Public Health Challenges in Nigeria by Livy-Elcon Emereonye.

 

There is no alternative to good health, and public health seeks to meet the health needs of the public. According to Everett Koop, “Healthcare is vital to all of us some of the time, but public health is vital to all of us all of the time.” Regardless of space and time, class and status, it impacts everyone.

The field of public health entails prevention and education of the general public to help improve the overall health and reduce risks to a population, as opposed to the provision of individual medical treatment to one patient at a time. Public health can be distinguished from healthcare in that instead of treating diseases and injuries one patient at a time, it focuses on preventing disease and injury in communities and populations. People who work in public health do not necessarily diagnose or treat patients on an individual basis like clinicians do in a clinical setting.

Public health is a science that is aimed at protecting and improving the health of individuals, communities and greater populations, which may be as small as a neighbourhood or as big as a region of the world. According to Pulitzer prize-winning science journalist and best-selling author, Laurie Garrett: In an ideal world, public health would mean no epidemics, safe food and water, well-informed citizens regarding personal health habits, immunized children, clean air and water, and little class-disparity when it comes to disease and life expectancy.

According to World Health Organization (WHO), the goal of public health is to prevent disease, promote health, and prolong life among the population as a whole. Therefore, “Public health works to protect and improve the health and lives of individuals, families, communities, and populations. It is practiced at the local level, the state level, the national level, and certainly at the global level.” It seeks to address health inequity on a local, national, and global scale because health disparities still exist, leading to populations that are disproportionately affected by diseases.

In other words, public health means “protection and improvement of the health of entire populations through community-wide action, primarily by governmental agencies. The goals of public health are to prevent human disease, injury, and disability; protect people from environmental health hazards; promote behaviours that lead to good physical and mental health; educate the public about health; and assure availability of high-quality health services.” Public health also includes the education of the public on ways to defend themselves against health risks. 

Public health professionals are motivated to identify the causes of disease and disability and implement solutions to address them. They research and track health trends including behavioral, biological, and environmental factors and utilize that result to help predict and prevent future health events or problems that could impact the health of the general population. 

Many public health workers have desk jobs in an office setting, while others may be dispatched out into the community for hands-on work with a given population. Workers may travel to outbreak areas or other events to help manage the spread and prevention of a disease on the front lines.

Professionals in public health, whether they are working at the local or global level, are committed to ensuring that healthcare is accessible to all segments of society. And regardless of the size of the populations they serve, public health professionals, work to prevent health problems from occurring or reoccurring, and mitigate the effects when problems do occur. They accomplish this task through educational programmes, the creation and implementation of policies, the administration of services, and through research. Therefore, a major objective of public health is to promote healthcare equity, quality, and accessibility.

The objectives of public health may be carried out through public or private endeavours, and many times efforts are coordinated among a number of private and public entities. According to World Health Organization (WHO), the goal of public health is to prevent disease, promote health, and prolong life among the population as a whole. Therefore, public health initiatives are aimed at fostering conditions in which people can be healthy within specific populations.

 

Within the public health organizations and government health agencies, there are hundreds of professionals such as scientists, engineers, medical laboratory workers, biostatisticians, medical researchers, epidemiologists, medical doctors, pharmacists and more, all working together to help fight the next threat to the nation’s health. There are many also non-medical positions such as administrators, human resources, accounting, public relations and communications professionals, who help public health organizations to work effectively and efficiently.

The World Health Organization recognizes the main objectives of public health initiatives to be:

  • To assess and monitor the health of communities and populations at risk so as to identify health problems and priorities
  • To formulate public policies designed to solve local and national health problems and priorities
  • To assure that all populations have access to cost-effective and appropriate care, which includes health promotion and disease prevention services

In fact, the goals of public health are to save money, improve the quality of life, help children thrive, and reduce human suffering by:

  • Assuring the quality and accessibility of health services
  • Preventing epidemics and the spread of disease
  • Preventing injuries
  • Promoting and encouraging healthy behaviours
  • Protecting against environmental hazard
  • Responding to disasters and assisting communities in recovery

Public health encompasses a wide array of topics and issues, such as chronic disease, the science of aging, mental health, injury prevention, disaster response, and tobacco control. Just a few of the contemporary topics in public health include:

  • Developing emergency preparedness plans
  • Examining the dangers of secondhand tobacco smoke exposure
  • Identifying ways to stop bullying in schools
  • Improving technologies that make clean drinking water available
  • Investigating the consequences of antibiotic use in industrial agriculture
  • Promoting family planning and reproductive health programs and policies
  • Promoting policies that protect the global environment

The U.S. Department of Health and Human Services identifies 10 essential public health services:

  • Monitor health status so as to identify and solve community health problems
  • Diagnose and investigate health hazards and health problems in a community
  • Educate and empower people about contemporary health issues
  • Inspire and support community partnerships to identify and solve health problems
  • Set policies and plans in motion so as to support individual and community health efforts
  • Enforce laws and regulations that are designed to protect the safety and health of communities
  • Pair people to beneficial personal health services
  • Provide a competent public and personal healthcare workforce
  • Evaluate the effectiveness and the quality of personal and population-based health services
  • Engage in ongoing research to discover innovative solutions and new insights to health problems

The public health system consists of official government public health agencies, private-sector business, and nonprofit organizations. (The entities of the public health infrastructure in the U.S. include:

  • More than 3,000 county and city health departments and local boards of health
  • About 59 state, territorial, and island nation health departments
  • A number of U.S. public health services agencies (HHS, CDC, EPA, FDA, OSHA, etc.)
  • Tribal health agencies (coordinated by the Indian Health Service)
  • More than 160,000 public and private laboratories
  • Hospitals and private-sector healthcare providers
  • National volunteer organizations (American Red Cross, American Cancer Society, American Diabetes Association, etc.)
  • State and local volunteer organizations)

The CDC recognizes the following as the ten greatest public health achievements of the 20th century:

  • Control of Infectious Diseases
  • Declines in Deaths from Heart Disease and Stroke
  • Family Planning
  • Fluoridation of Drinking Water
  • Healthier Mothers and Babies
  • Immunizations
  • Motor Vehicle Safety
  • Safer and Healthier Foods
  • Tobacco as a Health Hazard
  • Workplace Safety

Despite the expansion of services and the mobilization of resources, the incidence of preventable diseases remains high worldwide. One of the major goals of today’s public health community is to reduce the impact and prevalence of these diseases.

Other major global health issues now at the forefront include:

  • Infant mortality
  • Water scarcity
  • Environmental risk factors (factory emissions, car exhaust, tobacco smoke, etc.)
  • Tobacco use
  • Obesity

American Public Health Association passed a resolution that all public health agencies should provide the following (referred to as the Basic 6):

  • Collecting data on vital statistics
  • Controlling communicable diseases
  • Ensuring environmental sanitation
  • Offering maternal, infant, and child health services
  • Providing education to promote healthy behaviors
  • Providing laboratory services for the diagnoses of illnesses

In 1988, the Institute of Medicine published its renowned report, The Future of Public Health, which resulted in population-based strategies for improving community health efforts to control epidemics, reduce vaccine-preventable diseases, ensure safe food and water, improve maternal and child health, and conduct studies of health problems.

New risks, such as obesity, adolescent pregnancy, HIV, natural disasters, and bioterrorism were soon part of the nation’s public health efforts.

At this juncture, one would like to ask: where is Nigeria in all these things? Is there any policy statement on Nigeria public health?

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