Healthcare delivery in Nigeria has faced major challenges toward achieving universal health coverage. While significant progress was made in the first two decades after the country's independence in 1960, the economic downturn resulting from the plummeting of oil price of which Nigeria was dependent led to a series of twists and turns in the health sector. Health policies were subsequently influenced by external forces, and the adoption of the structural adjustment program signaled a shift from a predominantly welfare scheme to the introduction of user fee and the resultant proliferation of private healthcare provision. This paper discusses the crises that followed the turbulent health policies ever since by identifying some key factors that were glossed over by successive government regimes in formulating health policies in Nigeria. The paper concludes by suggesting a more inclusive model that will ensure equitability in the health sector and accessibility to healthcare services in the country.
This paper discusses the illness narratives of undergraduate students suffering from sickle cell anaemia. The study explores participants' concept of the self in relation to the disease on the one hand, and on the other, the construction of their identity in relation to significant others, friends and the wider community in order to gain a deeper understanding of their symbolic and interactional meanings. Data was generated from six undergraduate students in a private university in south western Nigeria. The qualitative data collection techniques used included in-depth interviews, unobtrusive observation and informal group discussion. The study was conducted over a period of two years and the data were content analysed. The study found that sickle cell patients defined the disease as "natural" due to its hereditary nature. Participants' experiences with the disease in relation to others were described as "frightening", "stressful" and "delimiting" within a broad sociocultural framework that is characterized by empathy and endurance. The findings suggest a more focused awareness campaign that stresses cooperation and understanding of the disease and interactions with sickle cell patients.
The epistemic foundation of reality, especially Westernderived knowledge, is often por trayed as universal and, therefore, as a given, while other forms that do not subscribe to the logic of Western paradigm are challenged and summarily dismissed as inferior to Western form and unworthy of any scientific investigation. The rhetoric of Western versus nonWest ern knowledge (especially those of African tradition), seems to be characterised in patron ising ways that suggest a knowledge form that is inferior to mainstream knowledge system of Western rationality. This rhetoric and ideological orientation are deeply entrenched in academic discourses regarding knowledge production and utility. For the most part, they have become entrenched in Western education and have remained dominant for centuries. The underlying assumptions of the discourse, however, remain unsubstantiated primarily because they are grounded in a scientific tradition that is antagonistic towards other forms of knowledge systems. We argue in this paper that the real difference between Western and African medical knowledge systems is not so much the outcome of the knowledge derived, but in the epistemic foundations that give rise to these knowledge systems. We contend that all forms of knowledge are contingent on specific contexts, and the evaluative criteria designed to measure their universal truth do not serve any useful function except to propa gate a false hegemonic narrative for the sole purpose of domination and exploitation. We conclude by advocating for the expansion of mainstream medical knowledge by researching other forms of epistemology without prejudice.
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