Transcript HEALTH NEEDS OF THE INDIVIDUAL AND THE FAMILY

3/31/2016
Akin Moses
HEALTH NEEDS OF THE
INDIVIDUAL AND THE FAMILY
DR AKIN MOSES FMCGP, FWACP
WACP UPDATE 2015
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The human needs identified by Abraham
Maslow in 1954 includes the following
except:
a. Communal
b. Ego
c. Intimate relationships
d. Self actualization
e. Security
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Pre-test
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A 53 year-old farmer is presenting to your clinic
with 2 weeks’ history of ear discharge, fever
and headache. The management needs of the
patient would include the following except:
a. Identifying the bio-psychosocial concerns o f
the patient
b. Ear syringing or toileting
c. Einsteinian model of care
d. Making a diagnosis
e. Suggesting a prostate specific antigen test
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Pre-test
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Which of the following stages of life is inappropriately
matched with the requirements?
a. Neonate: warmth, caregiver education, routine mop op
immunization, exclusive breast feeding
b. Preschool children: immunization, special education
services, prevention of home accidents, treatment of
infectious diseases
c. Adolescents: reproductive health education, prevention of
substance use, obesity prevention, prevention of road traffic
accidents
d. Middle age: stable homes, stable jobs, religious support
groups, pre conception screening
e. The Elderly: health insurance, nursing homes, hospices,
home based care
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Pre-test
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Which of the under mentioned stages of family
development may require all of the following for
comfortable living: screening for congenital anomalies
in the offspring, prenatal care, counselling for
pregnancy adjustments, immunization and folic acid
supplementation for the wife?
a. Family with teenagers
b. Actualizing family
c. Crystallizing family
d. Emerging family
e. Launching centre family
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Pre-test
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Child developmental disorders which need
special health care and social support services
to enable the affected live a functional life
includes the following except:
a. Sleeping disorder
b. Motor disorder
c. Learning disorder
d. Language disorder
e. Autism
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Pre-test
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oINTRODUCTION
oDETERMINANTS OF HEALTH NEEDS
OF AN INDIVIDUAL
oDETERMINANTS OF HEALTH NEEDS
OF A FAMILY
oMEETING THESE HEALTH NEEDS
oLIMITATIONS AND
RECOMMENDATIONS
oCONCLUSION
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OUTLINE
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NEED
Defined as the gap between a current and a
desired state of being.
Can be objective (measured) or subjective
(perceived) and physical or psychological.
Recognizing that needs change over time, they
are identified through a collaborative process
that is patient-centered, culturally sensitive,
evidence-based or informed, and outcomes
directed.
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INTRODUCTION
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A health need may be defined as what someone requires
in order to live a normal healthy comfortable life.
The continuum of health needs may include:
disease prevention and health promotion
public health and social services provision
 screening and diagnosis of diseases
acute care,
chronic disease management,
rehabilitation,
long term care, survivorship and palliative care.
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INTRODUCTION
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•
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Self-actualization needs
Ego needs
Social needs
Security needs
Physiological needs
The emergence of a new need usually depends on a prior or
lower level need being satisfied.
Individuals seek resolution of the lower unmet needs before
seeking resolution of higher levels.
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Four traditional approaches have been used for looking at
needs.
Basic human needs such as described by Maslow.
Maslow identified five types of needs arranged in a hierarchy:
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TYPES OF HEALTH NEEDS
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ABRAHAM MASLOW’S (1954) HIERACHICAL
PYRAMID OF NEEDS
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Felt or expressed needs
 “Felt" or desired by the individual.
 Individual must be aware of and be
able to express their needs.
 Health care providers might offer
opportunities from which the
customer makes a selection.
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TYPES OF HEALTH NEEDS
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Normative needs
 There is a gap or deficiency
between what is desirable (ideal) and
what actually exists.
 When a gap occurs, the individual
is deemed to be in need. Consider the
case of nutritional requirements.
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TYPES OF HEALTH NEEDS
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Comparative needs
 Seeks to compare the characteristics of
those who are receiving a particular
service or opportunity with those who do
not.
 If you do not have a service,
opportunity or program available to you,
but those in other areas do, then you may
be considered to be in need.
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TYPES OF HEALTH NEEDS
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GH. SSCE
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GENETICS
HEALTH STATUS
STAGE OF LIFE OF THE INDIVIDUAL
CHILD DEVELOPMENTAL PROBLEMS
SOCIOECONOMIC STATUS
ENVIRONMENTAL SITUATION
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DETERMINANTS OF HEALTH
NEEDS OF THE INDIVIDUAL
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Genes are the building blocks of heredity which contain DNA
and are passed on from parents to offspring.
Sometimes a gene mutation can be transferred to an offspring
by one or both parents resulting in a lifelong disorder which
will alter the individual’s ability to live a normal life to some
extent.
Individuals may have peculiar health needs based on their
genetic conditions or their genetic predisposition to certain
disease conditions.
These need to be taken into account when being reviewed by
health care providers. Allowances must be made to
incorporate preconception screening for genetic disorders
where a probability of the disease exists.
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GENETICS
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If the disease is present, special deliberate care must be taken
to identify their peculiar needs, attempt to cater for them and
anticipate other complications which may arise if adequate
care is not provided.
For instance a child with sickle cell anaemia may need special
vaccines to protect them from diseases they are more
susceptible to than the normal population.
For individuals with a genetic predisposition to
hypercholesterolaemia, diabetes and hypertension, lifestyle
counseling needs are a top priority when assessing their
health needs.
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GENETICS
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HEALTH STATUS
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All of the previously listed factors affect the health status of
the individual
Any malfunction of these factors may result in a deficiency
which will result in the individual performing below his
required potential.
This will cause certain adjustments to be made so he can
function maximally.
Disruptions in the any of the areas will in the end affect all the
other areas too. For instance, bad lifestyle choices will affect
the human biology and result in diseases which would require
ongoing care at health centers.
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HEALTH STATUS
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The handicapped may have special needs for
everyday living and in time of disaster e.g. The
hearing impaired may need hearing aids and
special arrangements to receive warning in times
of disaster.
 The mobility impaired will need specially
designed mobility facilities and safety devices in
place for them in case of emergencies.
Expectations / concerns of that person; for
example a person may be concerned about a
particular ailment because of media publicity or
a known friend / colleague who has suffered
from a particular illness.
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HEALTH STATUS OF THE INDIVIDUAL
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Health Needs of the individual will depend on the stage of life of
the individual. Each individual usually passes through the following
distinguished stages which results in peculiar health needs.
Neonatal (1st 28 days of life)
Infancy (1st 2 y)
Preschool (2 - 6 yrs)
School age (6 – 12yrs)
 Adolescence 12-18yrs (girls),14-20yrs (boys)
 Young Adulthood
 Middle age (40 – 65 yrs)
 Elderly>65yrs
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STAGE OF LIFE OF THE
INDIVIDUAL
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Neonates would require
Adequate feeding (exclusive breast feeding)
Immunization
Warmth
Prompt treatment of acute illnesses
Health education to the primary care givers on
how to cater adequately for them.
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HEALTH NEEDS BASED ON STAGE OF LIFE OF AN
INDIVIDUAL- NEONATAL PERIOD
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Infants will require:
Adequate nutrition
Growth monitoring
Immunization
Screening tests to diagnose disease such as
sickle cell anaemia,
Treatment of illnesses peculiar to this age group
(Diarrheal disease, febrile illness etc)
Prevention of home accidents
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HEALTH NEEDS BASED ON STAGE OF LIFE
OF AN INDIVIDUAL- INFANCY
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HEALTH NEEDS BASED ON STAGE OF LIFE
OF AN INDIVIDUALPRESCHOOL & SCHOOL AGE
These individuals would need:
Treatment of illnesses peculiar to this age
group (Diarrheal disease, febrile illness,
infectious illness etc)
Prevention of home accidents
Immunizations
Special educational services for the
challenged (behavioral or physical)child
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HEALTH NEEDS BASED ON STAGE OF LIFE OF AN
INDIVIDUAL -
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Reproductive health Education
Protection against teenage pregnancy,
 Counsel against dangerous peer influence
Alcohol abuse prevention
Substance use prevention
 Obesity
Prevention of road traffic accidents
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Adolescents (12 / 14 years – 20 years) require
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Young Adulthood (20 – 40 years)
 Reproductive healthcare facilities for Contraception (sex
education, family planning etc)
Conception (expectations, demands)
Premarital Screening and Counseling e.g. Genotype
Preconception screening in women to screen for
diseases like Rubella, Hypertension; DM; HIV; Obesity.
Advice on life style changes can be given during such
clinics like stoppage of cigarette smoking, alcohol or
medications that may affect fetal outcome.
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HEALTH NEEDS BASED ON STAGE OF LIFE OF AN
INDIVIDUAL –
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Regular health education on safety especially with
the use of fire arms and to discourage high risk
behavior which can expose them to diseases like STI,
HIV, liver cirrhosis (from chronic alcohol use),
bronchitis, lung cancer (from chronic smoking) and
substance abuse
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Infertility Clinic / gynaecology clinic
Ante natal care / maternity facilities
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HEALTH NEEDS BASED ON STAGE OF LIFE OF THE
INDIVIDUALS-YOUNG ADULTHOOD CONTD……….
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HEALTH NEEDS BASED ON STAGE OF LIFE
OF THE INDIVIDUAL-YOUNG ADULTHOOD
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Individuals working in factories will require safety
garments / goggles, to protect them from occupational
diseases like skin cancers, dermatitis, and lung disease.
Require routine check-ups to treat or exclude such
diseases.
Require regulatory bodies to ensure that safety
precautions and devices are available at the work place.
Health insurance in the case of any casualty.
Rehabilitation facilities for the injured e.g wheel chair
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Based on type of jobs:
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Middle Age (40 -65yrs)
Is a time of change for the individual. Two key
responsibilities dominate this time of life.
 1. Their children; Schooling or leaving homes will
create a lot of financial, emotional and logistics
adjustments for them.
 Needs:
Stable jobs for regular income
Stable homes for mental stability
Social / Religious support groups
Others include same needs as for young adults
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HEALTH NEEDS BASED ON STAGE OF
LIFE OF THE INDIVIDUAL-
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HEALTH NEEDS BASED ON STAGE OF
LIFE OF THE INDIVIDUAL-MIDDLE AGE
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May require their help and care as they face
illness and eventual death
Changes in relationship with spouse occur more
frequently during this period. Thus, this age
group is more prone to stress related illness
(anxiety, depression, fatigue syndrome,
hypertension, separation, divorce) and will need
appropriate health care.
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2. Their parents
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Elderly (above 65 years)
Have special needs because they are faced with
special problems like forgetfulness, poor vision,
impaired mobility, hearing defects etc.
Diseases like cancer and long term complications of
chronic illness or use of medication is more common
in them.
This group of people in addition to regular hospital
visits will require facilities for Home Based Care,
nursing homes, and hospices.
Few of these elderly can afford extended long term
care. Thus, they will require insurance to take care of
them in old age.
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HEALTH NEEDS BASED ON THE LIFE STAGE
OF THE INDIVIDUAL-
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Developmental disorders are a group of psychiatric conditions
originating in childhood that involve serious impairment in
different areas.
These disorders comprise language disorders, learning
disorders, motor disorders and autism spectrum disorders
Individuals with these disorders will require certain special
health care services and social support services to enable
them live a functional life.
They will require access to specialized health centres where
health care procedures should be performed by qualified
personnel who have had child specific training in the
procedure.
Special Educational centres need to be available for them so
they can learn skills to help them live as independently as
possible.
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CHILD DEVELOPMENTAL
PROBLEMS
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 In the school, every student who has a special health care
need requiring nursing care, intervention or supervision
should have a Health Care Plan written by a health care
professional.
In addition to a Health Care Plan, documentation should be
kept on Emergency Information, and an Emergency Plan and
Physician’s Orders for Health Care Procedures should be
readily available.
School personnel who are responsible for the education and
care of students with special health care needs should receive
training from persons who are certified or licensed to perform
the procedures being taught.
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CHILD DEVELOPMENTAL
PROBLEMS
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Social support services should be provided by government and
other establishments like religious bodies, private
corporations(as part of corporate social responsibilities) to
help support them
Health insurance may be made to cover their required health
care procedures as much as is possible
Bills may be passed to ensure employment of these
individuals as they progress into adulthood.
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CHILD DEVELOPMENTAL
PROBLEMS
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The socioeconomic status of an individual may go a long
way in determining the health needs of an individual.
The Indigent who live in crowded areas with poor
sanitation and lack basic amenities are at a high risk of
exposure to diseases.
They may be unable to afford Basic Medical Care so have
a higher rate of morbidity / mortality. Such people will
need access to affordable and accessible healthcare at
little or no cost.
Top career executives with a high socioeconomic status
may live a sedentary lifestyle and be at risk of certain
diseases such as diabetes, hypertension, dyslipidaemia.
They would require counseling on appropriate lifestyle
practices which will enable them live healthier more
productive lives.
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SOCIOECONOMIC STATUS
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The physical environment may affect health either via
physical, chemical or biologic risks.
Physical effects may come from noise pollution which
may lead to deafness, land pollution resulting in
increased infectious diseases from insects and sewage,
air pollution which may result in ARIs and allergies and
electromagnetic waves which may result in cancers.
Chemical effects may come from secondary tobacco
smoke, oil spills and emission of toxic substances from
manufacturing companies.
Biologic risks may arise during disease outbreaks from
polluted physical environments .
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ENVIRONMENTAL SITUATION
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Individuals in these environments have specific health needs
to protect them.
The asthmatic patients would require counseling against
pollutants which may make their symptoms worse. They will
also need access to health facilities to provide emergency care
if needed.
People living in areas with stagnant water and vegetation will
require ITNs to protect them from mosquito bites. They will
also need environmental sanitation education for better
health.
Legislation against smoking in public and industrial pollution
should be enforced.
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ENVIRONMENTAL SITUATION
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STAGE OF FAMILY DEVELOPMENT
FAMILY PROBLEMS
PRESENCE OF A CHRONIC DISEASE IN
A FAMILY MEMBER
CULTURAL SITUATION OF THE FAMILY
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DETERMINANTS OF THE
HEALTH NEEDS OF THE FAMILY
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Health needs of the family will depend on the stage of
family development.
Stages of family development include:

Beginning family i.e Young or newly married couple

Early child bearing

Family with under fives

Family with school children

Family with teenagers

Launching centre family

Middle aged family

Ageing family
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HEALTH NEEDS OF THE FAMILY
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BEGINNING FAMILY
Counseling on: Establishment of
harmonious relationships, adjusting to
pregnancy and planning for parenthood.
Immunization for wife
Prenatal care
Screening for congenital anomalies
Folic acid supplementation
VCT
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HEALTH NEEDS BASED ON STAGE OF FAMILY
DEVELOPMENT
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EARLY CHILD BEARING
Begins when age of first child between birth and 30
months
Counseling on demands of an infant; Exclusive
breast feeding, Complimentary feeding, discourage
use of feeding bottle.
Prevention of Home accidents
Common diseases such as diarrhea, malaria,
respiratory tract infections, acute otitis media etc.
Knowledge of available care for handicap condition
where present.
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HEALTH NEEDS BASED ON STAGE OF FAMILY
DEVELOPMENT CONTD
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FAMILY WITH SCHOOL CHILDREN
Begins when oldest child enters school
Counseling on balancing time and energy
to meet the demands of work, family and
adult social interest.
Other needs similar to preschoolers.
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HEALTH NEEDS BASED ON STAGE OF FAMILY
DEVELOPMENT CONTD
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FAMILY WITH TEENAGERS
Begins when oldest child is a teenager (10 – 13 years )
through adolescents (up to 19 years of age)
Counsel on demand and potential problems of this age
group (increasing independency and peer influence):
Counseling against Alcohol use, Smoking, Substance
abuse
Unwanted pregnancy, Sexually transmitted infections,
Reproductive health issues
Runaways, Fatal motor vehicle accidents
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HEALTH NEEDS BASED ON STAGE OF FAMILY
DEVELOPMENT CONTD
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LAUNCHING CENTRE FAMILIES
Begins when first child leaves home and lasts until
last child has left
Counseling on: Preparing their children to live
independently and accepting the departure of the
children
Reorganizing to re-establish the family units after
the children have left.
Knowledge of middle age issues, such as obesity,
hypertension, diabetes, cancers and other noncommunicable diseases,
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HEALTH NEEDS BASED ON STAGE OF FAMILY
DEVELOPMENT CONTD
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HEALTH NEEDS BASED ON STAGE OF FAMILY
DEVELOPMENT CONTD
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Last child has left home
Knowledge on: Maintaining satisfying
relationships both with aging parents and with
the children and their families.
Planning for retirement
Coping with physical and emotional health.
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MIDDLE AGED FAMILIES
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AGEING FAMILIES
Begins with retirement of one or both spouses and
continues until death of both marital partners
Adjusting to retirement with changing lifestyles and
accepting the deaths of friends and spouse.
Maintenance of general health and nutrition; fresh
food, exercise
Contact with family members
Maintain interest in politics, social events
Prevention of accidents; falls, burns
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HEALTH NEEDS BASED ON STAGE OF FAMILY
DEVELOPMENT CONTD
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Divorce, separation, domestic violence affects the health of
the entire family. Victims are at increased risk of poor health,
depression symptoms, substance abuse, development of
chronic diseases and chronic mental illnesses.
Children raised in such homes develop behavioral problems
such as aggressiveness and disrespect for parents,
involvement in risky behaviors like unprotected sex, drugs,
alcoholism.
Psychological problems like depression, anxiety and post
traumatic stress disorder, eating disorders are common in
such children.
Such a family will need access to health care facilities that can
discover their risks for these problems, prevent them as much
as possible, and manage such disorders / problems if they
arise
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HEALTH NEEDS OF A FAMILY WITH
PROBLEMS
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 Coping with the news of a diagnosis of a chronic disease introduces
a whole new dimension to the family structure. The family is faced
with the situation of readjusting expectations and roles, depending
on the affected family member.
 Needs of other family members often go unnoticed due to the heavy
demand of meeting basic needs of the affected member.
 Family members may also experience bouts of depression as a result
of strain between members over disagreements over treatment
options or the overall responsibility of caring for a the ill member.
 Family isolation may also occur due to the nature of the disease,
especially infectious diseases or diseases which are not well
understood.
 Due to the above, these families will need family counseling and
conferencing sessions to help them cope with the issues at hand and
assign roles amongst themselves in a non-threatening manner
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HEALTH NEEDS OF A FAMILY WITH A
MEMBER WITH A CHRONIC DISEASE
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The physical demands as well as time demands placed
on families can exhaust a family's well-being. Thus health
care services should be made available as well as access
to them in order to prevent burn out of the family
caregivers.
The physical and time demands can interfere with
parents' jobs which can lead to added stress on the
family system. Finding appropriate and quality child care
can also be taxing on the family and may result in one
caregiver staying home to provide the necessary child
care. Social supports in the society are necessary for
theses families. Community centres and churches may
provide the needed care.
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HEALTH NEEDS OF A FAMILY WITH A
MEMBER WITH A CHRONIC DISEASE
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Financial issues can have a tremendous effect on
families. Medical services as well as
transportation and home renovation needs may
be needed.
Much medical technology assistance can be very
expensive, depending on the type of equipment
needed and the severity of the disease or
disability.
Thus, health funding in the form of health
insurance and also social insurance is necessary
for these individuals.
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HEALTH NEEDS OF A FAMILY WITH A
MEMBER WITH A CHRONIC DISEASE
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All cultures have systems of health beliefs to explain what
causes illness, how it can be cured or treated, and who should
be involved in the process.
Western industrialized societies such as the United States,
which see disease as a result of natural scientific phenomena,
advocate medical treatments that combat microorganisms or
use sophisticated technology to diagnose and treat disease.
Other societies believe that illness is the result of supernatural
phenomena and promote prayer or other spiritual
interventions that counter the presumed disfavor of powerful
forces.
These should be taken into account when seeing a family.
Health professionals must be aware of the cultural beliefs in
the community so as to address them while seeing patients.
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HEALTH NEEDS OF A FAMILY BASED
ON THEIR CULTURAL ENVIRONMENT
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Cultural issues also play a major role in patient
adherence.
Certain cultural beliefs may also influence the prevalence
of certain diseases and thus precipitate the need for
certain health and non-health services.
For instance, in cultures where teenage pregnancies are
common, obstructed labour, VVF, RVF may be common,
thus services must be provided to prevent and treat this
if present. These health needs may include free
compulsory education for females, adequate obstetric
services.
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HEALTH NEEDS OF A FAMILY BASED
ON THEIR CULTURAL ENVIRONMENT
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Medical diagnosis(incorporating type & stage of
illness)
Psychosocial concerns or issues
(predisposing/risk factors, contributory factors,
sustaining factors, possible complications)
Needs ( age, gender, socio-economic status,
cultural beliefs, family dynamics, lifestyle,
presence of chronic disorder, peculiar
needs(location, job type, physical challenge)
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Assessing health needs in the
consulting room
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MEDICAL PERSONNEL
FAMILY
COMMUNITY
1. Immediate community
(friends, relations, neighbors, colleagues)
2. Schools
3. Support Groups, Non-governmental organizations
4. International Health agencies e.g. WHO
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WHO IS TO MEET THESE
HEALTH NEEDS
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The Medical Doctor is ultimately responsible for
delivering health care however he cannot function
without the nurses and other health professionals.
Health care can be provided for both the individual
and family through:
Well Baby Clinics; Where growth development is
assessed and minor illnesses are treated. New
diseases like hearing impairment, visual defects and
congenital malformations are discovered. Advice is
given to mothers about feeding, immunization, care
of the newborn / infant.
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MEDICAL PERSONNEL
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Routine Health check visits. During which physical
examination and screening tests for cancers (breast,
prostate, cervix) and diseases like Hypertension, DM,
Glaucoma can be done and advice given on life style
(need for exercises, weight loss, smoking, alcohol
consumption).
New problem visits either on outpatient basis or
through emergency department where diagnosis of
the cause of new symptoms and treatment is given.
Follow up visits for chronic illnesses. To relieve
symptoms, improve, control of disease, discuss
lifestyle or medication issues, and avoid target organ
damage or other complications of the disease.
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MEDICAL PERSONNEL
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Psychological / Behavioral Clinics
During any of the above visits, a doctor may be able
to pick up unapparent problems like / adolescent
abuse, elder abuse, dysfunctional family problems
and other psychosocial disorders.
During family visits, the doctors can help educate
them more on how to improve homecare or help
out in the management of an ill family member. The
doctor / social worker may also be an excellent
source of information about available community
resources e.g support groups, facilities for
handicapped etc.
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MEDICAL PERSONNEL
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HEALTH EDUCATION / AWARENESS
This can be given through the media (Newspapers,
Radio, TV, Internet), at school, churches, at hospitals
and other healthcare facilities, organized gatherings
e.g. seminars.
People could be taught about:-The need to report to
the hospital early in times of illness, simple first aid
and emergency care, safety in the home, during play,
at the work place or the road, reproductive health
and healthy living
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MEDICAL PERSONNEL
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ROLE OF THE FAMILY IN HEALTH
Provision of funds necessary to obtain the required
services
Psychological support to the patient (showing love,
empathy, affection)
Home care.
ROLE OF THE COMMUNITY IN HEALTH
Immediate community (including friends, neighbors,
colleagues) can help by assisting those with special needs
/ disability e.g. helping the hearing / mobility impaired to
get away from danger
Immediate first aid and transportation of the injured
(e.g. RTA victims) to health facilities with emergency care
services.
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WHO IS TO MEET THESE
HEALTH NEEDS CONTD
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SCHOOL AUTHORITIES / TEACHERS
Can help in the education of children about basic
hygiene, safety precautions, nutrition, first aid and
emergency care via the sick bay.
School lunch programme (where balanced meals are
given during breakfast or lunch) can be instituted in
schools.
SUPPORT GROUPS
Can be helpful to families who have members with
disability
Alcoholics, drug addicts can also be encouraged by
joining various support groups.
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WHO IS TO MEET THESE
NEEDS CONTD
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Provision of Basic Amenities like portable water,
accessible roads, good housing
Provision of Regulatory Agencies like:-NAFDAC
Occupational Safety and Health agencies
Road Safety Agencies to ensure safety on the road.
Environmental Protection Agencies will identify types
and sources of pollution e.g. for water pollution.
Provision of Safety / Rescue Agencies e.g. equipped fire
service.
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THE ROLE OF THE GOVERNMENT
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Provision of Health Care Facilities including:
 Hospital Outpatient Department; These can
offer health services by appointment or on a
walk in basis.
 Emergency Centers that are fully equipped.
These may be attached to hospitals or
located at strategic areas (e.g. Express Way).
 Primary health Care Centers. Provide
medical care either in rural or urban areas
that do not have enough physicians and
hospitals.
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Nursing Homes. For the care and supervision
of people requiring help in daily activities like
eating, dressing, bathing, toileting. Patients are
typically elderly.
Hospices. Provides care for people who are
terminally ill, It was based on the philosophy
that if you do not have medical hope of
recovery you should be as comfortable as
possible. Hospices address two big fears of the
dying patient: Fear of pain and Fear of being
alone.
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Mental Health Facilities .
Maternal and Child Care Facilities
Retirement Communities. These are built to meet the
needs of the elderly; facilities for security, maintenance,
provision of meals, basic amenities and home care
(bathing, dressing, taking medications) can be provided.
An on-site nursing home may be available.
Home HealthCare Can be offered by some hospitals
where a nurse goes to the homes of the elderly to
provide services e.g. injections, wounds, dressing, speech
therapy and physiotherapy.
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Rehabilitation Centers
 For people to regain some or all of their physical
abilities that they lost during injury, illness or disease.
e.g stroke patient may need physiotherapist,
occupational or speech therapist to restore use of
muscles affected during the stroke
 The Ministry of Health should set up an adequate and
effective Public Health Sector Department which will
be well funded and prepared especially to respond to
emergency situation (bioterrorism, outbreak of
diseases like SARS, bird flu etc). This will require
adequate planning, surveillance, effective laboratories,
health alert network and communication.
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ROLE OF GOVERNMENT CONTD
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Provision of policies that will enable people
afford and pay for medical services e.g
- Health Insurance Policies
Government aided Insurance Support
Health policies for the elderly e.g in the
United States, all Americans > 65 years have
some of their health problems / bills sorted
out by Medicare.
Encouragement of HMO.
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WHO, UNICEF; Have set up several policies / schemes to
improve health of the populace. For example UNICEF and
WHO have advocated the ‘Child survival Strategies’ in 1987 to
help reduce morbidity, mortality from childhood illness,)
Other programme set up by WHO include:

Tropical Disease Research

Human Reproductive Programme

Control of Diarrhea Disease

Expanded Programme on Immunization

RBM Strategy

Special Programmes on AIDS

MDGS – Millennium Development Goals
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ROLE OF NON-GOVERNMENTAL /
INTERNATIONAL AGENCIES
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 Non-Governmental Organization
affiliated with the WHO e.g. World Bank,
International Monetary Fund (IMF) are
also involved
 World Bank has helped in the training of
health sector staff and in financing
special health sector programmes e.g.
malaria, maternal morality, nutrition.
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INTERNATIONAL AGENCIES CONTD
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Other NGOs include:
 Red Cross
 Save the Children Alliance
 Private Foundations like Welcome Trust,
Ford Foundation, PEPFAR have also played
significant roles.
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INTERNATIONAL AGENCIES CONTD
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Essential health services delivery requires an
adequate supply and distribution of fully
qualified physicians, nurses and other health
care personnel. This is grossly inadequate.
Non availability / Inadequacy of health facilities
especially in rural areas.
Poor accessibility (Bad road network, lack of
means of communication)
Inadequate funding/ maintenance of health
facilities already in place.
Inconsistent health policies.
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LIMITATIONS OF MEETING
HEALTH NEEDS IN NIGERIA
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Little or no provision for the handicapped
/ disabled, elderly
Lack of networking and communication
system to help in collecting/ distribution of
data.
Political and public ignorance of the
meaning and importance of environmental
health and what is involved in protecting
the public.
Poverty / Ignorance
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HEALTH NEEDS IN NIGERIA
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Private sector involvement in health sector
Training of primary care physicians who will
practice in designated underserved areas.
Akin Moses
There is need for more public health awareness.
Poverty alleviation
Political appointments in the health sector should
be health professionals who understand the needs
of the sector.
Salaries of healthcare professionals should be
attractive so as to encourage more people to take up
jobs in the health sector.
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RECOMMENDATIONS
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THANK YOU FOR YOUR
ATTENTION
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