Determinants of health in Nigeria : a case study of Nsukka L.G.A., Enugu state

Bibliography: leaves 85-87.The primary aim of this study is to identify the major determinants of health status in Nigeria. This is done with a view to inform policy making in the health sector. Because of time and financial constraints, the study was limited to a particular geographic area Nsukka L.G.A. The study makes use of regression-based analysis to determine those factors that affect health status of individuals. Health status was measured as a categorical variable with a finite number of outcomes; this necessitated the use of the logit and multinomial logit models for estimation of the models used in the study. The selection of potential health determining factors included in the study is based on international literature on the subject. The literature supporting the study cut across different disciplines, such as: Epidemiology, Social Sciences, Economics and Health economics. The study is unique in the sense that it not only takes into account the effect of individual and household choices on health status, but also the effects of government intervention. In this light, some of the variables used for the study measure the effect of individual choices, some household, and the rest, government policies. The study is organised in seven chapters. The first chapter gives a brief introduction to the subject, an overview of Nigeria and the specific objectives of the study. Chapter 2 reviews international literature on 'determinants of health' and related subjects. The third chapter provides a detailed discussion on the development of the models used in the study and the problems associated with the measurement of health status. In addition to developing models to estimate health status, a model is developed to attempt to identify the factors that influence the incidence of water-borne diseases. Chapter 4 describes the data collection process, and the methods employed to achieve this. The fifth chapter provides descriptive statistics of the data collected from the sample site. The results of the models used for the study are presented in chapter 6. The results suggest that age, place of residence (urban or rural) and education for the younger members of the population have the most effect on health status of any individual within the sample location. Interestingly, the results show that increases in age and years of education for children aged 0 -18 years has a positive effect on their health, while an increase in age for those over 18 years of age has a negative effect on their health. Secondly, those who live in the rural areas are healthier than those who live in the urban areas. Also, the results show that people who get their drinking water from natural sources are more likely to suffer from a water-borne disease than those provided with potable drinking water. The results of the general models - to explain health status - also show that the government intervention had little or no impact on the health status of the people in the area. Chapter 7 reviews the past and current health policy thrust of the Nigerian health sector. The current health policy in Nigeria is very broad, and covers just about all the major health issues. The areas of priority in health are the prevention of HIV/AIDS, and the immunisation of infants/children. The results of this research suggest that the encouragement of enrolment of younger members of the population into schools, improvement of the living conditions in the urban areas and the provision of safe water to those people who depend on natural sources of water should be included as priority areas in policy-making in order to effect the efficient and effective improvement of the health status of the Nigerian population