Recent statistics from the World Health Organization (WHO) regarding Nigeria’s health status is deteriorating; the average life expectancy at 54 years is below the global average, maternal mortality is 608 per 100,000 live births, twice as high as South Africa’s 300 per 1,000 and almost 10 times Egypt’s 66 per 1,000. Besides, only 3% of HIV-positive mothers receive antiretroviral treatment. According to Omeruan et al. (2009), the major challenges of Nigeria healthcare system have been due to the unplanned consequences of social policy and declining health expenditure. Consequently, health services in Nigeria have suffered from various neglect and these had caused harm to the health status and national productivity. Women, children, and especially the core poor, die from avoidable health problems such as infectious diseases, malnutrition, polio, guinea worm, measles, complications at pregnancy and childbirth. Government’s expenditure has not provided adequate health infrastructure, especially in the rural areas of primary health care. The health sector suffers from the dearth of unqualified healthcare personnel and regulations, as Nigeria’s promising doctors, pharmacists, nurses and other health professionals continue to migrate from Nigeria to apply their services more profitably in other countries. Nigerians are being denied quality health care services, especially those in the rural areas. High profile individuals, especially the political class, continue to fly abroad on regular basis for medical treatment, further widening the inequality in accessing health care services. An increase in government expenditure and growth in per capita output in Nigeria do not speak for the increase in social welfare and health status in particular.
In Nigeria, ill-health is the major cause of hospitalisation and lack of drugs in the hospital is the major fall out leading to the patronization of quacks by patients coupled with suboptimal treatment of cases and inappropriate drug consumption.
Ill health caused about 90% of all morbidity and mortality in almost all ages and sex groups. It is also the leading cause of mortality in children below five years, a significant cause of adult morbidity, and the leading cause of workdays lost due to illness and diseases.
Malaria, in particular, is responsible for over 90% of reported cases of the tropical disease in Nigeria which suggests that it could be the largest contributor to total disease burden and productivity losses resulting from major tropical diseases in the country. Apart from HIV infection, which generally causes deteriorating health, lost labour time due to malaria is lesser, because children are more vulnerable to malaria than adults, whereas it is the opposite for HIV. Studies have shown that per malarial attack; typically entail a loss of four working days, followed by additional days with reduced capacity for about four episodes per year (Brohult et al., 1981; Picard and Mills, 1992). This implies that about 16 working days are lost in a year.
Malnutrition and food insecurity obviously cause health to deteriorate; unbalanced diet results in chronic diseases such as cardiovascular disease, cancer and diabetes (WHO, 2007). Poor environmental hygiene, malnutrition and infections by some parasitic micro-organisms often lead to sickness. Water is therefore said to be the major cause of man’s illness in ill health leads to a decrease in the time available for productive activities, increases in the cost of care and disease prevention, reduction in leisure time and disutility due to pains and inconveniences associated with sickness.
A country’s capability to improve its national output growth over time depends almost entirely on the size of its labour force. The increase in the healthy labour force, in turn, raises productivity. In Nigeria, labour productivity growth has been declining. This is because there is a huge decline in output per worker over the year due to ill-health. Following the structural adjustment programme in Nigeria, labour market underwent problems of unemployment which had an adverse effect on the health status of individuals in the economy as many public and private sector down-sized and these scenarios resulted in low production capacity. An analysis of the Nigerian labour force by sector shows that the industry sector that employs labour force less contributed more to the GDP while the Agricultural sector that employs the largest number of labour contribute less to GDP. (CIA World Fact Book (2009)). This implies that amount of labour force may not necessarily translate to high productivity especially when the health status of the concern labour force is low.