent of the population practicing it (Yaqub and Yandaki, 2000).

To date, Sokoto remains the seat of the caliphate and centre of Islamic learning. By virtue

of its origin and geographic locations Sokoto State comprises of Hausa, Fulani and

Zabarmawa. The settlement distribution during the Jihad period also favours the defense

factor in location. With colonialism in the 1900, and the emergence of Nigeria as a

political entity, many other ethnic groups from the South and Middle Belt have migrated

and taken permanent residence in the state. Although the Ibos and Yorubas top the list of

Southern migrants, the large numbers of almost all the 250 other ethnic groups in Nigeria

are comfortably pursuing their legitimate business or as employees of federal and private

organizations in the town. This multi-cultural heritage paved way for the large number of

registered cultural associations and ethnic group meetings that take place on weekends in

various locations of the metropolis. The large number of non-Hausa Fulani ethnic groups

is also an attestation to the peaceful environment the town has enjoyed for long.

The people of Sokoto engage in both rainy and dry season farming activities and using

the United Nations criteria on poverty, the majority of the people of Sokoto can be

regarded as poor. People of Sokoto are predominant Muslims and operate both the

Shari’ah and Conventional law. The prevalence of HIV/AIDS in Sokoto state can not be

compared with other states in the South, this might be as a result of their cultural

background mixed with religious believes (Abdulrahim, 2007).

34
CHAPTER THREE

Research Design and Methodology3.1. Introduction

Here an attempt is made to explain the research approach and methods of achieving the

stated objectives. Specifically, the chapter explains the sources of data, sample size and

sampling technique, questionnaire design and administration, techniques of data analysis

and model to be used for the study as seen below.

3.2. Sources of DataFor the purpose of this research work, two sources of data will be

used. They are primary and secondary sources. The former involves sourcing relevant

information from respondents through the aid of questionnaire as an instrument of data

collection. The latter consists books, journal articles, academic papers etc from libraries,

government offices, and internet.

3.3. Sample Size and Sampling TechniquesThe population size for this study consist

PLWHA in the metropolis. However, a total of 60 will be drawn from members within

Sokoto North and South Local Government Areas. Random sampling method will be

employed in choosing the respondents. Where necessary questionnaire will be channeled

and administered through the Sokoto State Action Committee on AIDS (SOSACA).

3.4. Questionnaire Design and Administration

35
The questionnaire consists of questions including both closed and opened ended ones. It

is divided into two sections. Section (A) deals with the personal data of the respondents.

The variables captured in the section include issues to do with respondent’s sex, age,

marital status, educational level and occupation. Section (B) contains research data which

cover variables such as income required for the treatment of the disease; respondent’s

income level, savings and expenditure aspects, awareness and access to microfinance

institutions in the metropolis amongst others.

While, the questionnaire is to be administered through the help of two research assistants

who are adequately trained to assist the researcher. Where necessary, the questionnaire is

going to be translated into Hausa language so as to ease the response of illiterate

respondents.

3.5. Techniques of Data AnalysisDescriptive and inferential statistical techniques

will be used in analyzing the data when collected. The descriptive statistics to be used

include percentages and tables. Inferential statistics in the form of Analysis of Variance

(ANOVA) and multiple regression analysis will be employed. The latter technique is

expected to identify the relationship between the dependent and independent variables.

While the former aims at discussing the responsiveness of respondents to the HIV/AIDS

treatment when classified by different income levels.

3.6. Model Specification The data collected would be analyzed using multiple

regression model. Thus, an econometrics model will be used to analyze the data when

collected. The model proposed for this study is given below:

Y = a + b1x1 + b2x2 +………. Xn Where Y is the dependent variable that is, Management

of the HIV/AIDS infection.Therefore, X1 = Access to Micro credit (AM) and X2

36
= Income Status (YS) as independent variables. These variables will be tested on the

dependent variable.

Also, a = intercept of the model or management of HIV/AIDS that does not depend on

access to micro credit and b1 – b3 = parameters of the model while, Xn on the other hand is

the error term.

CHAPTER FOUR

Data Analysis and Presentation

4.1 Introduction

This chapter deals with presentation and interpretation of data collected during fieldwork.

The method used in data collection was earlier discussed in chapter three. A total of 60

questionnaires were administered within the metropolis which only 37 (61.6%)

questionnaires were returned. The result of the data obtained could not be in any way

meaningful without a full and complete analysis of the obtained information, hence the

following analysis were divided into two sections; the first section discusses the socio-

economic characteristics of the respondents, while section two discusses the research

data.

4.2 Socio-economic Characteristics of the Respondents

37
4.2.1. Sex of the Respondents

The females infected almost double the male counterparts by ratio of 57:43. In other

words, the female respondents are 57%, while males are 43%. By implication, the

females are more infected with HIV/AIDS by 14% more than the males. This results is

not new has the previous research on PLWHA in the metropolis (Abdulrahim, 2007)

testified to this result where the proportion is 22%.

4.2.2. Age Group of the Respondents.

The modal age group of both sexes is within 31-40 years followed by 21-30 years, 40.5%

and 32.4% respectively. The next most infected groups are those below 20 years and

those within 41-50 years with 13.5% each. The least group infected are 51-60 years and

those above 60 years (2.7%) each. The Fig. 4.1 shows the age group by sex distribution.

The modal age group amongst the male and female are both 31-40 years followed by 21-

30 years. In this context the modal and the preceding groups are the same with when both

sexes were considered.

38
Source: Author’s Fieldwork (January, 2008)

Fig. 4.1: Age Group of the Respondents by Sex

4.2.3. Religion Appellation of the Respondents

The entire respondents are either practicing Islamic religion or Christianity. Those mostly

responded practicing Islam (54%) and Christianity (46%). The high figure of Muslims

might not be unconnected to the fact that the 80% of the population size (sample frame)

of those people of Sokoto metropolis from which the samples were taken from are

predominantly Muslims.

4.2.4. Educational Attainment of the Respondents.

The distribution of the respondents is explicit in the Fig. 4.2 below. The holders of Senior

School Certificate are most affected (37.8%) followed by those who attained J.S.S level

of education (13.3%). The analysis of the pattern shows that those with first degree or its

equivalent and above are 11% while those with Quranic to OND/NCE are 89%. Further

examination reveals that within the latter group, those with the intermediate certificate

(OND/NCE) are less affected (16%) compared to those with School Certificate and

below (73%). Summarily, those with high level of education are less infected than those

with low level of education. On a general note, the lower the level of education the more

39
the carelessness and promiscuity of individuals which thus, led to been infected with

HIV/AIDS.

Fig. 4.2 Educational Attainment of the Respondents

Source: Authors Fieldwork (January, 2008)

40
4.2.5. Marital Status of the Respondents

Married respondents are the highest with 40.5% followed by those who are single 27%.

Those separated and divorces are 10.8% and 13.5% while the least infected are the

widows who are 8.1%. The possible reason why the married respondents are the highest

in number would not be unconnected to insincerity with their sex partners. On the part of

high number of single respondents infected, it could be attributed to idleness, and

promiscuous life they lived due to youthful exuberance. The low number of divorced,

separated and widows infected is appreciated as could be possibly influenced by their

fear of societal reactions to their behavior having married earlier but currently unmarried.

Source: Author Fieldwork (January, 2008)

Fig. 4.3: Marital Status of the

Respondents

2.2.6 Number of Children of the

Respondents

Twenty respondents respond to this question. Eleven (55%) out them have between one

and two children. Four (20%) have three children, three (15%) with four numbers and

two (10%) with five children. None claimed to have more than five children (table 4.1).

Table 4.1: Number of Children of the Respondents


Categories Frequency Percentages
41
2 11 55
3 04 20
4 03 15
5 02 10
More than 5 00 00
Total 20 100

Source: Author’s Fieldwork (January, 2008)

4.2.7. Employment Status of the Respondents


Source: Author’s Fieldwork (January, 2008)
From

Fig.

4.4

42
below, 35% of the respondents are unemployed, students (18.2%) while orphans and

others are 16.2% and 2.7% respectively. On a general note, 73% of the respondents are

not working thus; only 27% of the entire respondents are working. Those working are

distributed between self-employment (16%) and civil servant (11%). Those who are not

working have range of excuses from being stigmatized (33%), physically weak and

sacked with 21% each to those who claimed to be retired and the full house wife. The

number of those not working is quite a significant loss to the economy of the nation when

it comes to computing the National Income.

Fig. 4.4: Employment Status of the Respondents

4.3 Research Data Analysis

4.3.1 Monthly Expenditure of the Respondents on Medication and other Purpose

Investigation about the amount the respondents spend on medication on monthly basis

revealed that almost all twenty eight respondents who respond to the question couldn’t

avoid buying their drug requirement in months. They however, in cure high expenses out

of their income, especially on opportunistic infections (Table 4.2).

Table 4.2: Monthly Expenditure of the Respondents on Medication and other


Purpose
Classification Income on Medication Income on other Purpose
Frequency Percentages Frequency Percentages
< #5000 08 28.6 05 17.9
#5000-#15000 12 42.9 09 32.1
#15000-#25000 03 10.7 08 28.6
#25000-#35000 05 17.9 06 21.4
#35000-#45000 00 00 00 00
Total 28 100 28 100

Source: Author’s Fieldwork, January 2008

Thus, 42.9% of them (28 respondents) expend between #5000 and #15, 000 per month,

28.6% spend less than #5000, 17.9% spend between #25000 and #35000 while the rest

43
10.7% claimed to spend between #15000 and #25000 on purchase of drugs. These in

compared to 32.1% (#5000-#15000), 28.6% (#15000-#25000), 21.4% (#25,000-#35,000)

and 18% (less than #5000) spend by the respondents on other purposes. Meanwhile, none

of them claimed to be spending between #35,000 and #45,000 on either medications or

for other purpose (Fig. 4.5).

Legend

Monthly Expenditure on Medication

Monthly Expenditure on other Purposes

Source: Author’s Fieldwork, January 2008

Fig. 4.5: Monthly Expenditure of the Respondents on Medication and other

Purposes

4.3.2 Financial Need’s Responsibility of the Respondents

44
From the table below (Table 4.3), the responsibilities of the respondent were mostly

carried out by family and relative (27%) followed by those who relied on Husband/wife

and NGOs (18.9%) each while others is 21.6% (Fig. 4.6) with 5.4% out of it are parent,

13.5% are taking their responsibilities themselves and only 2.7% out of these confirm

that the children were in charge.

Table 4.3: The Financial Need’s Responsibility of the Respondents


Classification Frequency Percentages
Family and Friends 10 27
Husband/Wife 07 18.9
MFIs 00 00
NGOs 07 18.9
Government 05 13.5
Others 08 21.6
Total 37 100

Source: Authors fieldwork (January, 2008)

On general note, the financial responsibilities of PLWHA were solely on family and

relative (54.4%) when combined with those who choose parent, husband/wife and

children. It is very unfortunate that none of the respondent’s financial need is taken by

MFIs.

45
NGOs
Husband/
Others
Wife
Fig.

4.6:

Financial Need’s Responsibility of the Respondents

Source: Author’s Fieldwork, January 2008.

4.3.3. Monthly Savings of the Respondents.

43% of the twenty eight respondents who respond to this question does not have saving at

all while 32% spend in advance. 25% of the respondent has average of #2500 savings per

month. This might as a result of their level of spending on medications and other

purposes as it has been established that none of them (respondents) can do without

buying drugs along with other needs. A further examination also revealed that it is those

who earned higher income per month as a result of their level of education were able to
46
save. On general note, the propensity to save is very low because of the generally low

income. To be able to save is to break the vicious circle of poverty. However, where 75%

of the respondents could not save requires attention by the government in view of the

need for economic development.

4.3.4. Awareness of Micro Credit Institutions in the Metropolis by the Respondents

The awareness of micro credit institutions in the metropolis were presented in a doughnut

graphic representation below (Fig. 4.7). 89% of the respondent recognizes NARCDB as

micro credit institutions in the metropolis; this might not be unconnected with the

activities of the bank in given small loan to small farmers and as we have noted earlier,

farming is the major activity of the people of Sokoto. Nagarta Microfinance Bank which

is community bank came second highest (70.3%) while the least is Federal Mortgage

47
Bank (51.4%), this might be as a result of the low performance of the bank which is

mainly given housing loan to people.

Fig. 4.7: Awareness of Micro Credit Institutions in the Metropolis by Respondents

4.3.5. Application and Purpose of Loan by the Respondents

43.2% of the respondents have applied for the loan while 56.8% respondents have not

applied in any micro finance institution in the metropolis. The result further revealed that

37.5% out of those who apply for the loan are for business purpose followed by those for

consumption and buying drugs (25%) each and lastly, 2.5% of the respondent apply for

the loan for building a house. This result shows that majority of the respondent want the

loan for business (Fig. 4.8).


Source: Author’s fieldwork (January, 2008)

S
our
ce:

Author’s fieldwork, January 2008

Fig. 4.8: Purpose of Loan by the Respondents


48
4.3.5. Access and Grant of Loan to the Respondents

Despite the little amount of the respondent (16 out of 37 respondents) that applies for the

loan, only seven (43.8%) were given while nine (56.2%) were denied the loan. The

reasons for the denial were ranging from lack of requirement (50%), stigmatization

(28%) while illness ground and others are 11% each (Fig. 4.9).

Sources: Author’s

Fieldwork, January 2008

Fig. 4.9: Reasons for

not given Loan by

MFIs

4.3.6. Effective Usage of the Loan Grant to the Respondents

Out of seven respondents who were given the loan, five (71.4%) respondent used the loan

for the purpose it were given, only two (28.6%) did not used the loan. The reason given is

that, the loan was used for other purpose not mention by them. When ask to grade the
49
amount given by MFIs, five (71.4%) out of seven respondents confirm that the loan is

grossly inadequate while two (28.6%) said the loan is inadequate.

4.3.7 Impact of Loan on the Respondents.

Five (71.4%) respondents out of seven agree that the loan has eased their difficulties

while the remaining two (28.6%) disagree that the loan has not have any impact on their

life. This might not be unconnected with the previous result (4.3.6) where the same ratio

(71.4:28.6) used the loan for the purpose that was given and those that did not use it for

the purpose it were given respectively.

When further ask to explain in what ways; all the respondents who collected the loan

agreed that they have access to drugs after collecting the loan, while 86% of them also

have access to self employ and overcome poverty respectively, those who choose

overcome stigma are 57% (Fig. 4.10), this shows that despite their empowerment

economically people are still stigmatize them.

50
Source: Author’s Fieldwork (January, 2008)

Fig. 4.10: Impact of Loan on the Respondents

4.3.8 Health and Physical Condition of the Respondents after Receiving Loan

Seven respondents who collected the loan were interview with respect to their health

condition after collecting loan from MFIs. The result is that 63% of them disclosed to

now have healthy condition and 37% very strong and healthy. None of them is however,

said to be either weak or very weak (Fig. 4.11). This is evidence that the empowering

economically have positive impact on the respondent.

Others
0

Very Strong & Healthy


37
Physical Condition

Healthy
63

Very Weak
0

Weak
0

0 10 20 30 40 50 60 70
Percentages

51
Source: Author’s Fieldwork (January 2008)

Fig. 4.11: Health and Physical Condition of the Respondents after Receiving Loan

4.3.9 Attitudes towards Respondents after Collecting Loan.

The ranges of attitudes towards the respondents by the society, especially their immediate

families after collecting loan from MFIs are hereby presented on five-point likert scale

with the frequency distribution of the respondents (Table 4.4).

Table 4.4: Attitudes towards Respondents after Collecting Loan.


Societal Assessment Frequency %
Rejected 01 14.3
Fairly Rejected 01 14.3
Undecided 02 28.6
Fairly accepted 03 42.8
Highly Accepted 00 0
Total 07 100

Sources: Authors Fieldwork, January 2008

From the above table (Table 4.4) out of seven respondents that respond to this question.

42.8% virtually concluded that they are fairly accepted by the society. Amongst the

people, 28.6% claimed to be undecided and 14.3% said they are fairly rejected and

rejected respectively. The area of interest is the level of acceptability that is recognizes to

have been established by 42.8% of the respondents. This information gets to prove that

the society is becoming compliant with the campaign on HIV/AIDS as regards the need

to show them care and love.

4.3.10 Ways to Manage the Disease

52
From Fig. 4.12 below, 92% of the respondents choose free treatment as way of managing

the disease, this followed by access to micro credit (83.8%) faithfulness (73%), sex

education (67.6%) and the least is the use of condom (48.7%). The reasons for these

might be not unconnected with religion belief of the respondent who sees condom as a

way of promoting promiscuity in the society. Also, this report revealed that there is the

need for the government at all level to assist PLWHA in given them free treatment and as

well as provision of micro credit for them by formal MFIs to ease their difficulties.

Source: Author’s Fieldwork (January, 2008)


Categories

Fig. 4.12:

Ways to

Manage the

Percentages Disease

CHAPTER FIVE

Summary, Recommendation and Conclusion

5.1 Summary

• Females are more infected than male by margin of 14%

• The member of age group of both sexes most infected is 31-40 years followed by

21-30 years.

53
• The lower the level of educational attainment the higher the level of carelessness,

promiscuity and thus susceptibility to infection.

• Married respondents are more infected, followed by single and least are the

widow.

• Average monthly income of the respondent is #2500 which is grossly inadequate

and below National minimum wages and even International Poverty Line.

• All the respondents are using substantial part of their income on drugs and other

purpose.

• 62.5% claimed to be physically strong and healthy after receiving loan serve as

evidence that the empowerment provides by MFIs have impact on their lives.

• About 54% of their monthly financial burden (drugs + food + finance) is bored by

relatives. However, governments have least support of 13.5% to the PLWHA in

the area of finance and materials. While, none claimed to be sponsored by MFIs.

Hence, there is the need to enlarge the scope of their (government and MFIs)

support.

• Most of the respondents loose their jobs due to stigma which in return contribute

to the reduction in family income. Hence, poverty sets into the families.

• The respondent also often advice that married couples are to be faithful to each

other, the unmarried should abstain from pre-marital sex and where unable to be

self-restraint they should use condom.

• The respondents seek the need for the governments and researchers to find the

cure for HIV/AIDS.

54
• They also suggested that society should be well informed that the disease (HIV) is

real.

• The respondents demanded for micro credit scheme in order to get them

economically empowered.

• The respondents expressed the need to sustain the supply of free test and drugs.

• Government to encourage more NGOS to assist the PLWHA.

• Employers always sacked the people infected with HIV/AIDS. The consequence

of this action by employers of labor always exacerbate high rate of poverty in the

society. Therefore, the employers need be enlightened not to throw them out of

job once they are not too weak to work.

5.2 Recommendations

Remedy I – Role of MFIs

• The MFIs should include an explicit HIV/AIDS commitment in its mission

statement and bi-laws.

• The MFI should identify itself clearly on its publications and literature as ‘an

HIV-sensitive.

• The MFIs should have a non-discriminatory policy for board and staff

recruitment. This will include a guarantee of confidentiality and privacy.

• The MFIs should highlight products and services that are likely to be of

particular relevance to AIDS impacted households and will actively market

these package

Remedy II – Control of the Disease

About control, the respondents suggested various ways. They range from proper access to

micro credit, use of condoms, being faithful to one’s sexual partners, youths to listen and
55
act on HIV and AIDS campaign and to further have moral restraints, religious bodies to

intensify preaches, health education to the society and free medical treatments. The

highest number of the respondents 92% and 84% believed that free treatment and proper

access to micro credit is the best way to manage the disease efficiently and effectively.

5.3 Conclusion

HIV and AIDS is indeed a problem issue, therefore, the society should be free to talk

about it collectively in their houses, neighborhoods, religious places, at party and so on

like other disease. This will significantly eliminate the social stigma. Consequently, MFIs

should include a risk management perspective to their mission and goals, to complement

the micro enterprises development perspective. They should present a public image as an

AIDS-sensitive institution and they should reinforce this image with non-discriminatory

policies with respect to board and staff recruitment and client selection, through the

promotion of public HIV/AIDS awareness, and through offering products and services in

support AIDS-impacted clients and their households.

BIBLIOGRAPHY

Abdulrahim, M. A. (August, 2007), A Survey on Socio-Economic Status of People


Living with HIV and AIDS (PLWHA) in Sokoto State. Unpublished
Research Report, UNDP-Sokoto.

Adelaja, M. A. (2005), “Understanding the Peculiar Characteristics of Microfinance


Clients in Nigeria”. In: Enhancing the Microfinance Sector for Sustainable
Development in Nigeria: The Policy, Stakeholders’ Roles and
Responsibilities. CBN Seminar to Mark the International Year of Micro
credit in Nigeria.

56
Ainsworth, M and Dayton, J. (2001), The Impact of the AIDS Epidemic on the Health
of the Elderly in Tanzania, Draft Report, World Bank Development
Research Group, Washington DC

Akanji, O. O. (2001), “Micro-Finance as a strategy for Poverty Reduction”. CBN


Economic and Financial Review. Vol. 39 No. 4

Akinkugbe, O. O and Falase, A. O. (2000), A Compendium of Clinical Medicine,Ibadan:


Spectrum Books.

Akintunde, S. F. (2004), Status of People Living with HIV/AIDS in Sokoto Metropolis,


an Unpublished Undergraduate Research Project Submitted to the
Department of Geography, Usmanu Danfodiyo University, Sokoto.

Alban, A. (1999), AIDS and Development Socio-Economic Perspectives,Speech


Presented at Seminar on HIV and Development. Copen Hagen Damida.
Accessed at www.google.com

Ali-Dinar, A. B. (2007), Reducing Stigma and Discrimination Related to HIV and AIDS:
Training for Health Care Workers.
http://www.engenderhealth.org/res/offc/hiv/stigma/index.html

Appropriate Health Resources and Technology Action Group (AHRTAG, 1997), Caring
With Confidence. Practical Information for Health Workers who Prevent
and Treat AIDS Infection in Children. London Russia press

Atta, I., Owusu, K and Zeitz, P. (October, 2002), Filling the Funding Gap: A Proposal to
Convert Debt Payments to Combat HIV/AIDS in Nigeria. Southern Links.
Assessed at www.Southernlinks.org on 11th of Sept., 2007.

Avert.com (2007), HIV-AIDS in Nigeria http//www.avert.org/aidsNigeria.httm

Barnett, T (1997), Agricultural Change under Structural Adjustment and other Shocks in
Zambia. University of Bath Centre for Development Studies, Bath, UK.
Assess to www.google.com on 13th of Sept., 2007.

Barnett, T and Whiteside, A. (1992), the Jaipur Paradigm, HIV/AIDS Society and
Economy: Case Studies and a Conceptual Framework. Assessed at
www.google.com on 13th of Sept., 2007.

Baylies, C and Bujra, J. (2000), AIDS, Sexuality and Gender in Africa: Collective
Strategies and Struggles in Tanzania and Zambia. Routledge, New York. NY
10016

Bechu, N. (1998), “The Impact of Aids on the Economy of Families in Cote d’Ivoire”.
In:Change Consumption among AIDS Affected Household.Answorth M,
Fransen I and Over M (Eds). Accessed at www google.com Aug 20, 2007

57
Bennet, O. (1990), Triple Jeopardy: Women and AIDS. London, Panos Institute.
Accessed at www.google.com Aug 20, 2007).

Bollinger, L., Stover, J and Nwaorgu, O. (September, 1999), the Economic Impact of
AIDS “Washington D.C. The Future Group International in
Collaboration with Research Triangle Institutes (RTI) and the Center for
Development and Population Activities (CEDPA). Accessed at
www.ask.com

Booysen, F., Van-Rensbury, D., Bachman, M., Engelbrecht, M. and Stey, F. (March,
2002), the Socio-Economics Impact of HIV-AIDS on Household in South
African. Accessed at www.mrc.ac.za/aids/march2002/economic.htm. On Aug
20, 2007

Broombery, J., Stemberg, M., Behr, G. and Masobe, P. (1997), The Impact of the AIDS
Epidemic in South African. Accessed of www.ask.com on Sept., 3rd
2007.

Carolyn, B. (2003), Microfinance and Households Coping with HIV/AIDS in Zimbabwe:


An Exploratory Study. Accessed at www.google.com

Casale, M and Whiteside, A. (March, 2006), “The Impact of HIV/AIDS on Poverty,


Inequality and Economic Growth”. Health Economics and HIV/AIDS.IDRC
Working Papers 3. Globalization, Growth and Poverty Working Papers
Series. Ottawa, Canada. www.idrc.ca

Cohen, D. (1998), “Poverty and HIV/AIDS in Sub-Saharan Africa”. HIV and


Development Programme. Issue Paper No. 27. Assessed at www.google.com on
13th of Sept., 2007.
Cornford, R. (2000), “Micro credit, Microfinance or Access to Financial Services. What
do Pacific People Need?” The Foundation for Development
Cooperation.Brisbane QLD 4000. Australia. www.fdc.au

Craddock, S. (2004), “Beyond Epidemiology: Locating AIDS in Africa”. In: HIV and
AIDS in Africa. Kalipeni, E. et. al (ed) Blackwell Publishing Ltd.

Crowe, D. (February, 2003), HIV/AIDS: Science or Religion. Accessed at


http://aliveandwell.org on 13thof Sept, 2007.

David, C., Ajayi, M., Olakunle, O. and Prosper, O. (2005), “The Impact of HIV-AIDS on
Nigeria Household”. In: AIDS in Nigeria. Accessed at
www.google.com on Aug 20, 2007.

Ehigiamusoe, G. (2005), “Tested Institutional Practices for Efficient Microfinance


Services Delivery”. In: Enhancing the Microfinance Sector for Sustainable
Development in Nigeria: The Policy, Stakeholders’ Roles and
Responsibilities. CBN Seminar to Mark the International Year of Micro
credit in Nigeria.
58
Enechuku, C. I (2005) “Role of Community Bank in Micro Finance Intermediation”. In:
Enhancing the Microfinance Sector for Sustainable Development in Nigeria:
The Policy, Stakeholders’ Roles and Responsibilities. CBN Seminar to Mark
the International Year of Micro credit in Nigeria.

Ezeanwu, A. C. (August, 2004), Community Participation in War Against HIV –AIDS.


African Heritage Foundation for Human Development, Lagos, Nigeria.
Accessed at www.ask.com on Aug 20, 2007

Federal Ministry of Health and NACA (December, 2002), HIV-AIDS; What It Means Of
Nigeria. Accessed on www.goggle.com on Aug 20, 2007

Frances, F., Colleen, G and Marry, M. (2004), Microfinance and HIV/AIDS. Accessed at
www.goggle.com on Aug 20, 2007

Ganyaza-Twalo, T and Seager, J. (2005), Literature Review on Poverty and HIV/AIDS:


Measuring the Social and Economic Impacts on Households.HSRC.
http://www.dochas.ie/documents/MicroFinance_literature_review.pdf.
on 11th of Sept., 2007.

Germann, S. (June, 2004), “Psychology Impact of HIV/AIDS on Children”. AIDS


Bulletin. 2004. www.mrc.ac.za/aids/june2004/impact.htm

Gilks, C. F. (1998), Sexual Health and Health Care: Care and Support for People with
HIV/AIDS in Resource –Poor Setting. London Department for International
Development (www ask com on 20th of Aug., 2007)
Haruna, G. (August, 2007), “Nigeria: Vulnerable Women as Face of HIV/AIDS”. This
Day Newspaper. August 16, 2007. Accessed on www.goggle.com on Aug 20,
2007

Hunter, S. S. (2003), Black Death: AIDS in Africa. Palgrave Macmillan, New York. N.I
10010

Ibrahim, M.T. (1999),”Socio-Economics Consequence of HIV-AIDS Basic for Urgent


Action to Stem the Scavenge in Nigeria”. Sahel Medical Journal Vol 2. no1

Ijaiya, A. T. (1997), Social Science Research Reporting: A Manual for Beginners.


Paragon Books Ltd. Ilorin. Kwara State

Interagency Collation on AIDS and Development (ICAD, 2001), HIV- AIDS and Micro
Finance accessed at www.icad.cisd.com on 20th of Aug., 2007

Irefin, D and Afolagbade, B. (2006), “The Socio-Economic Implications of HIV/AIDS on


Poor Families: Empirical Evidence from Brono, Nigeria”. In: Maiduguri
Journal of Arts and Social Sciences. Vol. 4, No. 1. ISBN: 0189-9716.

59
Jill, D., Kaman, K and Sylvan, O. (2001), HIV-AIDS –Responding to a Silent Economic
Crisis among Microfinance Clients in Kenya and Uganda. Microware-
African. Accessed at www Google com

Jiya, N. M. (2003), “HIV/AIDS Pandemic in Nigeria: The Role of the Youths in its
Prevention”. The Harmony Magazine. First Edition. Vol. 1. no.1

Kaiser, J. H. (May, 2007), “Daily HIV/AIDS Report”. Henry J. Kaiser Family


Foundation. Kaisernetwork.org. Wednesday, 16

Karlan, D and Zinman, J. (2006), Expanding Credit Access: Using Randomized Supply
Decisions to Estimate the Impacts. Assessed at www.google.com/search on 24th
Sept., 2007.

Kimotha, M. (2005), “National Microfinance Policy Framework and its Expected Impact
on the Microfinance Market in Nigeria”. In: Enhancing the Microfinance
Sector for Sustainable Development in Nigeria: The Policy, Stakeholders’
Roles and Responsibilities. CBN Seminar to Mark the International Year of
Micro credit in Nigeria.

Kpakol, L. M. (2005), “The Role of Micro Finance in Poverty Eradication”. In:


Enhancing the Microfinance Sector for Sustainable Development in Nigeria:
The Policy, Stakeholders’ Roles and Responsibilities. CBN Seminar to Mark
the International Year of Micro credit in Nigeria.

Lather, P and Smithies, K. (1997), Troubling the Angels: Women Living with HIV/AIDS.
Westviews Press, USA

Latifee, H. I. (June, 2003), Micro-Credit and Poverty Reduction. a Paper Presented at the
International Conference on Poverty Reduction through Micro-Credit Held
at Ceylan Inter-Continental Hotel, Taksim-Istanbul, Turkey. June 09-10.

Liew, J. (1997), Observations on Micro credit Scheme in the Pacific: Making Micro
credit more People-Centered. ESHDP Working Paper. Suva: UNDP.
Assessed at www.undp.org on 24th of Sept., 2007.

Loewenson, R and Chikumbirike, T. (2005), Community Based Monitoring and Research


on Food Security and Social Welfare. Paper for the SARPN meting, South
Africa. Assessed at www.google.com on 11th of Sept., 2007.

Long, L. D and Ankrah, E. M. (1996), Women’s Experiences with HIV/AIDS: an


International Perspective. Columbia University Press.

Lugalla, J. P., Emmelin, M. A., Mutembei, A. K., Comoro, C. J., Killewo, J. Z.,
Kwesigabo, G., Sandstorm, A. I and Dahlgren, L. G. (1999), The Social and
Cultural Contexts of HIV/AIDS Transmission in the Kagera Region,
Tanzania. Koninklijke Brill NV, Leiden. Assessed at www.google.ca on 10th
of Sept., 2007.
60
Mafeni, J. O and Fajemisin, O. A. (October, 2003), HIV/AIDS in Nigeria; Situation,
Response and Prospects. accessed at www google.com on 28th of Aug.,
2007.

Magill J .H. (2002), HIV/AIDS and Rural Microfinance- A Matter of Survival. Rural
Finance in the Age of HIV/AIDS. Research Report USAID. Accessed at
www ask com on 14th of Sept., 2007

Marlink, R. G and Kotin, A. G. (2004), Global AIDS Crisis: A Reference Handbook.


www.abc-clio.com

Mathins, S. (2003), “Economy and Epidemic; Micro Finance and HIV/AIDS in Asia”.
The Foundation for Development Operation British and Australia.
Accessed at www.google.com on 13th of Sept., 2007

Mujinya, P and Over, M. (June, 1993), The Impact of AIDS on Health Care Utilization
and Expenditure by the Fatally in North West Tanzania. IX International
Conference on AIDS. Berlin-Germany. June 6-11 (abstract w s –d 123 -1).
Accessed at www.google.com on 13th of Sept., 2007.

Mutangandura, G. (2000), Household Welfare Impacts of Mortality of Adult Females in


Zimbabwe: HIV/AIDS and Weakness in the Extended Family System. Draft
Report. Imperial College, Faculty of Medicine. London, UK.

Nampanya, S. N. (July, 2005), Social and Economics Risk Factor for HIV –AIDS
Affected Families in Zambia. Paper Presented at the International AIDS
Economics Networks of AIDS Symposium. Durdan, South African. July
7-8 accessed at www.ken.org /conferences/durpapers.htt. Mon July 20-
2007

National Intelligence Council (2002), The Next Move of HIV/AIDS: Nigeria, Ethiopia,
Russia, India, and China. accessed at www Google com on 13th of Sept.,
2007

Nigerian Center for Gender Health and Human Rights (December, 2002), “AIDS in
Nigeria: A Mid-Term Report”. NCGHHR Newsletter. Vol. iv. No. 2.
http://ncghhr.tripod.com/humanreghts

Nnaka, C. V. (2004), “The HIV/AIDS Virus: A Continues Challenge to Women in


Developing Countries”. In: International Journal of Gender and Health
Studies. Vol 2, No 1 and 2. ISSN: 1597-0191. Pg 165-171.

Nwabueze, C. (June, 2007), “Impact of HIV/AIDS Information Campaign on Sexual


Relationship among Tertiary Institution Students in Nigeria”. In: Maiduguri
Journal of Arts and Social Sciences. Vol. 5, No. 1. ISBN: 0189-9716.

61
Okonjo-Iweala, N. (2005), “The Role of Government in Micro Finance Development in
Nigeria”. In: Enhancing the Microfinance Sector for Sustainable
Development in Nigeria: The Policy, Stakeholders’ Roles and
Responsibilities. CBN Seminar to Mark the International Year of Micro
credit in Nigeria.

Okunna, C. S and Dunu, V. I. (December, 2006), Religious Constraint on Reporting HIV-


AIDS in Nigeria. A Presentation given at the Conference on Religion,
Media and Health in West African with Focus HIV-AIDS. Gimpa,
Accra- Ghana December, 13-15.

Olufemi, M.O. (July, 2004), The Dreaded Virus: HIV and AIDS. International Nigeria
Conference on AIDS. July 11-16. Pathfinder International Nigeria. Lagos,
Nigeria

Otim, M. (August, 2006), Micro-Finance for PWHIV in Settings of Extreme Poverty,


Finance and Administration, Kampala, Uganda. XVI International AIDS
Conference, Toronto, Canada. 13-18. Assessed at www.google.com on 11th of
Sept., 2007.

Parker, J. (May, 2002), Microfinance and HIV/AIDS: A Discussion Paper Written for
Micro Finance Practitioner Worldwide. International Global Micro
Enterprise Development. Accessed at www Google com

Richard, P and Leonon, M. (1986), Target Setting for Basic Need. Geneva International
Labour Office (accessed at www.google.com)

Romanns, D. D. (2006), “State Sponsored Rural Microfinance Programmes in Ghana: A


Performance Review”. In: International Journal of Economics and
Development. Issues Vol. 6, No. 1. Pg 12-28

Schoeberlein, D. R. (2001), Everybody: Preventing HIV and other Sexually Transmitted


Diseases among Young Teens 2nd Edition. RAD Educational Programs, U. S.
A

Shisana, O and Simbayi, L. (2002), South African National HIV Prevalence, Behavioral
Risks and Mass Media Household Survey. HSRC, Cape Town. Assessed at
www.google.com on 10th of Sept., 2007.

Singhal, A and Rogers, E. M. (2003), Combating AIDS: Communication Strategies in


Action. Sage Publication, India Printing Ltd, New Delhi 110048

UNAIDS (2007), National HIV-Syphilis Sero-Prevalence Sentinel Survey in Nigeria.


Assessed at http://data.unaids.org/Publications on 10th of Sept., 2007.

UNAIDS/WHO (2006), Epidemiological Fact Sheet Nigeria up date. Assessed


http://data.unaids.org/Publications/Fact-Sheets01/Nigeria_EN.pdf. on 10th of Sept., 2007.

62
UNFPA (November, 2007), Communication for Development Round Table Report
Managua, November 26-28. ftp://ftp.fao.org/sd/SDW/SDWW/IP-brief-final.pdf.

White, J and Robinson, E. (2000), HIV/AIDS and Rural Livelihoods in Sub Sahara
Africa. Natural Resources Institutes. Policy Series 6. Chatham, UK.

Whiteside, A. (1994), “AIDS and its Impact on the Economic, Social and Political
Environment”. In: Prospects for Progress: Critical Choices for Southern
Africa. M. Venter (ed), Cape Town: Maskew Miller, Longman. Assessed at
www.google.com on 11th of Sept., 2007.

Whiteside, A. and Barnett, T. (2003),”AIDS in the 21st Century” Disease and


Globalization. Macmillan. Palgrave.

Whiteside, A and Wood, G. (1995), “Socio-Economic Impact of HIV/AIDS in


Swaziland”. Ministry of Economic Planning and Development, Mbabane.
Assessed at www.google.com on 11th of Sept., 2007.

WHO (2004), Assessment of the Epidemiological Situation accessed at www ask com

Wilson, E. (2001), “AIDS Mushrooms into a Development Crisis”. In: The Unfinished
Agenda: Perspective for Overcoming Hunger, Poverty and Environmental
Degradation. Perr Pinstrup-Andersen and Rajul P. (eds) International Rood
Policy Research Institute (IFPRI). Washington DC. Assessed at
www.google.com on 13th of Sept., 2007.

Wyse, M. (August, 2007), “Older Cambodians ‘Know Less about AIDS”. In: Ageing and
Development. Issue 22, 2007. www.helpage.org

Wyss, K., Hutton, G and N’Diekhor, Y. (2004), Costs Attribute to AIDS at House hold
Level in Chad. AIDS Care. Assessed at www.ask.com on 13thof Sept., 2007.

Yamanchi, F. (March, 2007), Marriage, Schooling and Excess Mortality in Prime Age
Adult: Evidence from South Africa. International Food Policy Research
Institute (IFPRI) Discussion Paper 00691. Assess at www.ifpri.org on 18th of
Sept., 2007.

Yamano, T. and Jayne, T. S. (2002), Measuring the Impactsof Prime –Age Adult Death on
Rural Households in Kenya. Department of Agricultural Economics Staff
Paper, Michigan State University. Accessed at www Google.com on 13th of
Sept, 2007.

Yaqub, N. O and Yandaki, A. I. (2000), “Sokoto in the Scheme of Nigeria’s Socio-


Cultural, Economic and Political Development”. In: Usmanu Danfodiyo
University Sokoto at 25: Progress, Problems and Prospects. Illiya, M. A.,
Salawu, A. A., Jumare, I. M. and Akin-Hassan, W (ed). The University Press
Ltd and Master Prints, Kaduna

63
APPENDIX I

DEPARTMENT OF ECONOMICS
FACULTY OF SOCIAL SCIENCESUSMANU DANFODIYO UNIVERSITY, SOKOTO
(POST GRADUATE SCHOOL)
Questionnaire for People Living with HIV/AIDS in Sokoto Metropolis

Dear Respondents,I am a Postgraduate Student of the above mentioned institution and


currently undertaking an MBF dissertation titled ‘Access to Micro Credit and HIV/AIDS
Management in Nigeria: An Empirical Study of People Living with HIV/AIDS in Sokoto
Metropolis’. The research work is for academic purpose only. Thus, all information given
would be treated confidentially. Now kindly answer the following questions by either
ticking [√] or filling the space provided appropriately and honesty. Thanks for your
anticipated cooperation.SECTION A: PERSONAL DATA1. Sex a) Male [ ]
b) Female [ ]
2. Age a) Below 20 [ ] b) 21- 30 [ ] c) 31- 40 [ ] d) 41- 50 [ ] e) 51-60 [ ] f) above
60 [ ]
3. Religion a) Islam [ ] b) Christianity [ ] c) Traditional [ ] d) Others (Specify)…………
……….
4. Highest Educational Level Attained a) Quranic [ ] b Adult Educ [ ] c) Primary Sch.
[ ]d) Junior Sec. Sch. [ ] e) Senior Sec. / Vocational / Technical Sch. [ ] f) OND [ ] g)
NCE [ ]h ) HND/ BSc [ ] i) Others [specify ]……………………………………… …
……….
5. Marital status: a) Single [ ] b) Married [ ] c) Separated [ ]
d) Divorce [ ] e) Widow [ ] f) Others (specify)………………..
64
6. How many children do you have?
a) 2 [ ] b) 3 [ ] c) 4 [ ]
d) 5 [ ] e) more than 5 [ ]

7 Which among these categories do you belong? a) Student [ ]


b) Orphan [ ]
c) Self-Employed [ ] d) Unemployed [ ]
e) Civil Servant (Specify)……………………………………….
d) Others (Specify)………………………………………………8 If the answer to
Question 7 is ‘Unemployed’, why? a) Stigmatized [ ] b) Sacked
[ ] c) Physically weak [ ] d) others [specify]……………………
………… SECTION B: RESEARCH DATA1 How much money do you need for
HIV/AIDS treatment monthly ? #........................

2 Who is responsible for your financial need? a) family/relatives/friends [ ]


b) Husband [ ] / wife [ ] c) Microfinance institutions [ ] d) NGOs
[ ]
e) Government [ ] f) Others (specify)……………………………………
3 How much of your monthly income (earned) is used for HIV/AIDS medication? a)
Less than N5,000.00 [ ]
b) Between N5,000.00 to N15,000.00 [ ] c) Between N16,000.00 to
N25,000.00 [ ] d) Between N26,000.00 to N35,000.00 [ ] e)
Between N36,000.00 to N45,000.00 [ ]
4 How much of your monthly income (earned) is used for other purposes? a) Less
than N5, 000.00 [ ]
b) Between N5, 000.00 to N15, 000.00 [ ] c) Between N16, 000.00 to
N25, 000.00 [ ] d) Between N26, 000.00 to N35, 000.00 [ ] e)
Between N36, 000.00 to N45, 000.00 [ ]5 How much of this monthly earned
income is saved monthly? a) Nothing is saved [ ] b) Spending
income in advance [ ] c) Saving very little (specify)……………………..
d) Others (specify)…………………………………………..6 Are you aware of any

65
of the following microfinance institutions in the metropolis? a) Nigerian
Agricultural Rural and Community Development Bank [ ] b) Federal
Mortgage Bank [ ] c) Nagarta
Community Bank [ ]
d) Others (specify)………………………………………………….
7 If yes, have you ever applied for their credit facilities? a) Yes [ ]
b) No [ ]8 If Yes, for what purpose? a) Business
[ ] b) Building House [ ] c) Consumption purpose [ ]
d) Buying of Drugs [ ]
e) Others (specify) [ ]9 Have you given the loan applied for? a)
Yes [ ] b) No [ ]
10 If the answer to the question above is No, state why? a) I have been
Stigmatized [ ] b) Illness Ground [ ] c) I could not meet their
requirement [ ] d) Other [specify]…………………………………………………
11 If the answer to question 9 is yes, has the loan secured used for the purpose
given? a) Yes [ ] b) No [ ]12 If b above, explain why? …
……………………………………………………… ……………………………
………………………………………………………………
13 Grade the amount of credit secured from MFIs a) Grossly inadequate [ ]
b) Inadequate [] c) Adequate []
14 Has credit from MFIs eased your HIV/AIDS difficulties? a) Yes [ ]
b) No [ ]15 If yes, how? a) Access to self employment
[ ] b) Access to drugs [ ] c) Overcome the
stigma [ ] d) Overcome the poverty problem [ ] e) Others
(specify)…………………………………………………………16 How do you feel
physically after securing credit from MFIs? a) Very weak [ ] b) Weak
[ ] c) Healthy [ ] d) Very strong and healthy [ ] e)
Others (specify)…………………………………………………..
17 What has been the society’s attitude towards you after getting the credit from
MFIs?a) Rejected [ ] b) Fairly rejected [ ]c) Undecided [ ]
d) fairly accepted [ ] e) highly accepted [ ]

66
18 In what ways do you think this disease can be managed ?a) Access to
micro credit facilities Yes [ ] No [ ]b) Use of condom
Yes [ ] No [ ] c) Being faithful to one’s
sexual partner Yes [ ] No [ ]d) Sex education to school children
Yes [ ] No [ ]e) Free treatment to those infected
Yes [ ] No [ ]f) Others (specify)…………………………………………
……………

Appendix II

APPENDIX I: SPSS OUTPUT


Chi-Square Test
Frequencies
VAR0001
Observed N Expected N Residual
.00 1 1.3 -.3
4.00 1 1.3 -.3
6.00 2 1.3 .8
7.00 1 1.3 -.3
Total 5
Test Statistics
VAR0001
Chi-Squarea .600
df 3
Asymp. Sig. .896
a. 4 cells (100.0%) have expected frequencies less than 5. The minimum expected
cell frequency is 1.3.
NPAR TEST
/CHISQUARE=VAR00001
/EXPECED=EQUAL
/STATISTICS DESCRIPTIVES QUARTILES
67
/MISSING ANALYSIS

Correlations
[Data Set 0]
Correlations
VAR00001 VAR00002
VAR00001 Pearson Correlation 1 .970**
Sig. (1-tailed) .000
Sum of Squares and Cross-products 1.01E+009 898104286
Covariance 37257672 33263122
N 28 28
VAR00002 Pearson Correlation .970* 1
Sig. (1-tailed) *
Sum of Squares and Cross-products .000 852598571
Covariance 898104286 31577725
N 33263122 28
28
**.Correlation is significant at the 0.01 level (1-tailed).
DATASET ACTIVATE Data Set 0.
CORRELATIONS
/VARIABLES=VAR00001 VAR00002
/PRINT=ONETAIL NOSIG
/STATISTICS DESCRIPTIVES XPROD
/MISSING=PAIRWISE.

68