Podcast
Questions and Answers
Match the health policies with their focus areas:
Match the health policies with their focus areas:
National Health Policy 1988 = Based on the Alma-Ata declaration, promoting health for all by 2000. Revised National Health Policy 2004 = Aligned with the health sector reform agenda. National Health Act 2014 = Provides a legal framework for health services. National Health Policy 2016 = Focuses on achieving universal health coverage.
Match the components of the health system with their primary objective:
Match the components of the health system with their primary objective:
Health Financing = Sustainable funding and financial risk protection. Health Infrastructure = Adequate and well-distributed facilities. Health Information System = Integrated system for decision making. Human Resources for Health = Adequate health workforce at all levels.
Match the levels of the Nigerian health system with their responsibilities:
Match the levels of the Nigerian health system with their responsibilities:
Primary Level = Providing preventive care at the local community. Secondary Level = Providing services for serious cases referred from primary care. Tertiary Level = Formulating national health policies and providing specialized care. All Levels = Integrating inter-sectoral collaboration for health delivery.
Match the cultural elements with their descriptions:
Match the cultural elements with their descriptions:
Match the stages of the cultural process with thier characteristics:
Match the stages of the cultural process with thier characteristics:
Match the elements of culture in the Nigerian context with examples of their impact on health
Match the elements of culture in the Nigerian context with examples of their impact on health
Match the components of Task Shifting Policy (TSP) with the appropriate description:
Match the components of Task Shifting Policy (TSP) with the appropriate description:
Match the levels of Emergency Obstetric and Newborn Care (EmONC) with their healthcare services:
Match the levels of Emergency Obstetric and Newborn Care (EmONC) with their healthcare services:
Match the AnteNatal Care (ANC) tasks with the associated frontline Health Care Workers (HCWs):
Match the AnteNatal Care (ANC) tasks with the associated frontline Health Care Workers (HCWs):
Match the Labour and Delivery Tasks with the associated frontline Health Care Workers (HCWs):
Match the Labour and Delivery Tasks with the associated frontline Health Care Workers (HCWs):
Match the Immediate Post Natal Tasks with the associated frontline Health Care Workers (HCWs):
Match the Immediate Post Natal Tasks with the associated frontline Health Care Workers (HCWs):
Match the Immediate Newborn Care Tasks with the associated frontline Health Care Workers (HCWs):
Match the Immediate Newborn Care Tasks with the associated frontline Health Care Workers (HCWs):
Match the Postnatal Care Tasks with the associated frontline Health Care Workers (HCWs):
Match the Postnatal Care Tasks with the associated frontline Health Care Workers (HCWs):
Match the Post Abortion Care Tasks with the associated frontline Health Care Workers (HCWs):
Match the Post Abortion Care Tasks with the associated frontline Health Care Workers (HCWs):
Match the Family Planning Tasks with the associated frontline Health Care Workers (HCWs):
Match the Family Planning Tasks with the associated frontline Health Care Workers (HCWs):
Match the IMCI Tasks for Under-5 children with the associated frontline Health Care Workers (HCWs):
Match the IMCI Tasks for Under-5 children with the associated frontline Health Care Workers (HCWs):
Match this policy plan with the following description: Designed to improve the numerical strength of the existing health facilities rather evolving a clear health care policy, federal government with the assistance of the World Health Organization introduced the Basic Health Service Scheme as part of efforts to achieve the then WHO standard of 1 doctor to 10,000 populations.
Match this policy plan with the following description: Designed to improve the numerical strength of the existing health facilities rather evolving a clear health care policy, federal government with the assistance of the World Health Organization introduced the Basic Health Service Scheme as part of efforts to achieve the then WHO standard of 1 doctor to 10,000 populations.
Match the descriptions to the correct Tier in the Nigerian Healthcare System
Match the descriptions to the correct Tier in the Nigerian Healthcare System
Match the following descriptions to the correct disease or condition:
Match the following descriptions to the correct disease or condition:
Match the following examples of public communication campaigns to the best description:
Match the following examples of public communication campaigns to the best description:
Match the factors for a developed country with the correct disease profile:
Match the factors for a developed country with the correct disease profile:
Match the following steps to the best description:
Match the following steps to the best description:
Match the following descriptions to the best example of bias:
Match the following descriptions to the best example of bias:
Match the best term to the following description: 'When individuals in studies give answers to what makes them look good, instead of the truth'
Match the best term to the following description: 'When individuals in studies give answers to what makes them look good, instead of the truth'
Match the study design to the description:
Match the study design to the description:
Match the following to the best description: How one treats a condition or an illness.
Match the following to the best description: How one treats a condition or an illness.
Match the descriptions to the best public health initiative:
Match the descriptions to the best public health initiative:
Match the term to the BEST description of what it means:
Match the term to the BEST description of what it means:
Match the public health description to what it is testing and for
Match the public health description to what it is testing and for
Match the government organization to the specific responsibility:
Match the government organization to the specific responsibility:
Match the best statement to this description: A method for quantifying the disease impact on a population that incorporates both the length of life lost as well as the level of the impairment during life into one composite metric.
Match the best statement to this description: A method for quantifying the disease impact on a population that incorporates both the length of life lost as well as the level of the impairment during life into one composite metric.
Match the stage to the best description: An approach to address health issues that considers factors beyond medical treatments, involving social, economic and environmental factors to impact.
Match the stage to the best description: An approach to address health issues that considers factors beyond medical treatments, involving social, economic and environmental factors to impact.
Match the descriptions to the best word used in public health:
Match the descriptions to the best word used in public health:
Match the word with the description to assess public health:
Match the word with the description to assess public health:
Match the public health intervention with the description for how to prevent a disease or death:
Match the public health intervention with the description for how to prevent a disease or death:
Match the theory to best behavior change application in public health for individual or community impact:
Match the theory to best behavior change application in public health for individual or community impact:
Match the following terms to describe health systems with their definition:
Match the following terms to describe health systems with their definition:
Match the correct description to the following common term: Policies that protect individuals health in workplace.
Match the correct description to the following common term: Policies that protect individuals health in workplace.
Flashcards
Health
Health
A state of complete physical, mental, and social well-being, not merely the absence of disease.
Policy
Policy
Statements and decisions defining priorities and main directions for attaining a goal.
Health Policy
Health Policy
A set of clear statements and decisions defining priorities and main directions for improving health and health care in a country.
System
System
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Health System
Health System
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Population
Population
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Population Policy
Population Policy
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First Ten Year Development Plan
First Ten Year Development Plan
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First National Development Plan
First National Development Plan
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Second National Development Plan
Second National Development Plan
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Third National Development Plan
Third National Development Plan
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Fourth National Development Plan
Fourth National Development Plan
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National Health Policy 1988
National Health Policy 1988
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Governance and Stewardship
Governance and Stewardship
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Health Services
Health Services
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Health Financing
Health Financing
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Human Resources for Health
Human Resources for Health
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Health Infrastructure
Health Infrastructure
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Health Information System
Health Information System
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Health Research
Health Research
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Partnership for Health
Partnership for Health
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Community Participation and Ownership
Community Participation and Ownership
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Objective of National Health Policy
Objective of National Health Policy
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Primary Level of Healthcare
Primary Level of Healthcare
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Secondary Level of Healthcare
Secondary Level of Healthcare
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Tertiary Level of Healthcare
Tertiary Level of Healthcare
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Cultural Factors (affecting health)
Cultural Factors (affecting health)
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Tradition
Tradition
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Customs
Customs
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Beliefs
Beliefs
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Taboos
Taboos
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Practices
Practices
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Personal Factors
Personal Factors
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Task Shifting Policy
Task Shifting Policy
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Basic Emergency Obstetric and Newborn Care
Basic Emergency Obstetric and Newborn Care
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Comprehensive Emergency Obstetric and Newborn Care
Comprehensive Emergency Obstetric and Newborn Care
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Study Notes
Common Terms and Definitions Relating to Healthcare
- Health: A state of complete physical, mental, and social well-being
- Policy: Clear statements and decisions defining priorities to attain a goal through organizational decisions and mechanisms.
- Health Policy: Clear statements and decisions to improve health and healthcare, aiming to enhance communication among health policy stakeholders.
- System: A complex whole with interconnected parts to achieve objectives.
- Health System: Organizations, institutions, and resources devoted to producing health actions, with the goal of protecting and improving people's health, promoting, restoring, and maintaining health, and preventing household poverty due to illness.
Building Blocks of a Health System
- Leadership and governance
- Health financing
- Health human resources
- Health services
- Health information system
- Medical products, vaccines, and technology
Population-Related Definitions
- Population: The number of people in a geographical area, or a subgroup of people or animals.
- Population Policy: Purposeful measures aimed at affecting demographic processes like fertility, mortality, and migration.
Health System Development in Nigeria
- Before 1988, health care programs were in development plans, with no comprehensive National Health Policy.
First Ten Year Development Plan for Development and Welfare 1946-1956
- The Walkers-Harkens Plan (1946-1956) was the first official plan for developing health services in Nigeria, conceived as a modest framework, however the 1952 constitution divided the country into three regions, transferring powers to Regional Representatives.
Regional Health Plans in the Period 1952-1962
- The Government of Western Nigeria produced the first regional health policy paper, with the Northern and Eastern Regions following.
- These plans were mostly noncommittal on new issues, and the Federal Minister of Health's attempt to introduce a Health Insurance Scheme in Lagos in 1963 was unsuccessful.
First National Development Plan 1962-1968
- The Nigerian government designed this plan after independence emphasizing construction of health centers to improve public health, however it neglected provenative medicine and the rural population.
Second National Development Plan 1970-1974
- The General Yakubu Gowon administration focused on correcting deficiencies from the first plan and restoring health facilities destroyed during the civil war from May 30, 1967, to January 8, 1970.
- The plan's failure was due to the civil war's aftermath and the resulting challenges.
Third National Development Plan 1975-1980
- The focus was on improving the number of existing health facilities as apposed to evolving clear health care policy, in 1976, the federal government, partnered with the World Health Organization, introduced the Basic Health Service Scheme, aiming for the WHO standard of 1 doctor to 10,000 people.
Main Objectives of the Basic Health Service Scheme
- Increase the coverage of medical services from 25% to 60%.
- Give priority to preventive health measures.
- Guarantee community involvement in health service delivery.
- Use suitable medical technology in each community.
Strategies of Basic Health Service Scheme
- Train health personnel from the community to support doctors and nurses.
- Build health structures, including 19 schools of health technologies and comprehensive health center in each local government with 4 primary health centers and 20 health clinics.
Fourth National Development Plan 1981-1985
- Designed under President Alhaji Shehu Shagari, it identified shortage of manpower and poor state of private medical practice, mal-distribution of health institutions favoring of urban centers with just 20% of the total population as problems.
- It was the 1st plan allowing the local government tier to participate fully and included all government levels through self-reliance, focusing on equitable distribution of healthcare through the Basic Health Service Scheme.
Objective of the Fourth National Development Plan
- Provide adequate and effective PHC for the entire population and achieve 80% coverage.
- Correct imbalance among preventive programs in the 8 components of PHC
- Use local government authorities as the basic implementation unit and the federal ministry of health as the coordinating agency.
Factors Facilitating the Success of the 4th National Development Plan
- Global awareness and pressure to make healthcare accessible.
- Favorable political
- Effective leadership from the federal ministry of health
Reasons for the Failure of the 4th National Development Plan
- Inadequate strategies for implementation.
- Huge amount spent on salaries and personnel.
- The scheme was delayed due to a change in government in 1983.
The National Health Policy 1988
- The first National Health Policy predicated on the Alma-Ata declaration of 1978 which promoted “health for all by the year 2000”.
- Minister of Health Professor Olikoye Ransome-Kuti worked to implement PHC Policy based on the Alma Ata Declaration, introducing a comprehensive national health policy focusing on preventive medicine and healthcare services at the grass root.
The National Health Policy 1996
- Maintained Primary Health Care, however was not formally endorsed.
The Revised National Health Policy 2004
- The National Health Policy was revised.
Other Relevant Policies
- National Strategic Health Development Plan (or NSHDP) (2010-2015)
- National Health Act 2014
- National Health Information System Policy 2014
- National Health Policy 2016
- Health Sector Component of the National Food and Nutrition Policy and Strategic Plan of Action 2014-2019
- National Strategic Health Development Plan II (NSHDP II) 2018-2022.
Managerial Tools in Health Development
- Governance and Stewardship: Control to ensure directives with authority, leadership, and policy environment to deliver health care.
- Health Services: Preventive, curative, promotive, and rehabilitative health care to ensure access to quality care for all Nigerians and strengthen traditional medicine.
- Health Financing: Sustainable funding to provide quality health services and ensure financial risk protection, including revenue generation, and purchasing.
- Human Resources for Health: Providing an adequate health workforce for all levels.
- Health Infrastructure: Adequate and well-distributed healthcare facilities that meets quality and safety standards.
- Health Information System: Integrated health information system for decision-making at all levels, providing data to inform policy and resource allocation.
- Health Research: Organized study to discover facts related to health, developing a robust research system for reliable health data.
- Partnership for Health: Cooperation among groups to improve health, promoting partnerships among sectors for optimal resource use.
- Health Promotion, Community Participation and Ownership: Encouraging community involvement to strengthen active participation and ownership in health planning.
Philosophy of the Nigerian Health Care System
- The goal is to improve healthcare accessibility to primary, secondary, and tertiary care. PHC is seen the main focus for delivering effective service through community planning, inter-sectoral collaboration, and enhancing functional integration.
- Decree No 29 established a National Primary Health Care Development Agency (NPHCDA) in 1992 to institutionalize PHC services, including monitoring, resource mobilization, and technical support.
Levels of the Nigerian Health System
- The Nigeria health system operates inter related federal, state, and local government levels with primary, secondary, and tertiary levels of health care delivery.
Functions of the 3- Tiers (Level) Of Health Care
- Local Government Area (Primary) Level: provides community focused preventative PHC services, mobilizing community members, recruit PHC staff, enforces environmental laws and implements PHC services
- The State Government (Secondary) Level: provides health centers services for serious cases referred from PHC, establishes facilities, and manages institutions.
- The Federal Government (Tertiary) Level: the height of health care, which formulates polices and gives funds and support.
Primary Level Health Team
- Medical officer of health - chairman, community health officers, community health Extension workers (Junior & Senior), Voluntary Village Health workers (VVHW) and TBAS, Registered Nurses and Midwives, Environmental health Officers, Medical laboratory and Pharmacy Technicians, Dental therapist, medical health record officer and others as relevant.
State Level Health Team
- Medical Doctors, Registered Nurses/Midwives, Pharmacists, Laboratory Technologists, Radiologists and other supportive staff.
Tertiary Level Health Team
- Ophthalmologists, Otolaryngologists, Gynaecologists, Obstetricians, Consultants, Professors, Pharmacists, Laboratory Scientists, Radiologists, Psychiatrists, Dermatologists, Statisticians, and Nurses/Midwives
Rationales for the 3-tiers
- Ensures prevention and treatment of common problems from the grass-root level
- To facilitate the referral and treatment of more serious cases to a more specialized centre
- To avoid waste of resources
Factors Affecting Health Globally and in Nigeria
- Health is influenced by cultural, social, economic, environmental, and personal factors.
Cultural Factors
- Customs, beliefs, taboos, and practices that affect health and well-being.
- Elements of Culture:*
- Tradition (customary activities), Customs ideal norms with negative health impacts
- Beliefs opinions regarding events
- Taboos forbidden activities
- Practices event carried out by individuals
Socio-economic Factors
- Includes lack of knowledge, inadequate infrastructure, poverty, illiteracy, and negative attitudes towards modern health systems affecting people's health and ability to address health needs.
Environmental Factors
- Air pollution, inadequate waste disposal, poor housing, water, and air pollution.
Personal Factors
- Personal hygiene and health awareness, affect individual's well-being including observance of simple rules about health behaviour
Approaches to Health in Different Political Development Levels
Healthcare System in Developing Countries
- Characterized by the coexistence of modern and traditional health services without integration.
- Modern health services are inversely proportional to the health needs of the majority
- Modern health care services are concentrated in the urban areas
- Health care services are institutionalized for dealing with specific diseases
- Healthcare systems are more curative oriented
Health Care System in Developed Countries
- Priorities on modern health care services, directly proportional services
- The services are directly proportional to the health needs of the majority of the population
- The services are equitably distributed across the nation
- Health care services are institutionalized for dealing with all forms of diseases
- The services are preventive oriented
Health Status in Developing Countries
- Low health status
- Uncontrolled population growth
- High mortality/morbidity rates
- Lack of infrastructure
- Unstable government and economy
- Lack of medical services
Health Status in Developed Countries
- High health status
- controlled population growth
- Low mortality/morbidity rates
- Infrastructure is functional
- stable economy
- readily accessible medical services
Introduction to Task Shifting
- One of the strategies for achieving the MDGs 4, 5, & 6 and in recent times SDG 3. The policy focuses on priority areas like reproduction, maternal and newborns as well as HIV, TB, malaria and communicable diseases.
- Task shifting aims to scale access to effective health services by using mid-level workers.
Task Shifting Policy
- Rational redistribution of tasks to improve the efficient usage of less qualified workers for a greater amount. This aims to strengthen the health system and improve critical services within reproductive, maternal, newborn and child health RMNCH, tuberculosis, malaria and HIV
Emergency Obstetric and Newborn Care (EmONC)
- Integrated care to equip facilitate to offer with evidence based interventions. This caters to material and new born mortality, with basic (BEmONC) and comprehensive (CEMON.
- Signal functions are the indicators of the leverl of care being providing at a maternity centre or key intervention to maternal and newborn death.
Routine Maternal Care
- Monitoring and managing labour using the Partograph
- Infection prevention measures
- HIV testing and counseling
- Care for HIV-positive mothers and HIV-exposed infants
- Use of ARV for PMTCT if mother is HIV-positive
BEMOC for Mothers
- Parental administration of MgSO4 for severe pre eclampsia and eclampsia
- Assisted vaginal delivery
- Parental administration of oxytocin for haemorrhage
- Parental administration of antibiotics for maternal infection
- Manual removal of placenta and retained product of conception
CEMOC for Mothers
- Cesarean Section
- Laparotomy for ectopic pregnancy
Routine Newborn Care
- Thermal protection
- Exclusive breastfeeding
- Infection prevention including hygienic cord care and application of chlorhexidine to prevent umbilical cord sepsis
- Use of antiretroviral drugs for HIV-exposed babies
BEMONC for Newborn
- Antibiotics for prevent infection
- Corticosteroids in preterm labour
- Newborn resuscitation using ambu-bag
- Kangaroo mother care for low birth weight babies
- Alternative feeding for baby unable to breastfeed
- Injectable antibiotics for neonatal sepsis.
CEMONC for Newborn
- Intravenous fluids and administration of oxygen
Frontline Health Care Workers: Tasks and Recommendations
- ANC Tasks assigned to CHEW*
- Identify and refer pregnant women in the community to go to the antenatal clinic (JCHEW)
- Takes appropriate history by asking relevant questions
- Conducts physical examination
- Assesses needs of women and her family
- Gives appropriate advice and guidance
- Perform routine screening test including testing for HIV
Labour and Delivery Tasks
- Perform vaginal examination
- Identifies onset of labor
- Initiate and/or Continue ARV for HIV positive pregnant women
- Use partograph to monitor progress of labor, maternal and fetal well-being and take appropriate action, including referral where required
Immediate Post Natal Tasks assigned to CHEW
- Performs active management of the third stage of labour (AMTSL)
- Administers uterotonic (oxytocin or misoprostol)
Immediate Newborn Care Tasks assigned to CHEW
- Provides essential newborn care
- Helps the baby breath in the first one minute from birth
- Promotes initiation of breastfeeding and educate mother positioning and attachment for breastfeeding.
Postnatal Care Tasks assigned to CHEWs
- Provides information and counseling on self- care, nutrition, safer sex, breastfeeding, PP family planning, healthy lifestyle.
- Assesses maternal well-being including maternal nutrition
- Supports exclusive breastfeeding
Post Abortion Care assigned to CHEWS
- Provides contraceptive method or refers as necessary
- Provides emergency contraceptives
- Screen women and families for signs of domestic and sexual violence, take first line measure and ensure effective referral
Family Planning Tasks assigned to CHEW
- Provide FP education/counseling and help women choose preferred method of contraception
- Promote dual protection for HIV positive
- Provide contraceptive method or refer as appropriate
Tasks in IMCI for Under-5 children
- Identify and Check for general Danger Signs for referral
- Identify, classify and treat for difficult breathing as severe and pneumonia or very severe disease; pneumonia or no pneumonia
- Identify, classify and treat dehydration as severe; some or no dehydration
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