Yashua Alkali Hamza MD, FWACP, MPH
The rigid traditional western concept of health based entirely on diseases or the absence of has done little to reduce the burden of diseases particularly in third world countries. In its most recent report, the World Health Organization identifies Nigeria as having the world’s second-highest number of maternal deaths with approximately 59,000 of such deaths taking place annually. Majority of these cases occur because less than 10% of deliveries are attended to by skilled personnel. In our communities, people distrust the hospitals; they prefer to deliver at home partly because they feel more comfortable being attended to by relatives who though are unskilled understand them better. This gap between modern medicine and societal needs have not served my people well. It has contributed to the unacceptably high rates of maternal mortality and the subsequent deaths of the children left behind.
Health promotion as a public health concept first came into existence in the 20th century following a long period of time when public health was viewed mostly as a field of “sanitary legislations and reforms” Following the first International conference on health promotion by the World Health Organisation in Ottawa in 1986 and a series of others, the final one held in Thailand in 2005 ended with the resolve to reduce health care inequality by globalising health care.
Health promotion involves the individual and the community in decision making about their own health. It also takes into consideration the decision making process by policy makers because the more people value health, the more willing they will be to make the appropriate allocation and resources to promote and safeguard their own health. While social and cultural factors contribute to the high maternal mortality rates in Nigeria, the problem is also a political and economic one. The failure of the government to adequately regulate and fund the health system has sustained the prevalence of maternal death in the country”.
The new shift in healthcare approach has interesting implications for health care providers and the relationship between health care providers and their patients. Involving the community in healthcare decision-making may be difficult at first for a society that has been led to believe in the “Doctor knows it all” philosophy. It would take a lot of awareness creation on the benefits of health promotion. This concept however, has been met with a dose of scepticism particularly from the doctors whose training has been biased towards the traditional concept. Other health care providers would most likely welcome the concept that would give them more far-reaching powers. I sincerely believe that it is only through this huge shift in mind-set of health care providers and patients that we can begin to achieve the health for all objectives and begin to see a society more appreciative of health and living as a whole.