MEZIESBLOG

CHAPTER ONE

Health refers to the state of being free from illness or injury (McSherry & Douglas, 2011). According to Carless and Douglas (2018), good health simply highlights complete emotional, physical, and social well-being.

Health is wealth. As a positive concept, it emphasizes personal and social and personal resources—as well as physical capacities (Goldman Schuyler et al, 2016). Healthcare therefore exists to help people enjoy optimal state of health, but this objective is prone to various economical, socio-political, and cultural challenges (Plianbangchang, 2018).

On this premise, global health is the understanding of healthcare in an international and interdisciplinary context, and it entails the study, research, and practice of medicine for the purpose of improving health as well as healthcare equity for everyone around the world (Seçkin et al, 2018). Global health initiatives, thus, transcend medical boundaries to exploit opportunities in non-medical disciplines—such as cultural studies, economic disparities, epidemiology, environmental factors, public policy, and sociology, among others (Lueddeke, 2020). The World Health Organization (WHO) is one of the frontline agencies focused on advancing global health. Government administrators, non-government organizations (NGOs), researchers and leaders in different fields are also contributing towards the actualization of WHO’s Millennium Development Goals (MDGs), which include: (a) eradicating extreme poverty and hunger (b) reducing child mortality (c) improving maternal health (d) combating HIV/AIDS, malaria and other diseases (e) ensuring environmental sustainability and (f) developing a global partnership for development (Hassall, 2020; Remedios et al, 2020).

To achieve these goals, WHO relies on partners providing support for national efforts in the following ways:

• Establishing global health care norms and standards, as well as guidelines for prevention and treatment.
• Providing necessary technical support required to implement guidelines in every country.
• Analysing social and economic factors that influence attainment of health goals.
• Highlighting the broader risks and opportunities for both national and global health systems (Orhun, 2021).

But despite huge efforts from the global institution—such as assisting national authorities to develop and implement health policies/plans; helping governments collaborate with development partners to align external assistance with domestic priorities; as well as gathering, storing, and disseminating relevant data on health to improve national budget on health and monitor progress—there’s need for more investments in community health (Schweer Rayneret et al, 2021). Challenges from the COVID-19 pandemic however proves that every country is vulnerable to health crisis no matter the effectiveness of innovative health management strategies and level of disaster risk preparedness (Osland et al, 2020). Apart from the Coronavirus, which infected millions of people worldwide, other public health problems in 2021 include: mental health conditions, alcohol and substance abuse, food safety, healthcare-associated infections (HAIs), heart disease and stroke, HIV, prescription drugs overdose, as well as nutrition, physical activity, and obesity. These public health concerns are a reason for the institutionalization of Primary Health Care (Shroff & Jung, 2020).

Innovation is the solution to modern-day healthcare management (Browne et al, 2017), and PHC systems around the world must either embrace innovation for higher productivity and sustainable growth—or remain stagnant, and eventually, lose their relevance (Best et al, 2012). In recent decades, healthcare has experienced different forms of innovation designed to enhance quality of life and improve life expectancy—thanks to more effective use of diagnostic and therapeutic options. But since COVID-19 and its socio-economic implications on every country, healthcare organizations have faced unexpected challenges to upgrade quality of service, lower cost, and eliminate waste. For these reasons, innovation has become a major focus (Cherry et al, 2020).

As global economies worsen, health workers maintaining high standard of service or sacrificing their lives to save others will not be enough. Thus, the healthcare industry needs far-reaching changes driven by innovation in management. But despite the urgency, policymakers must understand that innovation in healthcare is an outcome of collaborative efforts among stakeholder groups. Factors driving people’s need for health innovation include changing trends in healthcare services. For example, the availability of customized health technologies has changed the traditional encounter-based care delivery approach to managing chronic ailments (Janice et al, 2017). Additionally, there’s shortage of healthcare workers and/or care providers across the world. Costs of medications and therapeutic care are also high, and most healthcare givers are poorly trained, thus, the available workforce is not fully prepared to adapt in a fast-paced work environment. A constantly decreasing budgetary allocation to the health sector in most countries also hampers growth of health systems. These factors, together with other socio-economic forces, buttresses the fact that a shift to innovative management is necessary in healthcare (Carvalho et al, 2020).

While the WHO is addressing global health concerns, countries have different approaches to managing national health. The Federal Government of Nigeria (FGN) launched its Primary Health Care plan (PHC) in 1988 as a local approach for delivering quality, equitable and affordable healthcare services to communities—in line with WHO guidelines (David-West & Nwagwu, 2018). PHC is well-rooted in Nigeria’s National Health Policy (NHP) and has been the bedrock of the nation’s health system (Olukoga et al, 2010). Data from WHO shows significant decline in child mortality rate as well as a remarkable leap in life expectancy at birth. Per capita government expenditure has also increased, with fluctuations since 2008, when FG invested a record-high amount in the health system. Healthcare budget in 2019 was ₦1.2 billion. But the problem is: PHC in Nigeria has performed below expectations despite the national and international support. Studies show that most health infrastructure/facilities are dilapidated and poorly equipped. Additionally, health workers are inadequately trained, and salaries are either owed by the three-tier government or delayed—a sad situation which does not enhance output. On the part of health administrators, there is also a problem of corruption, abuse of power and gross incompetence. These setbacks are responsible for the continued poor health ranking of Nigeria in comparison to other countries in sub-Saharan Africa. According to Shroff and Jung (2020), Global leaders need country-specific health plans driven by innovation and public health development. Therefore, policymakers in Nigeria’s health system have a responsibility to find effective solutions as the nation risks failure to attain its 2030 Sustainable Development Goals (SDGs).

For example, recent data from the Nigeria Demographic and Health Survey (NDHS) show that mortality rates caused by preventable diseases, despite low, have remained. Moreover, low-income earners are facing challenges of childhood diseases since the 2016 economic recession (Osakede, 2021). The 2018 forecast from NDHS on Nigeria’s healthcare is disheartening, and it supports the call for immediate adoption of tested-and-proven innovative healthcare management strategies. A study of the data highlights the undeniable reality that only 3% of Nigerians (aged between 15 and 49) have access to health insurance. The infant mortality currently stands at 67 deaths per 1,000 live births—which means that one out of eight children in Nigeria will die before they are 5 years old. Further, neonatal mortality rate (i.e., a probability of dying in the first month of life) is at 39 deaths per 1,000 live births. According to a 2018 data from NDHS recently analysed by the United Nations Children’s Education Fund (UNICEF), about 25% of Nigerians still practice open defecation; only 39% of households in rural areas practise improved sanitation, and this poor hygiene level is a probable cause of deadly infections and death. The poor sanitation index is why Nigerians still account for around 25% of the global Malaria challenges despite national and international interventions spearheaded by WHO. This research will examine community health in Nigeria for the purpose of proffering innovative health management strategies that can improve delivery of health care.