Care Plan as an Effective Service Tool to Improving Well-being of Vulnerable Households: A Case Study of Lagos and Calabar, Nigeria

Abstract

Background and Objective: Over the years, efforts have been made through public health interventions and policy design to implement programs aimed at addressing economic, structural, and human factors contributing to household vulnerability across developing countries. Care plan development is the process of identifying specific goals and interventions required to improve the well-being of vulnerable individuals and families, with discrete actions needed to achieve such goals. The objective of this study is to evaluate the effectiveness of the care plan in enhancing the well-being of vulnerable households in various communities across Cross River and Lagos States.

Methods: This study compared and analyzed data collected using the National Household Vulnerability Assessment tool at baseline and follow-up after 2 years (2016–2018) from 406 households in Cross River and Lagos State, covering 14 communities across six local government areas. Changes in the vulnerability status of households, in relation to the effective use of care plans for service provision and intervention monitoring, were identified, and analyses were conducted to determine the significance of these effects.

Results: Findings of this study showed that out of a total of 226 households assessed in Cross River State, 174 (76.99%) which were in the “More Vulnerable category” at baseline reduced to 120 (53.09%), while those in the Most Vulnerable category representing 0.88% (2 households) during the baseline study reduced to 0% after the administration of the care plan. In Lagos, out of 180 households sampled, 142 (78.88%) in the “More vulnerable category” at baseline reduced to 81 (33%) at follow-up, while seven households (3.88%) reported as “Most vulnerable” at baseline, reduced to 1 (0.55%). In measuring the effectiveness of the care plan on the above changes in vulnerability status, a t-test analysis indicated that 13 of the 14 communities in Lagos State and all five (5) communities sampled in Cross River showed a significant influence of the care plan. The results showed that highly significant differences between the baseline and follow-up vulnerability levels at p < 0.05 across the investigated communities.

Conclusion and Implications for Translation: The care plan had a positive and significant impact on improving the well-being and vulnerability status of vulnerable households in Lagos and Cross River. A care plan should therefore be considered a valuable service tool in guiding and monitoring interventions required to improve the well-being of vulnerable individuals and households.