POVERTY AND HEALTH
By
Dr. S. Asa
Department of Demographics
Faculty of Social Sciences
Obafemi Awolowo University
Ile-Ife, Nigeria.
''One place for infectious diseases to hide is among the poor...''
-Paul Farmer, Harvard Medical School professor
Two basic terms or concepts are identifiable in the topic. They are Poverty and Health. The third actually will be dealt with as a function understanding the two basic concepts. In discussing the concepts therefore, there will be the need to review some definitions about the two concepts.
POVERTY
There is absolutely no widely accepted or universal definition of poverty. The dominance of what poverty is arose from the perspective of western economy. The absolute and relative poverty have been identified. By absolute poverty, it is a situation in which the individual earn less that 1USD ($1) a day or any minimum standard quality of life. Officially this translates to earning less than N 115.00 or in the black market N120.00 (can you imagine?). The relative poverty simply indicates that people are poor compared to other people.
Poverty can be seen from either a MEANS perspective or an ENDS perspective. The ends perspective has to do with examining the adequacy of resources at the reach of the poor and therefore the extent to which basic need could have been met. The ends perspective focuses on the actual outcome of deprivation or the extent to which basic need have been met. The Means perspective sees poverty as a function of income while the Ends perspective sees it as a function of well being.
A combination of social and statistical definition of poverty has also been employed by most economics and social workers. The social definition views poverty as lack of essential items or basic needs/amenities such as food, clothing, water and shelter.
“At the
UN
’s World Summit on Social Development, the ‘Copenhagen Declaration’ described poverty as “…a condition characterized by severe deprivation of basic human needs, including food , safe drinking water , sanitation facilities, health , shelter, education and information.” When people are unable to eat, go to school, or have any access to health care, then they can be considered to be in poverty, regardless of their income”. (ThinkQuest
Team, 2006)
HEALTH
“Health
, as defined in the World Health Organization (WHO) constitution:
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Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
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The definition was updated in the 1986 WHO "Ottawa Charter for Health Promotion" to say health is a "resource for everyday life, not the objective of living", and "health is a positive concept emphasizing social and personal resources, as well as physical capacities.””
In order to understand the topic of discussion, it will be appropriate to examine this table.
Indicators (2006)
Population- mid year (000s)
Nigeria
144.7
Sub
Africa
770
Saharan Low Income
Group
2,403
GNI per capital (Atlas method, US$)
GNI (Atlas method, US$ billions)
Most Recent Estimate (2000-2006)
Poverty (% of population below national poverty line)
Urban Population (% of total
Population)
620
89.7
Average Annual Growth (2000-2006)
Population (%) 2.5
Labour (%) 3.6
-
49
842
648
2.4
2.6
-
36
650
1562
1.9
2.3
-
30
Life expectancy at birth (years) 44
Infant Mortality (per 1000 life births) 100
Child malnutrition (% f children under
5)
29
Access to an improved water source (% of population)
48
Literacy (% of population age 15+)
Gross primary enrollment (% of schoolage population)
Male
69
103
111
47
96
30
56
59
92
59
75
-
74
61
102
98 108
Female 95 86 96
Culled from The World Bank Group: This table was prepared by country unit staff; figures may differ from other World Bank published data. 9/28/07
Note: 2006 data are preliminary estimates.
This table was produced from the Development Economics LDB database.
STATE OF HEALTH
Health systems in Nigeria can be said to be poor. The factors responsible include majorly poor level of socio-economic characteristics of majority especially the rural dwellers. This is to a large extent dictated by political factors. These factors result in bad governance, corruption, poor financing and very inadequate provision of health services.
The Federal Ministry of Health (1999) revealed that 18,258 registered PHC facilities, 3,275 secondary facilities as well as 29 tertiary facilities. These do not suggest that they are all functioning health facilities. It is either that they are poorly equipped or lack qualified health personnel. The data as at 1999 further showed that 67% of the PHC facilities, 25% of the
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secondary facilities and 28 tertiary facilities belong to the public sector. More than two-thirds of households in Nigeria are residing within 10km range of any health facility. The WHO in 2000 ranked the overall health system of Nigeria with regards to performance as 187 th among 191
Member States. Diseases which are preventable have been attributed to be majorly as a result of poverty. Marternal death is estimated to be about one mother’s death in every ten deliveries.
NATIONAL HEALTH POLICY
“The goal of the National Policy shall be to establish a comprehensive health care system, based on primary health that is promotive, protective, preventive, restorative and rehabilitative to every citizen of the country, within the available resources, so that individuals and communities are assured of productivity, social well being and enjoyment of living.
NIGERIA AS A CASE STUDY
Poverty is widespread in Nigeria in spite of its rich resources in mining and especially oil wealth.
More than 70% of its population is classified as poor with 35% living in absolute poverty.
Nigeria is rated world 20 th
poorest nation. Of note is the severity in rural areas where social amenities/infrastructures/services are either non-existent or fast diminishing or limited. Among the rural dwellers, 44% and 72% of male and female farmers cultivate less than 1 ha per household. It is to be noted that 90% of the country’s food is produced by these group of peasant farmers who majorly depends on rainfall and not irrigation systems and have little or no access to health facility.
CAUSES OF POVERTY IN THE RURAL AREA
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Neglect of rural infrastructure
Lack of investment in health, education and water supply
Lack of strong political will towards rural development
Application of wrong model targeted at solving the rural problem
No policy formulation
Wrong policy formulation
Wrong policy implementation
Increase in Population on limited resources
Civil unrests
Limited education opportunities and poor health perpetuate the poverty cycle.
In their study on Public Social Spending in Africa, Castrol-Leal et al (1999) using seven African countries as a case study, revealed that:
 illness reporting are less likely among poorer households than their better-off counterparts.
 the poor are more inclined to self-treat than the rich.
 the poor are less likely to seek private modern care
 the poor rely mainly on the public system.
The following reveals some criteria Used by local people in Asia and Sub-Saharan Africa for well-being.
Disabled
Widowed
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-
-
-
-
-
-
-
-
-
-
-
-
-
Lacking land, livestock, farm equipment, grinding mill
Cannot decently bury their dead
Cannot send their children to school
Having more months to feed, fewer hands to help
Lacking able-bodied members who can fend for their families in the event of crisis
With bad housing
Having vices (e.g. alcoholism)
Being “poor in people” lacking social supports
Having to put children in employment
Single parents
Having to accept demeaning or low status work
Having food security for only a few months each year
Being dependent on common property resources.
LESSONS FROM THE DEMOGRAPHIC AND HEALTH SURVEYS
• Improvement in the reproductive health of all Nigerians at every stage of the life cycle
• Acceleration of a strong and immediate response to curb the spread of HIV/AIDS and other related infectious diseases
Strengthen the national response to HIV/AIDS to rapidly control the spread of the epidemic and mitigate its social and economic impacts
References:
A. Englama and A. Bamidele (1997) “Measures Issues in Poverty” Central Bank of Nigeria
Economic and Financial Review Vol. 35: 315-331
A.S.F. Atoloye (1997) “Strategy for Growth-Led Poverty Alleviation in Nigeria. Central Bank of
Nigeria Economic and Financial Review Vol. 35: 298-314
Bob Baulch (1996) “Neglect trade-of in Poverty Measurement. Poverty policy and Aid IDS
Bulletin Vol. 27: 1: 36-42
Chambers (1995) “Property and Livelihoods: Whose Reality Counts?” IDS Discussion Paper No.
347.
Florencia castro-Leal, Julia Dayton, Lional Demery and Kalpana Mehra (1999) “Public Social
Spending in Africa: Do the Poor Benefit?” Research Observer Vol. 14 No. 1: 49-72
Paul Shaffer (1996) “Beneath the Poverty debate: Some Issues” Poverty, Policy and Aid IDS
Bulletin Vol. 27:1: 23-35
Federal Ministry of Health (2004) “Revised National Health Policy”
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