An approach to effective health care delivery in a developing nation: A case for Nigeria

Delivery of health care services in the developing countries is at present, yielding little or no results to the people being served due to programme structurelessness and lack of goal orientation. Those charged with programmes relating to health services have failed to identify the health problems in their communities. Even when these problems are identified, lack of planning, effective programme execution and evaluation has often brought failures. The result has been poor health for the people. If health services programmes are to be considered successful there must be guarantees that such services are at the disposal of the people wherever they are. In order to achieve complete geographical and population coverage of health services, a state should be organized into provinces, divisions, districts and sectors with the health services also organized according to levels of care (i.e. primary, secondary and tertiary levels). Thus, in any given province, we shall have a number of divisions, districts and sectors, each determined to serve a certain size of population. Also, the size of the population required for effective provision of different levels of care will increase with the complexity of the medical condition involved. Connecting these levels of care, must be referral system whereby complex cases at lower levels can be spent to the level immediately above. Since many health problems are preventable, particular attention must be paid to this area in the overall health services programme. Notably among measures to be taken are effective immunization programmes and environmental health services, both to be strongly sipported with health education. Immunization of the whole population must be the first task in the field of public health. In addition to coverage of all ages in mass immunization at the onset, a further campaign for routine childhood immunization should be essentially carried out. Another important area is environmental health. At present, a considerable number of the health problems in our society are the consequences of wide range of environmental factors. Most health hazards from the environment are those resulting from water supply, food sanitation, waste disposal, housing, inadequate rodent and insect control, pets and domestic animals, occupational source, air pollution and accidents.