**6. References**

210 Health Management – Different Approaches and Solutions

(Fasola, 2006, Chavunduka, 2009; Mafimisebi & Oguntade, 2010). In the same vein, higher incomes may tend to give a household access to the more expensive OM which is regarded as faster in action and status enhancing. On the contrary, an increase in household size and the number of elderly people in the household beyond the mean value will increase the probability of use of TM by 0.0047 and 0.0137, respectively. This is understandable because if household size increases in a scenario of constant or slowly rising income, per capital expenditure reduces making the household to prefer the cheaper TM to OM in the case of a health problem. In the same way, with increase in the number of elderly people that are usually repositories of TM knowledge, there is a higher

Surprisingly, age of household head that was statistically insignificant in the model for rural farmers was significant at 5% in the model for urban farmers. For urban farmers, a unit increase in the age of household head and household size will lead to 0.0054 and 0.0122 increases in the probability of using TM. This may be a result of the fact that higher age confers higher and better information on and knowledge of TM in Africa where such knowledge is most willingly shared among the elderly. On the other hand, a unit increase in

Inadequate access to health services is one of the components of rural poverty which is prevalent in Nigeria. Inadequate access to health services determines, to a large extent, the decision of rural households to either patronize OM or TM. This study assessed the distribution of OM infrastructure in Ekiti State Nigeria, focusing attention on the ruralurban dichotomy. It further looked at the extent of patronage of TM and OM among

Result of the analyses indicates that inequality exists in the distribution of OM infrastructure in Ekiti State. There was a distinct rural-urban dichotomy in the provision of OM infrastructure in the state. This was caused largely by the concentration of private investment in OM infrastructure in the urban LGAs because of their profit motive. This emphasizes the need for the public sector to continue to moderate the distribution of OM infrastructure through its investment. In doing this, attention should be paid not only to the population of the LGAs but also to their land areas. In addition, the existence of private OM infrastructure in the respective LGAs should be considered in citing new public OM

The results from primary data analysis with respect to the urban LGA seem to establish an indirect nexus between poverty and utilization of TM. The fact that the use of TM increases with household size and age of household heads; two independent variables that are positively correlated with poverty in several studies, is an indication that as poverty increases in Nigeria, urban households have the tendency to revert to the use of TM. Similarly, for rural households, the use of TM increases with household size and the number of elderly people in the household. These two variables are also positively correlated with poverty, implying that increases in poverty among rural households will lead to increases in the use of TM. This is a justification for a welfare oriented health

Given the tendency for the use of TM in Nigeria, steps that will improve the practice of TM, ensure sustainable use of TM resources and re-orientate farming households on how to

income will translate to a 0.0064 fall in the probability of using TM.

farming households with special emphasis on the rural-urban dichotomy.

probability of use of TM.

**5. Conclusions** 

infrastructure.

policy in Nigeria.


http://www.uneca.org/acgd/mdgs/GrowthInequalityPoverty.pdf


http://www.wcc-coe.org/wcc/what/interreligious/cd33-01.html.


Health Infrastructure Inequality and Rural-Urban Utilization of

2008/cr08250.pdf.( Accessed 15-04-2011)

Global Studies & Geography, 2009. Available at

*World Bank Research Observer*, 16 (2) 157-168

http://people.hofstra.edu/geotrans. Accessed on 14th October 2010

*Asian Development Review*, Vol. 24, (1): 32-48 Available at

*CBN Bullion* 23. 4: 66-70

15-04-2011)

15-04-2011)

04-2011)

Publishers, Sudbury

(Accessed 15-04-2011)

*of Health Services*, 22: 429 - 445

Orthodox and Traditional Medicines in Farming Households: A Case Study of Ekiti State, Nigeria 213

Okunmadewa, F. (1999). International agencies response to poverty situation in Nigeria.

Republic of Sierra Leone (2008). An Agenda for Change: Second Poverty Reduction Strategy

Rodrigue, J.P. (2009). *The Geography of Transport Systems*, Hofstra University, Department of

Sachs, J. D. (2004). Health in the Developing World: Achieving the Millennium Development Goals. *Bulletin of the World Health Organization*, 82 (12): 947–49 Srinivasan, T. N. (2001). Comment on Counting the World's Poor,' by Angus Deaton", *The* 

Tandon, A. (2007) Measuring Government Inclusiveness: An Application to Health Policy

www.adb.org/documents/ periodicals/adr/.../adr-vol24-1-tandon.pdf (Accessed

Turnock (2004). Public Health: What it is and What it Does, 3rd Ed., MA: Jones and Bartlett

UN (2008). End Poverty 2015: Millennium Development Goals Report. Available at

UNDP (2003). Millennium Development Goals, National Reports: A Look through a Gender

Whitehead, M (1992). The Concepts and Principles of Equity in Health. *International Journal* 

WHO (1986). Ottawa Charter for Health Promotion. World Health Organization, Geneva WHO (1996). Equity in health and health care. World Health Organization, Geneva WHO (2011) Health systems policies and service delivery WHO African Region: Nigeria

 http://www.who.int/hpr/NPH/docs/hp\_glossary\_en.pdf (Accessed 15-04-2011) WHO, (2001) WHO Country Cooperation Strategy: Nigeria, World Health Organization

http://www.who.int/countries/nga /about/ccs\_strategy02\_07.pdf (Accessed 15-

World Bank (2008). Country Assistance Evaluation. Nigeria: Independent Evaluation Group

World Bank, (1993). A strategy to Develop Agriculture in Sub-Saharan Africa and a Focus for the World Bank. Africa Technical Department Series, 2003, 83-900 World Health Organization (2001) Macroeconomics and Health: Investing in Health for

Approach Paper. Available at *lnweb90.worldbank.org/oed/oeddoclib.../nigeria\_cae\_* 

WHO, (1998). Health Promotion Glossary. WHO/HPR/HEP/98.1 Available at

Regional Office for Africa, Brazzaville Available at

http://www3.who.int/whosis/cmh (Accessed 15-04-2011)

*approach\_paper.pdf* (Accessed 15-04-2011)

Economic Development, Available at

http://www.un.org/millenniumgoals/pdf/Sub-Saharan%20Africa.pdf (Accessed

Lens. Available at http://www.undp.org/women/docs/mdgs-genderlens.pdf

(PRSP II) (2008 -2012) Available at http://www.imf.org/external/pubs/ft/scr/


http://hdr.undp.org/en/reports/global/hdr2010/papers/HDRP\_2010\_12.pdf


Harttgen, K. & Misselhorn, M. (2006). A Multilevel Approach to Explain Child Mortality

Herrero, C., Martínez, R & Villar, A. (2010). Improving the Measurement of Human

Lancaster, P. A. & Coursey, D.G. (1984) *Traditional Post-Harvest Technology of Perishable* 

Available at http://www.fao.org/docrep/x5045e/x5045E00.htm#Contents

Leger, S. (2001). The Anomaly that Finally Went Away *Journal of Epidemiology and* 

Mafimisebi, T. E. (2010). Technology Adoption and Economic Development: Trajectories

Mafimisebi, T.E. & Oguntade, A.E. (2010). Preparation and Use of Plant Medicines for

Marmot, M. (2009). Marmot review: first phase report. Strategic review of health inequalities

consultation/Marmot\_Review\_First\_Phase\_Report (Accessed 2/10/09) Musa E. O. & Ejembi C. L. (2004). Reasons and outcome of paediatric referrals from first-

http://hdr.undp.org/en/reports/global/hdr2010/papers/HDRP\_2010\_12.pdf

*for Economic Research (IAI), Discussion Papers*, September

Development. Human Development Research Paper 2010/12

http://www.who.int/countries/nga/areas/health\_systems/en/index.html

4269-6-1, http://www.ethnobiomed.com/content/6/1/1

*Community Medicine & Primary Health Care, Vol. 16(1): 10-15* NBS (2006). Nigerian Core Welfare Indicators*.* National Bureau of Statistics. [http://www.nigerianstat.gov.ng/nbsapps/cwiq/2006/survey0/

NBS (2007). Directory of Health Establishments in Nigeria, 2007. Available at

NBS (2010). Federal Republic of Nigeria: 2006 Population Census. Available at

NEEDS, National Planning Commission, Abuja, 125 pp.

Lagos State, Nigeria *The Social Sciences*. Vol. 2 (1): 51-55

www.nigerianstat.gov.ng (Accessed 14-04-2011)

www.nigerianstat.gov.ng (Accessed 14-04-2011)

eview\_2010.pdf

(Accessed 15-04-2011)

*Community Health*, 55: 79

Publishers, New York, USA

and Under-nutrition in South Asia and Sub-Saharan Africa *Ibero America Institute* 

*Tropical Staples*. Food and Agriculture Organization of the United Nations, Rome.

within the African Agricultural Industry. In: *Nanotechnology and Microelectronics: Global Diffusion, Economics and Policy,* Ekekwe, N. (Ed.) 298-313 , IGI Global

Farmers' Health in Southwest Nigeria: Socio-Cultural, Magico-Religious and Economic Aspects, *Journal of Ethnobiology and Ethnomedicine*, 6:1doi:10.1186/1746-

in England post-2010. Available at http://www.ucl.ac.uk/gheg/marmotreview/

level health facilities in Sabongari, Zaria, Northwestern Nigeria. *Journal of* 

outputInformation/ cwiqreports.html] webcite Accessed on 14th October 2010

Nolte, J. & Mckee, M. (2004). Does Health Care Save Lives? *The Nuffield Trust*, London, 58 NPC (2004). Nigeria: Draft National Economic Empowerment and Development Strategy-

O'Brien, L., Williams, K. & Stewart, A. (2010). Urban health and health inequalities and the

Oguntade, A. E. & Yusuf N.A. (2007). Health Infrastructure inequality: A Case Study of

role of urban forestry in Britain: A review http://www.forestry.gov.uk/pdf/ urban\_health\_and\_forestry\_review\_2010.pdf/\$FILE/urban\_health\_and\_forestry\_r


http://people.hofstra.edu/geotrans. Accessed on 14th October 2010


WHO, (2001) WHO Country Cooperation Strategy: Nigeria, World Health Organization Regional Office for Africa, Brazzaville Available at http://www.who.int/countries/nga /about/ccs\_strategy02\_07.pdf (Accessed 15- 04-2011)


http://www3.who.int/whosis/cmh (Accessed 15-04-2011)

**A New Economic and** 

**Twenty First Century** 

*Northern Territory Clinical School, Darwin, Northern Territory,* 

Robert Parker

*Australia* 

**Social Paradigm for Funding** 

**Recovery in Mental Health in the** 

Mental illness is a significant factor in disease related disability throughout the world. About 16% of the global burden of disease not attributable to communicable disease has been attributed to mental disorders (Prince et al 2007) with substance abuse disorders contributing to a further 4% of this burden (ibid). In Australia, "Mental Disorders" were considered to be the third major cause of health loss (behind cancer and cardiovascular disease) in 2003 but were estimated to increase at a significant rate to move ahead of cancer and become the second major cause of "health loss" by 2013 (Begg et al 2008). This burden of mental illness is particularly pronounced in the youth of Australia with disabilityadjusted life years (DALY's) for mental illness calculated to be above 90,000 (compared to the next highest of 48,000 DALY's due to injury) for the 15 to 24 year old age group in 2003 (Eckersley 2011). Along with the current burden of disease attributed to mental illness, there is a number of challenges facing societies in the developed and developing world that are likely to lead to an increase in mental illness. Sartorius (pers comm) has recently outlined some of these challenges. They include: weakening of community resilience mechanisms, increasing awareness of gaps and unreachable opportunities, migration of people, talents and capital with the subsequent loss of social capital in some societies, the challenges of increased urbanisation on community supports and family structures, the changing nature of privileged families in developed society with less children, longer life spans and more fragile family structures, the decrease of middle class "norms" in developed countries and the additional increase of the middle class in developing countries with potential economic and social alienation from less privileged groups, the changing role of women and the implications that this has for child care and care of the elderly and the changing paradigms of medicine itself with increasing use of technology in addition to evolving ethical issues

**1. Introduction** 

such as euthanasia.

The severity of personal disability from mental illness is pervasive.

this inner experience for severe mood disorder:

The poetry of Anne Sexton in the poem "Sickness unto Death" (1977) helps describe some of

Young, F. W. (2001). An Explanation of the Persistent Doctor-Mortality Association. *Journal of Epidemiology and Community Health*, 55: 80-84. **12** 
