Concept of primary health care in Nigeria

Concept of primary health care in Nigeria Introduction The concept of primary health care (PHC) was formulated by the 134 countries that met at the Alma-Ata conference in Russia on September 12, 1978 which was organized by the World Health Organization. Primary health care is a part of the three-tier system of health care in Nigeria. These are the tertiary health care, which the federal government is in charge; the secondary health care, under the auspices of the state government and the primary health care, controlled by the local governments. In the late 1980s there was a national initiative to overhaul the primary health care system through the adoption of a new national health policy, in the context of which the federal and state governments issued directives giving local government areas full jurisdiction over the delivery of primary health care services.1, 2 The local Government, the State Government and the Federal Government respectively are responsible for all financial aspects, including personnel costs, consumables, running co sts and capital investment. The Federal government through the federal ministry of health sets overall policy goals, co-ordinates activities, ensures quality, training and implements sector programmes. â€Å"Primary health care according to the world health organization means essential health care based on practical scientifically sound and socially acceptable methods and technology, made universally accessible to individuals and families in the community through their full participation and at a cost which the country can afford to maintain at every stage of their development in the spirit of self reliance and self determination. It is the first level contact of the individual and community in the national health system, thus bringing health care as close as possible to where people live and work and contribute the first element of a continuing health care process†.3 It is essentially aimed to promote health, to cure diseases and to rehabilitate. Nigeria is one of the few countries in the developing world to have systematically decentralized the delivery of basic health and education services to locally elected governments.4 BACKGROUND: Nigeria has an enormous population of around 120 million in 20035, with a growth rate of about 2.9% per annum. It is hailed as the giant of Africa and yet ranked among the poorest nations of the world.6 The management of the health sector has been poor and this has affected the quality of services to the general populace. Although Nigeria has an extensive national health infrastructure, it lacks the resources needed to function effectively Nigeria is now decentralizing its health system and clarifying the responsibilities and services at each level, which should result in better management and coordination. In addition, its health policy has been guided by the Bamako initiative to encourage and sustain community participation in primary health care services.7 The evidence base for primary care orientated health care system Primary care that is, care from the viewpoint of the doctors who has been in contact exclusively to the patients appearing for care- has apparent limitation. From the evidence given by the World Bank table and world health report 2000. It shows that Nigeria is one of the very poor countries. It has a clear symptom of imbalance between resources in poor performance, deteriorating facilities and low working moral among staff. There a high mortality rate in child and adult. The structures of the economy have fallen from 2004, raised a little bit in 2005 and remain constant between 2006 and 2007. This shows that due to lack of adequate resources in will affect the orientation of the health care system. The development of primary care in Nigeria An effective primary care system is critical for any country, developed or developing, to maximize outcomes and minimize costs.8, 9 Accurate and relevant data gathering and information processing are necessary for any field of endeavour whether in health care or any other field. It has long been recognized that clinical issues in primary care in Nigeria are different from those in other types of care. For example, the predictive values of symptoms may be quite different in different settings and clinical evidence derived from other settings may have limited applicability to primary health care and delivery. This is due not only to differences in the prevalence of specific diseases, but also to the fact that patients in primary care have many problems and the clinician must prioritize the diagnosis and management of all of these together over time, often in a setting where continuity of care plays a crucial role.10 Primary care is the backbone of Nigeria health system. Primary care plays a vital role in deployment of all resources through appropriate channels in promoting, maintaining as well as improving health. All these confirm the definition of primary health care which states that â€Å"essential health care based on practical, scientifically sound, as well as socially acceptable methods and technology made universally accessible to individuals and families in the community by means acceptable to them and at a cost that community and country can afford to maintain at every stage of their development in a spirit of self-reliance and self determination. It forms an integral part of both the countrys health system of which it is the central function and the main focus of the overall social and economic development of the community. It is the first level of contact of individuals, the family and the community with the national health system, bringing health care as close as possible to where people live and work and constitutes the first element of a continuing health care process†11. This implies that patients or individuals have a direct access to the appropriate source of care. It equally shows that it deals more with common and well defined problem in a community setting as well as affordable. Though, the development if primary care in Nigeria has improved immensely but it still shows some major defects. Reasons for the current status of primary care within the health care system The coverage is inadequate: it is estimated that 54% of the population have access to the modern health care services. The rural communities and the urban poor are not well served due to inadequate staff and infrastructure. Lack of basic health data is a major constraint at all stages of planning, monitoring and evaluation of health services. The basic infrastructure and logistic supports are often defective owing to inadequate buildings maintenance, medical equipment and vehicles and unreliable supply water and electricity also poor management of medicines, vaccines and other supplies system. The financial resources allocated to the primary care services, especially to some priority areas are inadequate to permit them to function effectively. Distribution of resources in Nigeria: The Federal and State Government allocate 15% of the state budget to health services. Within the available resources, high priority shall be accorded to primary health care with particular reference to the less privilege areas and groups. Community and financial sector resources shall be mobilized in the spirit of self help and self reliance. How the resource should be used in future: In the light of importance of health in socio-economic development: all the governments of the federation should review their financial allocation to health in relation to the requirements of other sectors of the economy. High priority programmes for primary health care should have the first consideration on any additional resources that may be available Within the health care system, effort should be made to redistribute the financial allocation among health promotion, preventive and curative health care services. This is to ensure that adequate emphasis and awareness are placed on health promotion and preventive services without comprising curative health services Governments of the federation should explore additional avenues for financing the health care system especially health insurance schemes and health development levies. The users should pay for curative services while the preventive services should be subsidized. Governments of the federation shall encourage employers of labour and the financial sectors to participate in the financing health care services. Workforce and resource issues in Nigeria: The workforce and resources issues have been a theme of discussion in the country. Earlier health services was focused primarily in the urban areas, this made them to be experiencing adequate health care delivery than rural areas. Even though health institutions such as leprosaria and dispensaries had been established for rural areas, these did not cater for the communities outside their immediate zones. The problem is that rural people were effectively overlooked in health care delivery, since the existing institutions were inaccessible to them due to cost and logistic constraints. Another basic problem is the inadequate staff situation to meet the needs of the country. But after training the staff most of them get a job in urban area where they are paid more. Quality of care issues in Nigeria: Quality of care varies among patients, politicians, managers, clinicians and other actors within the health care system12. She stressed that quality occurs when good decisions regarding care are made so that resource are utilized effectively and better health outcomes are produced. Quality of health care is a multidimensional and multifaceted concept interwoven with value judgements about what constitutes good quality13. There have been several definitions of quality of health care. â€Å"Quality of care is the degree to which health services for individuals and populations increase the likelihood of desired outcomes and are consistent with current professional knowledge†14. Accessibility: assess to hospitals or medical centres from the rural areas can be problematic from the patients due to geographical or financial barriers. In some rural areas there are little infrastructure for primary care but there are no qualified doctors. This is due to the fact that most of the doctors are aboard or in the city trying to earn comfortable and decent living. Comprehensiveness: Nigeria health system can be categorized into the Public and the Private health services. The public health sector is further divided structurally into the Primary Health Care (PHC), Secondary Health Care (SHC) and the Tertiary Heath Care (THC). Though, World Health Organisation (1978) suggests that in order for primary care to be comprehensive, all development- oriented activities should be interrelated and balanced so as to focus on problems of the highest priority as mutually perceived by the community and the health system, and that culturally acceptable, technically appropriate, manageable and appropriately selected interventions should be implemented in combinations that meet local needs. This implies that single- purpose programs should be integrated into primary health care activities as quickly and smoothly as possible.11 In Nigeria, there are referrals but the problem the patients (either rich or poor, over 60 of age or not) faces is that they must pay pa rt of their hospital bill before any treatment can be commence. In United Kingdom most of the treatment the NHS pays the bills. Co-ordination of services: there is no co-ordination of services because of the way things are in Nigeria there is no accountability of the patients medical history. Patient can decide to move from one doctor to another without any referral. The system is not like in United Kingdom where the technology is computerized that you can pull out people medical records anywhere. Equity: in Nigeria there is no equity. This is country full of corruption even in the hospital. For instance Jane to the hospital around 8.00am, then John and Amy went around 8.30am and 9.00am. Because they are related to the staff in that particular hospital they will see the doctor before Jane. In United Kingdom people wait for their turn unless is on emergency bases. How could quality of care issues be made better in Nigeria over the next 10 years? Quality of care issues can be made better by monitoring and evaluation of the health care system, with minimum categories of indicators as follows: Health policy: proper distribution of health resources, financial, manpower, physical facilities to reflect the degree of equity by geography and by urban/rural ratios; government should devise appropriate mechanisms for supporting and involving the communities in the planning and implementation of health services; an organizational framework for managerial process. Health status: proper documentation of patients health status for instance nutritional status as indicated by weight of babies, weight and height measurement of infants and children in relation to age. Socio-economical indicators related to health and living standard: such as sanitation, housing condition, work condition, food availability, and adult literacy. Provision and utilization of health care indicators: immunization this includes the percentage of children at risk who are fully immunized against the major childhood diseases; the incidence of the six diseases in children under 5 years of age and the mortality rate due to the six disease in children under 5years of age. Prevention and control of epidemic diseases indicators shall specify disease specific incidence and prevalence rate. Adequate provision of the essential drugs. The coverage by referral system indicators shall state the proportion of population in a given with access to the within 5 kilometres or 1 hour travel time, the proportion of the referred cases who made use of the services and availability of referral services. Promotion of health in school. Recommendations for the development of primary health care: The national health policy: the aims are to achieve health for all Nigerians based on the national philosophy of social justice and equity. Therefore, a health system based on primary health care is adopted as the means of achieving the goal. Since health development contributes to and results from socio-economic development, the sectors should mutually be supportive and together contribute to the ultimate goals of the nation. All the governments of the federation should review their financial allocation to health in relation to the requirements of other sectors of the economy. High priority programmes for primary health care should have the first consideration on any additional resources that may be available More staff should be trained and an increase in wages for those who will agree to serve in the areas Facilitation of monitoring and evaluation data collection system within the nation. In conclusion: Primary health care in Nigeria have evolved through a series of historical developments. Though, it is the backbone of Nigeria health system but has been judged to be unsatisfactory and inadequate in meeting the needs and demand of the public as reflected by the low state of health of the population. The population should abide by principles primary health care based on equity and justice. However, if the services are available accessible as well as acceptable to and affordable by every individual, community and the nation; if the masses concentrate on solving those health problems that take the greater toll of life.

Indian Middle Class And Shopping Essay

For the current generation of consumers, the meaning of shopping has changed. It is not just a mere necessity, as it was earlier, but much more than that. The factors that affect store choice and draw customers to the shopping centre include space, ambience, and convenience and moreover an array of choice under one roof. The growth of integrated shopping malls, retail chains and multi-brand outlets is evidence of consumer behaviour being favourable to the growing organized segment of the business. Space, ambience and convenience are beginning to play an important role in drawing customers. Malls, which are now anchored by large outlets such as Westside and Lifestyle and are resided by a lot of Indian and international brands, are also being seen as image benchmarks for communities. Today retailing in India is done through a vast number of unorganized retailers with over 12 million retails outlets spread across the country in various sizes and formats. India has the largest retail density with 9 stores available for every 1000 people. The Indian retail industry is providing 8% of the countries employment with its vast distribution of retail stores across the country. The retailing in India is undergoing a gradual change as market conditions and technological developments combined with affluent, highly mobile and time starved consumers are playing an important role in the changes happening in the retail sector in India. Marketplaces in urban demographic settings attract large number of buyers and sellers, which can be termed as market thickness. Co-existence of many shopping malls along with traditional markets in a marketplace causes market congestion. The co-existence of street markets and the rise of shopping malls have been major trends of retailing in developing countries for decades. However, the increasing emphasis on growing cities with contemporary marketplaces have induced shift of agglomeration format (AF) from a marketing perspective, including the consumer preferences on routes to market. There are some generic similarities and conceptual differences between street markets and shopping malls. The AF-specific characteristics perceived by consumers lead to the change in consumer behavior towards markets preferences for shopping. In centrally managed and enclosed shopping centers in the retailing sector, eight underlying factors of varying character that drive customer satisfaction are selection of market outlet, atmosphere, convenience, sales people, refreshments, location, promotional activities and merchandising policy. FACTORS THAT AFFECT / INFLUENCE CONSUMERS BEHAVIOUR TO BUY IN MALLS. A person is likely to be influenced in making his/ her purchase decisions if he/ she is accompanied by another individual while making a shopping trip. There are many factors that play a vital role in consumers â€Å"decision making†. Some of the prominent among the factors are the image of the store, risk associated with the consumers in purchasing the product and the price perception of consumers on the store or about the product category. Store image contain by many elements like the stores opening and closing time, the availability. The risk factor plays an important role in making the decisions for the product that are new or untried by the consumers so far. Perceived risk is the expected negative utility associated with the purchase of a particular brand.

Second Periodic Test

PERIODIC EXAM ENGLISH Name: _________________________________Year & Section: _________________________ I. SPEAKING: DIRECTIONS: Tell whether the statements below use a RISING INTONATION or a RISING- FALLING INTONATION. Write R for rising and RF for rising-falling intonation. _____1. Have you study your lessons? _____2. I have seen the movie twice. _____3. When is the deadline for the submission of our project? _____4. Are you sure? _____5. She might be late. II. READING & LITERATURE A. DIRECTIONS: Use the articles A, AN and THE in the nouns below: 6.The leader of ___________ group is good. 7. _______ apple a day keeps the doctor away. 8. My father is ________ honorable man. 9. We went to _________ DILG office. 10. ______ new song is being played. B. DIRECTIONS: Select the reference material needed below. Write your answer on the space provided. _________________________11. The population of the Philippines in 1990. _________________________12. The meaning of the word â€Å"outrageou s†. _________________________13. The different kinds of insects. _________________________14. The color of the Japanese flag. ________________________15. The stress mark of the word â€Å"sedimentary. † ( YEARBOOK OR ALMANAC, ENCYCLOPEDIA, ATLAS, DICTIONARY ) C. DIRECTIONG: Supply the missing word in the analogy below: 16. School is to study as church is to ______________________. 17. Bark is to dog as buzz is to _______________________. 18. White is to good as black is to ___________________. 19. Sun is to day as moon is to ____________________. 20. Allah is to Muslim as Christ is to ___________________. D. DIRECTIONS: Encircle the letter of the correct answer. 21.Who is the wife of Leon? a. Mariab. Emeliac. Lumnay 22. What did Mr. Angeles brought to his family? a. caretelab. beansc. mats 23. The following are dead children of Mr. Angeles EXCEPT†¦ a. Josefinab. Marcelinac. Victoria 24. He was the brother of Leon. a. Juanb. Antonioc. Baldo 25. She was the new wife of Awiyao. a. Madulimayb. Madulumnayc. Lumnay E. DIRECTIONS: TRUE OR FALSE. WriteT if the statement is true and F if it is wrong. ___26. Maria was afraid of Labang. ___27. The beads given to Lumnay by Awiyao will be given to Madulimay in the wedding. __28. All the children of Mr. Angeles have received a mat. ___29. Marcelina’s mat has a symbol of Aesculapius for she is a medical student. ___30. The passing at night at the Waig was one of the tests given by Leon’s father to Maria. ___31. Maria was a typical city woman. ___32. Maria was not accepted by the family of Leon. ___33. The mats brought by Mr. Angeles were special and unique. ___34. The reason of the separation of Awiyao and Lumnay was Madulimay. ___35. Lumnay joins in the wedding dance and finds also a husband. III. GRAMMAR A.DIRECTIONS: Identify the pattern of the sentences below. Write S-TV-DO or S-TV-IO-DO in the space provided. _________________36. Mr. Angeles gave Nanay Emilia a mat. _________________37. A wiyao left Lumnay. _________________38. Leon showed Maria the place. _________________39. Mr. Angeles brought presents. _________________40. Awiyao comforted Lumnay. _________________41. Mr. Angeles remembered his dead children. _________________42. Leon’s family accepted Maria. _________________43. Awiyao gave her the beads. _________________44. Lumnay offered Kabunian a pig. ________________45. Awiyao asked Lumnay a question. B. DIRECTIONS: Look for the prepositions in the poem below. Encircle a preposition only once. A thousand times in my dreams I have walked with you Hand in hand, down the glittery way Without a worry, not a care in the world, No sorrow, no torture, no dismay, There we were: two figures in the incessant night, Swallowed by the searing darkness Embraced by the fleeting sadness, And then we would look to the sky and see, The shining harvest of the distant stars, Our sky, our sky, my starlight, our sky sown with stars.

comparison FDR and Wilson essays

comparison FDR and Wilson essays Although the United States is only three hundred and some years old, it has seen numerous wars and problems, be it world or domestic. At this time it is important to have a president who can solve those problems. I believe that two of best United States presidents were Franklin Delano Roosevelt or FDR, and Woodrow Wilson. Although both of them were great presidents and they had many characteristics in common they also had numerous differences. FDR was born in New York on January 30, 1882. He graduated from Harvard University in 1904. While Woodrow Wilson was born in 1856, and he graduated from College of New Jersey. FDR was United States 32nd President, while Wilson was 28th. FDR made an amazing impact on United States during the Great Depression, at this time some 13 to 15 million Americans were unemployed. While FDR had a major problem on his hands, Wilson was lucky not to have as many domestic problems. And few that he did have, he successfully solved by passing couple of laws. In the world situation FDR was involved in WW2. He tried to keep United States out of the war as long as he could, but finally after bombing of Pearl Harbor he decided that we had no choice but to enter the war. On the other hand Wilson had his work cut out by WW1. He also tried to keep United States out of the way of the war as much as possible, but after the Zimmermann note was intercepted and translated by the British, in which the Germany asked Mexico to attack United States, Wilson had no choice but to enter the WW1. The legislation field was FDRs specialty. During his time in office he passed numerous laws, that changed the United States, from New Deal that helped America get out of the Great Depression, to Manhattan Project that allowed scientists to use federal fund towards building of an atomic bomb. Finally FDR passed the Social Security Act that gave tax money to support people by unemployment compensation, tax money ...

Free Essays on Rousseau

Rousseau’s claim that desires, emotions, and morals are a product of culture is correct. There is no such thing as human nature; therefore, society is necessary for a civil life. This is so because only society can inculcate values and behaviors required for civil existence. The primitive man is self-centered, lazy, and solitary. Innately, instinct and self-improvement lay dormant in the primordial man. Potential to reason and develop language evolve due to the human’s association with other beings such as family. In relationships, humans learn valued emotions and behaviors that become their culture. The variety of culture on Earth indicates that each one was individually developed. This development is attributed to the different qualities that were uplifted by the people within each culture. According to Rousseau, the first humans were indifferent to the opinions of others and maintained a level of healthy narcissism. In this state, the free humans were able to survive off of two instincts: self-preservation and compassion. Without family, a precursor to society, man would still live off of two instincts. As family became more important, man was able to develop the institution of society and comply with its unique sanctions and norms. Human behavior is socially established patterns adopted from society, thus ruling out the theory of a universally intrinsic human nature. Society has become a needed function in the lives of people. When comparing cultures of the United States and China, the social directions of these societies are different. The Unites States uplifts competition and individualism; on the other hand, China uplifts harmony and collectivism. Neither culture is considered better than the other, because although they are different they share the quality of civilization. The societies in both of these countries determine the quality of life the citizens will live. The influence of society ramifies throughout cultur... Free Essays on Rousseau Free Essays on Rousseau Rousseau’s claim that desires, emotions, and morals are a product of culture is correct. There is no such thing as human nature; therefore, society is necessary for a civil life. This is so because only society can inculcate values and behaviors required for civil existence. The primitive man is self-centered, lazy, and solitary. Innately, instinct and self-improvement lay dormant in the primordial man. Potential to reason and develop language evolve due to the human’s association with other beings such as family. In relationships, humans learn valued emotions and behaviors that become their culture. The variety of culture on Earth indicates that each one was individually developed. This development is attributed to the different qualities that were uplifted by the people within each culture. According to Rousseau, the first humans were indifferent to the opinions of others and maintained a level of healthy narcissism. In this state, the free humans were able to survive off of two instincts: self-preservation and compassion. Without family, a precursor to society, man would still live off of two instincts. As family became more important, man was able to develop the institution of society and comply with its unique sanctions and norms. Human behavior is socially established patterns adopted from society, thus ruling out the theory of a universally intrinsic human nature. Society has become a needed function in the lives of people. When comparing cultures of the United States and China, the social directions of these societies are different. The Unites States uplifts competition and individualism; on the other hand, China uplifts harmony and collectivism. Neither culture is considered better than the other, because although they are different they share the quality of civilization. The societies in both of these countries determine the quality of life the citizens will live. The influence of society ramifies throughout cultur...

Arizona Law Essay Example | Topics and Well Written Essays - 1250 words

Arizona Law - Essay Example I shall use general information about the law and its open discussions as culled from various magazines, newspapers, and journals online in order to help persuade the reader to rethink their position should they be in full support of the law. After all, every law is subject to political discussion. Those who support the controversial law do so on the basis that the senators and other politicians in Washington are incapable of passing effective anti-immigration laws. That is why the state of Arizona has chosen to enforce its own version of an anti-immigration law. After all, who better to know the effects of illegal immigration into their state than the state politicians? They are familiar with the immigration problem of their state and therefore, should be the most authoritative when it comes to finding methods of keeping these illegal immigrants out of the country. Let us not forget the most important aspect of anti-immigration law enforcement, it must be based upon a law that was p assed by consensus on a national level over at the Capitol. The enforcement of the nitty gritty points of the law is the responsibility of those deputized by the national senate. The budget for anti-immigration law enforcement is also worked into the country's budget every year. But under the Arizona anti-immigration law, the budget for enforcing the law as stated in SB 1070 should come from the federal government. Under no circumstances should the enactment of such laws be done under the supervision and authority of the state under a localized anti-immigration law. (Navarette Jr., Ruben â€Å"The Truth About Arizona's Anti-immigration Law†) If Arizona is allowed to breakaway from the law as defined by Washington, then all the other states must be given the same freedom to enforce their anti-immigration laws. There is also the local and national economic and agricultural aspect to consider at the moment while the law is in effect. Although it is true that Washington has a har d time coming up with a cohesive anti-immigration plan that both sides of the political spectrum can get aboard on, they have to first consider the local economy and workforce of the state before passing such laws. These state legislators seem to have forgotten that the reason that illegal immigrants proliferate in the state is because there are jobs to be had. Jobs that our fellow Americans frown upon or refuse to do under the scorching heat of the sun. (Kain, Erick â€Å"Why Arizona's Controversial Immigration Law is Bad for Business†) Without these illegal immigrants to do the job without complain, is there anyone else who would willingly come forward to do those menial jobs? Let's face it, only the migrant workers who work illegally in the country would be willing to do those jobs in exchange for far less than they should actually be paid One of the key points that is being addressed as an explosive issue when it comes to the enforcement of this bill is that certain secto rs of society believe that the law will encourage racial profiling. The belief stems from the fact that the law is far too broad and open to interpretation that those enforcing it will not have any qualms about asking for citizenship identification papers because he is exposed to various races every â€Å"single day of his working life. It is believed that SB 1070, in its original content may : ...unlawfully

The Google Boys Essay Example | Topics and Well Written Essays - 500 words

The Google Boys - Essay Example However, soon the fellows found a common topic of interest, and by January 1996, the 24-year-old Larry and 23-yar-old Sergey had started collaboration on their first search engine called BackRub, which could analyze the â€Å"back links† pointing to a given website. The friends were limited in cash and had to borrow computers for their network. BackRub became popular in the campus. The work on the new technology was continued. Larry and Sergey bought a terabyte of disks at bargain price to build their computer housing. The Google’s first data center was in Larry’s dorm room. Having set up a business office, they started looking for potential partners. However, the new technology was not known and many companies, including Yahoo, refused a wonderful chance to get hold of it for almost no money. So Larry and Sergey decided to promote their engine themselves. All they needed was money. It was Andy Bechtolsheim, one of the founders of Sun Microsystems, and then a friend of a faculty member, who gave his blessing and a check for $100,000 to a new company, Google Inc. Sergey tells that they met Andy very early one morning on the porch at a Stanford faculty member’s home in Palo Alto. â€Å"We gave him a quick demo. He had to run off somewhere, so he said, ‘Instead of us discussing all the details, why dont I just write you a check? It was made out to Google Inc.†. While such a company didn’t exist it was impossible to deposit the check. So for a couple of weeks Sergey, who was, obviously, the business organizer, set up a firm, locating funders among family, friends and acquaintances. As a result, the initial investment made almost $1 million. Google Inc. opened in September 1998, in a friend’s garage in Melno Park, California. The new company had a staff of three, with Craig Silverstein, now Google’s director of