HEALTH, a fundamental human right
plays crucial roles in the production and
reduction of poverty .It has direct linkage
to quality of life and level of productivity.
The economic status of a country or group
of countries has direct relationship to some
debilitating diseases ravaging such countries
and citizens. That is why some diseases like
HIV/AIDS, Tuberculosis and Malaria are
labeled diseases of the poor. Thus the slogan
‘healthy nation is a wealthy nation’
Health a state of complete physical,
mental, psychological and social well being
and not merely the absence of infirmity
is the most important social gold of any
country world wild. In both developed
and developing countries, governments
are intimately involved in the provision of
preventive, promotive and curative health
services and the scope and ranges of tasks
and responsibilities of health authorities
have broadened in the recent years to
provide services to meet the health need of
the population. Countries all over the world
have formulated and still formulating various
strategies to ensure that governments, local
stakeholders and development partners
work tirelessly towards poverty alleviation/
reduction.
The linkage between health and poverty
and their inter-relationship with broader
issues of public health, development and
human rights are well recognized and
noted in various international commitments
and declarations in recent years. The
importance of health in the context of human
development cannot be overemphasized
because of its roles in the production and
reduction of poverty. That is why some
diseases like HIV/AIDS, TB and malaria are
sometimes linked to the economic status of the
countries. The assumption is based on the fact
that low/poor and middle income countries
cannot adequately fund the health sector to
provide quality health care services to meet
the health needs of the population. On the
individual levels the purchasing power of the
people could be so low that they cannot afford
to pay for quality healthcare services even if
available.
At the global level, reduction of poverty and
improving health status of the world population
was high on the agenda of outgoing MDGs and
the current SDGs. The developing countries
need strong political will, commitments and
purposeful stewardship to make meaningful
headway in terms of poverty reduction and in
the provision of quality health services. Global
health initiatives should tailor their activities
and energies towards meeting the health needs
of the poor if the SDGs are to be met within
the time framework. Developments strategies
should be fashioned in ways that give priority
to common health problems and should be
implemented in ways that the impacts are felt
by poor people. It is not an understatement to
point out that millions of people worldwide are
excluded from both essential basic health care
and benefits of modern health and medical
technologies because of their extreme poverty.
Factors responsible for this poor-rich health
divide are majorly due to lack of responsiveness
by the healthcare system to the needs of the poor,
weak health system, underfunding, low quality
of care and the fact that public health spending
benefits the non-poor group more than the
poor. Take the case of Nigeria for example;
the Nigeria health care system is networked
between primary, secondary and tertiary
health services featuring many partnering
actors. The primary health care (PHC ) is the
largest in term of its policy scope and coverage,
providing basic health services for about 70%
Nigerians residing in the rural and semi-urban
areas. It obvious that many of the frightening
health indices of Nigeria are as a result of long
term negligence of the PHC characterized
by inadequate health manpower at these
peripheral health facilities , poor infrastructures
and insufficient supply of equipment and drugs
coupled with people’s inability to bear hospital
and medical cost. Most of these health facilities
are poorly equipped, short-staffed with broken
and obsolete structures and materials The
tertiary health facilities that cater for the few that
are rich are moderately equipped with modern
health technologies/equipment in the name of
serving as teaching institutions. The country
needs to hugely invest in the PHC so that the
poor masses in the rural communities can be
covered health wise as we are advocating for
universal health coverage, one of the pillars of
Sustainable Development Goals (SDGs).
We all know and are aware of the fact that
the financial gap between what is currently
available and what is needed is huge, but
prudent and transparent management of the
available financial resources will go a long way
in reducing the health burden of the poor. It is
important to point out that though adequate
funding of health sector is crucial for the
provision of quality health serves, other factors
like the internal and external environment in
which the health system operates also affect the
services. The internal environment concerns
with the strengths, weaknesses relating to the
structure of the health system, the strategies, the
skills, the staff and the valued norms (culture)
while the external environment concerns with
the treats and opportunities relating to the
political, technological, socio-economic and
legislative factors. It is very important to note
that no matter the amount of money pumped
into the health sector we may not achieve the
desired gold if the environmental factors are not
favorable.
The push for the measurement of the health
of the poor is a growing importance not
because health and its equitable distribution
are worthy and agreed goal in themselves but
due to increasing awareness of the crucial roles
health plays in the production and reduction
of poverty. Poverty in this context should be
viewed beyond income to include sense of
powerlessness, inability to influence what is
happening around one and lack of community
empowerment to take responsibility for their
health. The ways each person, households and
communities respond to illnesses and shocks
holds direct implication for the health-poverty
linkage. Ill –health reduces productivity and
increases the burden on households leaving
them less able to withstand shocks. Sick people
are less able to work productively and most
times have to pay for medical expenses. The
poor have no insurance against serious illnesses
and have difficult in borrowing money from the
bank and in most cases they resort to selling the
little assets they have to enable them pay the
medical bills for major illnesses. This situation
reduces their ability to deal with further crisis.
Prolonged ill-health and epidemics can run the
households and community down
The maternal and infant/child mortality
we are experiencing in Nigeria today are
partially due to poverty. Many families
and households cannot afford the cost of
antenatal care, delivery care cost and postnatal
care cost. This leads to poor health
seeking behavior and in extreme cases self
denial.
Some other serious health problems that
the global health initiatives tended to ignore
in the past are chronic and topical diseases
such as stroke, heart diseases, hypertension,
diabetes etc. The belief in many circle then
was that chronic diseases mainly affect the
rich people, this led them to focus on the
big three i.e. HIV/AIDS, TB and malaria.
Thank God for the realization that about
70% of the chronic diseases deaths occur in
low and middle income countries. The fact
is that while these poor countries continue
to grapple with the problems of infectious
diseases, they are also experiencing an
upsurge in chronic diseases risk factors and
deaths especially in urban settings. Poor
people everywhere are more likely than the
wealthy to develop chronic diseases and
die from them. In low and middle income
countries, people tend to develop chronic
diseases at younger ages, surfer longer often
with preventable complications and die as a
result.
Chronic diseases can lead to substantial
financial burden that could push the
individuals and households into poverty.
The way out
One of the effective ways of improving the
health of the population is through heavy
investment in health sector and putting in
place sustainable and broad based economic
development policy.
Governments in low/middle income
countries as a matter of fact should channel
funds to the people/group in greatest health
need and to most cost-effective interventions,
adequately fund the health sector and at the
same time empower the people financially
through poverty alleviation programmes not
palliative measures.
There is the need to develop pro-poor
health strategies that give priority to the
common problems for which cost-effective
intervention exist. Such intervention should
be monitored so as to measure the changes
in the level of poverty overtime and progress
in health and education outcomes amongst
the poor.
Governments to develop and implement
two interlinked free maternal and child
health care services as follows:-
i) Maternal services from 0-9months
ii) Two phases of child care
First phase- 0-1year
And second phase- 1-5years
The first phase of child care (0-1year) should
include free immunization (as it is done in
Nigeria) and basic nutrition while the second
phase of child care (1-5years) should
be limited to immunization, record keeping
and tracking of the child. Strengthening
these linkages between maternal and child
health services with PHC will minimize the
health hazards of women and children in the
roadless rural communities
There is the need to put in place or develop
implementable poverty reduction strategies
because of the strong link between ill-health,
vulnerability and poverty.
Finally, any workable strategies/
measures put in place to improve heath are
an important aspect of strategies to reduce
poverty

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