Health inequalities

1. Inequalities in Healthcare
access and outcomes:
Policies and Strategies

2. Introduction
Basically, health disparities are the unfair and avoidable differences in health that occur across different parts of the population
and between different socioeconomic groups. Considerations including life expectancy, the prevalence of potential health
concerns, and access to treatment are all important (Chukwudozie, 2016).
Where we are born, where we grow up, where we live and work, and where we age may all have an impact on our physical and
mental well-being. This word refers to the "broader determinants of health," which are just as important.
It is sometimes a difficult and time-consuming endeavor to make connections between the many larger determinants of health.
When unemployed, people often have to make compromises, such as downgrading to a smaller apartment without a yard or
giving up their habit of buying costly, perishable fruits and vegetables. This suggests that certain demographic groupings have a
higher risk of ill health than the general population as a whole. Access to healthcare is another area where disadvantaged
populations suffer disproportionately (Palmer et al., 2004).
A number of factors might be at play here.
Hours of Operation
Verbalization (spoken and written)
Possibility of obtaining transportation
Childcare
Literacy
a lack of assurance brought on by erroneous beliefs and previous failures
These inequalities disproportionately affect people of African, Asian, and other minority ethnicities, as well as those who fall

3. There are big differences in health outcomes across communities.
Health inequities are persistent and far-reaching, affecting everyone from the place of supply to the point
of arrival. While it would be tragic if everyone was unable to enjoy optimal health, it would be unjust if
health disparities persisted despite being avoidable. Qidwai et al. (2004) state that healthcare equality
occurs when there is a fair distribution of both healthcare resources and healthcare services. This is
done regardless of attention to a person's socioeconomic status, with the sick, poor, and powerless
constituency being the major focus. Financial and political resources are needed to achieve healthcare
equality. Financial stability is a key factor in determining healthcare spending (Qidwai et al., 2004).
Tests, research funding, proper and current infrastructure, and consumer accessibility to these facilities
are all essential components of an effective healthcare system that contribute to early disease diagnosis
and improve the health of a country. The eradication of the disease in African countries is hindered by a
lack of sufficient financing for healthcare (Mensah, 2014).
Health and social care policies and procedures provide the framework for delivering services in a variety
of contexts and instruct caregivers on how to manage various aspects of service provision.
This article examines how various national policies have attempted to address health, care, and
economic inequalities. It's not only about health care access but also about health care outcomes
inequality. Health disparities are compounded by socioeconomic, governmental, and wealth disparities.
Risks linked with conception, development, and mortality may be minimized by adjusting these life
periods' individual settings.

4. Plans and Methods
To steer everyone's efforts in a certain way, leaders issue policies. Policies are a kind of long-term plan that may provide light
strategies. Policies may be used in any way the management deems appropriate. For instance, if a firm decides to launch a ne
division, it will need to make certain choices about recruiting in accordance with the policy, including whether to look internally
outside for applicants, the salary range to provide and any other perks that should be offered. A company's rules are like a ro
map; they help everyone stay on the same page and foster a steady, structured atmosphere for the business (HESRi 2019).
HESRi (2019) defines strategies as "the planned, deliberate actions by which an organization seeks to attain its objectives." It's
comprehensive plan for completing the task at hand. By "comprehensive plans," we mean those in which we detail our long-ter
objectives, settle on a course of action, and allocate the necessary resources. If a business has carefully considered its options
may be better able to adjust to its dynamic environment. Typically, the decision is made at the executive level of the firm.
One such policy is the World Health Organization's (WHO) Health Equity Policy Tool (2019), which maps out a set of actionab
steps leading from five health criteria to policy areas in the name of health equity. The World Health Organization's Health Equ
Status Report is an additional useful tool (HESRi 2019). It helps governments monitor, enforce, and execute policy action
particular areas to decrease health inequities.
In the UK, we see four different kinds of health inequalities. Factors such as protected characteristics, a socioeconomica
disadvantaged population, the presence of marginalized groups in terms of health, and geographical isolation are all example
This has been shown by (Gelormino et al., 2015). Each of these facets represents a possible barrier to or effect on the policy
implementation and must be addressed.
In each of these regions, there is a subset of the population that suffers from a lack of healthcare options or a sufficient quality
life (Fig. 1)

5. Fig. 1. Domains of health inequality (Source: Dalgren G.,
1995)

6. Building Blocks of a Strong Maternity Leave Policy
Maternity leave is the period of paid leave provided to working moms so that they may care for their families and
continue to advance in their chosen fields. It's formal recognition of moms' contributions to society and the
economy. It's crucial for the success of women in the workplace, where they need to be treated with dignity,
given equal opportunities, and protected from discrimination and harassment.
Instead of just the usual maternity leave and pumping breaks, moms are now protected in seven other ways.
The right to breastfeed, access to quality child care, paid and unpaid maternity leave, access to quality
healthcare, job stability, and protection from discrimination are all fundamental.
According to ILO, (2014), employees in the public sector may be excluded from or given preferential treatment
compared to those in the private sector, agriculture, or other industries. Before women can get benefits, they
must be working full-time or have worked for the company for a certain amount of time.
While some nations allow mothers to choose their own start date for maternity leave, the vast majority need at
least six weeks off to allow the new mom to rest and recover. The quantity of vacation time, however, varies
considerably from country to country.

7. Pregnancy and Childbirth: Protecting Women's Health
The goal of human rights is to ensure that people are happy and fulfilled in their daily lives so that they can
contribute effectively to society. Since human survival depends on reproduction, it stands to reason that
women should be afforded the fundamental right to safety during childbirth. Thus, it is essential that women
and their newborns get proper care in the first hours after delivery (the minutes, hours, and days following
giving birth) (Chen, 2001).
The right to maternity leave and employment protection throughout pregnancy and birth are crucial because
they demonstrate the degree of loyalty the employer has to the well-being of the mother and the infant. While
some postpartum symptoms can be treated quickly to prevent them from becoming problematic, others can
develop and often persist. This also makes it easier for the mother to recover physically after giving birth,
breastfeed with confidence, and go to any postnatal or antenatal visits or briefings she needs to.

8. The formulation of a policy strategy and model
There must be quick action taken in the form of a universal health insurance system to address these vast discrepancies in
healthcare finance. According to the statistics, health insurance penetration in Nigeria is low at best. Social health insurance,
as envisaged by the Lagos Health Bill, was passed as early as 1962, only two years after independence. I'm not sure why it
was cut short (UNICEF, 2009).
The government of Nigeria took over the major role of health care finance in the years after the country's independence,
principally via the provision of free, universal health care in public institutions. Due to the government's reliance on oil export
revenues, free healthcare was cut off in the 1980s when those revenues suddenly dried up. To further demonstrate the
viability of health insurance in Nigeria, the Ministry of Health established a committee in 1985, and by mid-1991, preparations
had begun for the program's launch. Originally scheduled to begin in 2005, Nigeria's National Health Insurance Scheme
(NHIS) didn't become legislation until 1999, eight years after the initial implementation date.
Multiple types of insurance, each with its own set of NHIS-recommended coverage levels and pricing structures, are among
the organization's top recommendations. Those that spring to mind immediately are detailed below.
The Formal Sector Social Health Insurance Program, which is required for businesses with ten or more employees, covers
both public and private sector professionals.
Everyone, regardless of their income level, has access to the health care they need, and the program aims for economic
parity by raising taxes on the rich. However, as most Nigerians are either self-employed, work for SMEs, or are unemployed,
this appears to foster a specific type of inequity (Holmes et al., 2011). This is because a fair and equal service is only
available to a select population of people employed by organizations with ten or more employees.

9. Groups of at least 500 people engaged in an economic activity together are eligible for coverage under the Rural Community Social
Health Insurance Program. It is managed by the affiliated groups, and the monthly premiums paid by participating households are
determined by the members' individual priorities. Despite this, studies show that the program still has problems like low participation
rates, incompetent management, a lack of guiding legislation, high costs, and inadequate risk management practices.
To ensure that all Nigerians have access to high-quality medical care, to shield families from the financial burden of costly medical
care, to slow the rate at which health care costs are rising, to distribute treatment costs more equitably across social strata, to
distribute medical facilities more uniformly across the country, and to provide more funding for the health sector are all NHIS goals.
But in UNICEF (2009), there is evidence to imply that these goals have not been accomplished. One of the major aims of the
insurance plan is to reduce the need for out-of-pocket payments, which argue are a symptom of inequity in the healthcare system
since they disproportionately affect the poor. However, Ogaboh, Wilson & Innah, (2015), contend that the NHIS only protects
federal government employees, who account for less than 5% of the Nigerian population, and that commercial health insurers and
community-based health plans cover less than 1% of the Nigerian population combined. If we extrapolate this to the whole
population, we find that just around 6% of us are covered by any type of insurance. The great majority of individuals (94%) pay for
their own medical expenses). Only if most of the poor do not have access to health insurance can the high mortality rate of a
preventable and treatable illness like malaria be explained.
The American Health Association (AHA) made the Health Equality Transformation Model (WHO, 2019) in order to make the
Equality Roadmap, which is a tool for AHA members and the healthcare industry to use to remove barriers to health equality in the
communities they serve.
We can break down the route map into three sections:
The Health Equity Improvement Strategy
The Health Care Quality and Affordability Assessment

10. Action for Health Equity
In a similar vein, efforts are made to reduce health inequities. It is imperative that intervention
partners prioritize improving the health of those who have the worst health outcomes first and in the
shortest amount of time due to the complexity, overlap, and unequal distribution of the core causes
of health disparities and inequalities. Every step must be rationally justified, directed toward a certain
outcome, and methodically carried out.
Some approaches that might be useful are:
To give direct help to health workers in the form of technical advice and advice on policy.
Assisting governments and experts in working together to solve drug policy issues such as
regulation, quality, cost, insurance coverage, and responsible use, and keeping an eye on
how these policies are put into practice.
Collaborating with the European Union, the World Foundation to Combat AIDS, Tb, and
Hepatitis, and the European Institute for Disease Control and Prevention

11. Conclusion
Inequalities in health and social care are a problem in Nigeria and other nations in sub-Saharan
Africa. The international health community may use several models, including the WHO's Health
Equity Policy Tool and the AHA's Health Equity Reformation models. NHIS, or Nigeria's National
Health Insurance System, plays a significant role in reducing health disparities in the country.
Government strategies include providing direct technical and policy support to communities and
villages, establishing networks on drug legislation initiatives, and strengthening and implementing the
NHIS to overcome implementation challenges and ensure that all Nigerians enjoy the same health
outcomes over time.

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