CHAPTER ONE 

                                               INTRODUCTION

Health Services in Nigeria have evolved via a number of historical developments including succession of policies and plans of action which had been introduced by previous administrations. The services are judged to be unsatisfactory and inadequate in meeting the health needs of the public as exemplified by the low state of health standard of the population.

Documents have been prepared against the historical background of the growth and development of health programmes. Policies and strategies that emerged from it were based on appreciation of current status of health of Nigerians with careful evaluation of major factors affecting the health of Nigerians and the nature of interventions that can result in improvement, rapidly and economically.

Federal Government of Nigeria has for long desired to have a sustainable health delivery system capable of maintaining high health status of her citizenry. Federal ministry of Health (2004) which is charged with such responsibilities came up with a well articulated document titled “Health Sector Reform Programme” (HSRP). The document was aimed at setting

goals, target and priorities for federal, states and local governments to follow not excluding health development partners in taking actions that are to address Nigerian health problems.

In line with her (Nigeria) aspirations and desires, in November 2003 a policy titled. National Health policy Declaration of the Federal Republic of Nigeria was produced. The policy stipulates that, all tiers of governments are hereby committed to take actions that will permit them to live socially and economically productive lives at the highest possible level.

Various programmes enunciated, thus far, were based on the

philosophy of social justice and equity. Even the first attempt by the colonial Masters in their development package entitled "Ten year development and welfare package" of 1946-1956 addressed some health issues.

In view of the prevailing health problems in the world, in 1978 the

World Health Organization (W.H.O) had a declaration at Alma-mata in then Union of Soviet Socialist Republic (U.S.S.R) captioned “Health for all by year 2000”

It was a worldwide health programme against health problems. This therefore means that every human being has the right to access health services at affordable cost and within 10 kilometers radius. Nigeria, being a signatory and in fact, a member of W.H.O had to draw her health programmes to meet the target within the time frame and beyond. Such actions of hers gave birth to the following programmes Primary Health Care (PHC), National Programme on Immunization (N.P.I), Roll Back Malaria (RBM), Riverblindness and others.

1.2      STATEMENT OF THE PROBLEM

Health is often referred to as wealth, for a nation to be developed, it must have high standard of living indices. Health is therefore, a folcrum on which the economy of a nation revolves. It is the core of growth and development of any nation. Olise (2007:15) observed that in the last two and half decades, many diseases that were thought to be declining and those previously unknown have become major public health problems, thus affecting Nigerian health status.

W.H.O – UNICEF (1975) report, as cited in Olise (2007) asserts that only 20% of the rural population in developing countries benefited regularly from the basic Health Services. This led to emergence of various programmes on health aimed at solving the problems.

Federal Ministry of Health (2006:6) stated that in Nigeria, malnutrition is widespread, for instance 4.3% of all children less than five years of age are stunted, 9% wasted and 25% are underweight NDH (2003). It was further reported that 6% of the death are due to underlining malnutrition.

World wide malaria day (2008:2) states that malaria has been largely responsible for the country's poor health status adding that 4 deaths of children under 5 and 1 in 10 deaths among pregnant women were direct consequences of malaria infection which has become a great drain on the economy of the country. This has resulted in the decrease of Nigerian health status.

Various programmes were initiated to address these health problems with a view to raising living standards of citizenry. One of such programmes was House for all programmes under the administration of President Alhaji Shehu Shagari. The programme was short-lived and did not achieve the set objectives. Today problem of housing for Nigerians is enormous. Voice of Nigeria (2004) had it that virtually all the bridge in Lagos has been converted to residential quarters owing to lack of accommodation for Nigerians.

Furthermore, in 2004, the Federal Government initiated another programme called National Health Service (NHS) aimed at reducing death rate and increasing national productivity. Despite this, death is taking its toll and productivity is getting to its lowest ebb. It seems as if nothing is done to salvage the health status of Nigerians from its’ total collapse, hence the need for this study, in order to find out where the problem lies so as to prefer solutions. The study questions are:

1.       What are the major causes of poor health standards in Nigeria?

2.       Do similar factors exist in Kogi State?

3.       What are the possible solutions?

1.3      OBJECTIVE OF THE STUDY

The general objective of this study is therefore to examine the effects of Federal Government Health programmes on Nigerian health status. The specific objectives are stated as follows:

1.       To find out the strategies employed in raising Nigerian health status for the benefit of health managers and Nigerians

2.       To find out the effect(s) of such strategies on Nigerian Health status.

3.       To identify the obstacles militating against the achievement of the Nigeria health programmes.

4.       To proffer possible solutions to the problems of poor health status of  Nigerians.

1.5      SIGNIFICANCE OF THE STUDY

The prevailing socio-economic and health challenges, and the need to attain efficiency and effectiveness in health administration in Nigeria, justify the need for this study. Against this backdrop, the significance of this study is two fold viz: Theoretical and empirical.

Theoretically, this study will add to the volume of already existing literature on the Federal Government Programmes and Health Status in Nigeria. It will equally serve as a source of vital information to students and researchers alike and may equally help those who may wish to explore in greater details other dimensions of the study.

It is therefore hoped that the present enquiry will stimulates further efforts and studies in the field of health programmes administration. In the light of the above, it may enhance scholarly and intellectual criticism that will later shape and address the future needs, problems and direction of Government health Programmes in Nigeria.

Data generated from this study, may serve as to strike a new dimension or bargaining point in the relationship among the stake holders. 

 Empirically, the study may help the management of public organisations in formulating and implementing effective policies and programmes that address the future health needs of the nation. It is finally hoped to motivate and strengthen the stake holders especially if it were done well to continuously explore alternative effective strategies in the light of evolutionary trend organisation.

1.5      OPERATIONALIZATION OF KEY CONCEPTS.

Attempt has been made to define salient concepts used in the course of this project work. Below were the key operational definitions in this work.

PHASE: This is referred to as a stage of development or a stage in history. It is a critical level of development.

HEALTH: A state of complete physical, mental, social, technological and economic well being of an individual and not merely absence of any disease injury or infirmity.

PROGRAMME: This is a course of action designed to be

implemented by individual governments and nongovernmental organizations. It is phased out in project form for easy implementation and evaluation.

STATUS: Social position in relation to other people within the environment or society. It is also a state of one's health position when compared with international standards.

CHANGE: Means leaving one's presence state or action to another aimed at achieving the overall objectives(s) of the programme.

CASE STUDY: is a sample taken from the universe for the purpose of study which serves as a representative of the whole or the universe as the case may be.

1.6      SCOPE AND LIMITATIONS OF THE STUDY

The scope of this study is to examine the changing phases of Health programmes as it affects health status of Nigeria citizenry and performance of health managers. It covers a period of four years (i.e. from 2004-2008). Its intention is to x-ray the implications of these programmes on health.

The study is limited to Kogi State which serves as a case study. Relevant data and Questionnaire from the state ministry of health were analysed. In the course of this research work, the researcher was faced with enormous problems that affected his performance. The greatest limitation lies in the fact that the validity of the result or findings is based on two factors viz: the objectivity of the researchers and authors of the work consulted especially in the area of literature review, (which is a secondary source of data) and on the sincerity of the respondent in providing the essential information.

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