International Handbook of Medical Education

By Abdul W. Sajid; Christine H. McGuire et al. | Go to book overview

22
Nigeria

OLATOYE OGUNBODE

Nigeria is a Sub-Saharan African country with a 1988 population of 112 million, distributed 85 percent in rural areas and 15 percent in urban centers. The nation's birthrate of 50.4 per 1,000 (world average 29) is countered by an infant mortality rate of 114 per 1,000 live births and a death rate of 17.1 per 1,000 (compared with the world average of 11); projections made in 1988 were for a population of 119 million in 1990 and 166 million by the year 2000. Life expectancy for males is 46.9 and for females 50.0; with expenditure for health at 3.3 percent of the GDP ( World Almanac Supplement 1988). Indigenous medical traditions were the basis of Nigerian health care before the introduction of Western medicine. Traditional medicine still plays a role, especially in the rural areas. English is the official national language. The Nigerian Minister of Health noted in 1990 that:

Although Nigeria has no accurate data, publications from Nigerian universities and surveys conducted by various government agencies provide a good picture of the state of people's health. These sources indicate that the major health problems in Nigeria are infectious diseases, especially diarrhoeal diseases and respiratory tract infection in children. Malaria is a major cause of death for children under five. Malnutrition and poor health practices are prevalent among the population. Pregnancy and childbirth continue to constitute a major threat to the lives of women between 15 and 45 years of age. It is also estimated that the country's high mortality rates for all ages are similar to those of other developing countries. ( Alike-Catha 1990)


OVERVIEW OF THE HEALTH CARE DELIVERY SYSTEM

The health care delivery system in Nigeria evolved from the public health services originating in the British Army Medical Service ( Makanjuola, Osuntokun, and Erihosho 1990). Following integration of the army with the colonial government, medical care was extended to local civil servants and their families and eventually to the local population living close to government stations. Further extension of Western medicine occurred following World War II under the

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