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Understanding the Nigerian Healthcare Delivery System: a Paradox of Preventive Medicine Since the Colonial Epoch

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Understanding the Nigerian Healthcare Delivery System: a Paradox of Preventive Medicine Since the Colonial Epoch International Journal of TROPICAL DISEASE & Health 34(3): 1-9, 2018; Article no.IJTDH.46702 ISSN: 2278–1005, NLM ID: 101632866 Understanding the Nigerian Healthcare Delivery System: A Paradox of Preventive Medicine Since the Colonial Epoch Iroju Opeyemi Anthony1* 1Department of History, Obafemi Awolowo University, Ile-Ife, Nigeria. Author’s contribution The sole author designed, analysed, interpreted and prepared the manuscript. Article Information DOI: 10.9734/IJTDH/2018/v34i330094 Editor(s): (1) Dr. Thomas I Nathaniel, Department of Biomedical Sciences, School of Medicine -Greenville, University of South Carolina, Greenville, USA. Reviewers: (1) Jose Luis Turabian, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Spain. (2) Chinawa Ndubuisi Elijah, Univerity of Uyo Teaching Hospital, Nigeria. Complete Peer review History: http://www.sdiarticle3.com/review-history/46702 Received 27 October 2018 Accepted 16 January 2019 Opinion Article Published 18 February 2019 ABSTRACT No human society is mundane to healthcare delivery method. Apparently, the process of healthcare delivery depicts the extent of the social development of a particular society. However, the healthcare delivery process in Nigeria from the colonial era attained a new paradigm by shifting from the practice of traditional medicine to the western styled patterns. Since the colonial Nigeria, both the traditional and western medicine has been dependable sources of preventive medicine for the Nigeria populace. In spite of the outright condemnation of the traditional healthcare practices, it received unbridled patronage by a larger Nigeria populace, thus the post-independence Nigeria witnessed a paradox of health care delivery. Aim: This paper aims to provide an understanding on the revolutions in the healthcare delivery system in Nigeria since the colonial period. Methodology: An extensive review of literature was carried out to elicit information on the Nigerian healthcare delivery since the colonial period. Results: The study revealed that the Nigerian healthcare delivery system is characterized by high cost. The study also showed that Nigeria has been witnessing inequitable distribution of healthcare facilities since the colonial period. Conclusion: The healthcare delivery system in Nigeria is not a colonial invention but the advent of _____________________________________________________________________________________________________ *Corresponding author: Email: [email protected]; Anthony; IJTDH, 34(3): 1-9, 2018; Article no.IJTDH.46702 the colonial masters brought about an outstanding transformation in the healthcare delivery process of most Nigerian societies. Thus, the practice of preventive medicine is indigenous to the Nigerian people. Keywords: Healthcare; healthcare delivery; Nigeria; colonial; social development; traditional medicine. 1. INTRODUCTION perspective, and as such transcends the physical well being of an individual. Obviously, since the Healthcare delivery system is an enormous colonial period, approaches to healthcare aspect of any human society from time delivery had become a main concern, particularly immemorial. This brings to one’s understanding with the dominant influence of the western styled that the African traditional healthcare delivery healthcare pattern, which invariably is often system was a notable practice in the pre-colonial considered as the most acceptable means to Nigeria. As such, the practice of medicine was solving health related problems. By implication, indigenous to the people of Nigeria. Hence, it is the traditional method to healthcare became erroneous to believe that medical services came considered unacceptable to the western to Nigeria with the advent of British colonisation healthcare approach. Nevertheless, the way and [1]. Accordingly, health service in Nigeria today is manner in which the traditional approach to to a large extent based on orthodox healthcare healthcare continue to survive and thrive depicts delivery system, yet it can be said that the a sustainability of the indigenous health African traditional medicine is unconsciously a institutions in spite of modernity associated to the part of the world from which most of the modern colonialism and the post-colonial experience in medicine has evolved [1]. This simply posits that Nigeria. the traditional medical practice is pivotal to the discovery of what became known as modern It is from this perspective that this paper seeks to medicine. Hence, western medicine seems critically examine the dynamics of the healthcare difficult to be separated from the traditional delivery system in Nigeria. An emphasis on the medicine. Nevertheless, western medicine is factors relating to the dichotomy between the two observed to have had an overbearing influence predominant forms of healthcare delivery system on the African traditional healthcare since the in Nigeria is considered in this paper. emergence of the European in Africa, and Furthermore, the paper historicises the factors Nigeria in particular. In fact, David Arnold is of that played out to the gradual relevance of the the view that the practice of modern form of traditional healthcare delivery system in the late th medicine is a colonising process [2]. To this end, 20 century. This is in line with the view of the the western healthcare delivery system is World Health Organization (WHO) which symbolic of civilisation and modernity which recognizes traditional healthcare delivery system understandably is antithetical to the African as a preventive medicine [1]. healthcare system which is perceived as being uncivilized by the forerunners of the western The remainder of the paper is as follows: section healthcare system. 2 deals with colonialism and the dynamics of healthcare delivery while section 3 discussed the Emphatically, the colonial and western contact Nigerian healthcare system in the post had profound consequence on the African independence period. Section 4 concludes the traditional world view. That is, the traditional study. system and values are rated low and inferior as compared to western values and culture. 2. COLONIALISM AND THE DYNAMICS Apparently, the indigenous institution of OF HEALTHCARE DELIVERY healthcare in Nigeria to a very large extent forms part of the cultural settings and religious belief It is truism that the healthcare delivery system in system of the people. That is, the traditional Nigeria is not a colonial invention. This was religion explains the well being of an individual. evidenced by the indigenous medical practice Falola posits that, to ensure good health, children that was intrinsic to the over 400 ethnic groups and prosperity, it is strongly believed that spiritual that later became Nigeria in 1914. These beings must be worshipped [3]. This expression indigenous medical practitioners were known clearly opines that, health in the traditional sense throughout the various ethnic groups as in Nigeria is viewed from the religious traditional healers [4]. Prior to colonial rule, these 2 Anthony; IJTDH, 34(3): 1-9, 2018; Article no.IJTDH.46702 traditional healers had variant names by different with the advent of British colonisation [1]. The groups. Among the Yoruba, the traditional colonial health service structure no doubt healers were referred to as babalawo, adahunse established the western medical practices as or onisegun and iya agbebi (midwives) [5]. The the most dependable healthcare system. role of the babalawo was to diagnose and heal Nevertheless, the African traditional medicine is the sick through the use of medicinal herbs (such unconsciously a part of the overall traditional as stem, bark, leaves, root, fruits, seeds, and medicine of the world which most of the modern flowers), animals (such as snakes, tortoise, scientific medicine has evolved [1]. This simply snails, lizards, chameleons and insects) and implies that traditional medicine is a key factor in minerals (such as salt, alum and camphor). the evolution of modern scientific medicine. However, in cases where the ailments persist, However, this is not to conclude that in practice, the babalawo consults his oracle and prescribes both shared similarities in its forms. the appropriate rituals and sacrifices in order to reveal the cause and cure of the ailments. The From historical perspective, the first half of the duty of the iya agbebi (midwives) on the other 19th century marked the revolutionary period in hand was to take care of pregnant women and to the healthcare system in Nigeria. Schram assist them during labour or childbirth. In the succinctly affirms that, by the first half of the 19th Igboland of Nigeria, the traditional healers were century, the Church Missionary Society began referred to as the dibia. Their role was to help the introduction of modern scientific medicine [8]. individuals to understand the forms of their Hence, the modern scientific medicine was illness and how to cure them [6]. They also gradually established as an alternative to the performed rituals to appease gods on behalf of several existing indigenous system of medicine individuals in the community. The Wombai [9]. Understandably, the provision of healthcare dominated the Hausa land during the pre-colonial became a colonial policy intended towards period [7]. Their major role was to provide care ensuring a better living condition for the people for the sick and the wounded during wars while within the Nigerian State. Since the pre-colonial the Gozan of the Nupe
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