NIGERIA

A lack of access or utilisaiton of health services, along with poor diet and malnutrition (especially in under-fives) have been identified as key risk factors for the health of Enugu residents. The health system in Enugu City is facing a double burden of communicable and non-communicable disease, with malaria endemic as in most parts of the country, high rates of water-borne diseases include diarrhoea, typhoid fever and dysentery, which peak seasonally due to environmental conditions such as surface runoff and flooding increasing contamination of drinking water sources. Key non-communicable diseases include hypertension, diabetes, coronary heart diseases and eye diseases, and there are poor track records on managing these cases.

The health system of Enugu State involves a complex plurality of providers; the State health system comprises of seven Ministries and Agencies, with the traditional and alternative health care providers also coming under the State Ministry of Health. Enugu City itself has several public, mission and private-owned health facilities that offer primary, secondary and tertiary levels of care.  Most public hospitals in the city suffer from poor infrastructure, lack of equipment, and/or outdated or non-functional equipment. However it is the numerous informal health service providers in the city that are the primary source of health care for the urban poor. How to strengthen the links between these public and informal providers of health care will be a focus of the CHORUS research to improve the delivery of essential and quality health services for those living in the urban slum areas.