Social Determinants of Health in Africa

Abstract

This chapter examines the social determinants of health (SDH) in Africa. It highlights some theoretical perspectives relevant to understanding the SDH, including the production of health and structural and system approaches. The chapter argues that the high prevalence of both communicable and noncommunicable diseases in Africa is a consequence of adverse social forces that predispose people to various diseases. Africans live in challenging social situations and have a comparatively high disease burden. Most are disadvantaged because the resources required for healthcare are insufficient. The high prevalence of poverty on the continent is significantly associated with poor population health caused by impoverished living and working conditions that negatively impact nutritional status, access to clean water, hygiene, healthcare services, and health status. In Africa, unequal healthcare access and outcomes among social groups are common, and vulnerable populations disproportionately bear the brunt of the disease burden.

Inequalities in the prevalence of Caesarean section and associated factors in rural and urban Nigeria: insights from the 2018 Nigeria Demographic and Health Survey

“…CS prevalence similarly differs between rural and urban Nigeria across geographic, educational, and socioeconomic factors. The substantial divergence in CS utilisation observed in our study strongly suggests limited access or potential barriers in rural Nigerian settings-consistent with the concept of social inequities occasioned by geographic and socioeconomic inequalities 39 . This observation gains further support across regions in the country.…”

“…This position aligns with the ndings of a study on user fee exemption in Nigeria, which revealed lower CS rates among low-income women, notwithstanding the availability of free maternal healthcare services 23 . Thus, a multifaceted intervention strategy, addressing systemic issues (social injustices, for example), promoting high-quality education, ensuring equal opportunities, creating job prospects, and empowering individuals and communities to enhance their economic well-being, is likely to yield more effective and enduring results 39 . Moreover, the distinct urban factor related to religious a liations underscores the need for faith-based and culturally sensitive health communication strategies.…”