Suchergebnisse

AbstractData sources from the 1980s are used to examine the main features of Nigeria's population patterns and trends. Fertility has remained relatively constant up until very recently, when there has been evidence for a decline in fertility in the south of the country. In the north, fertility remains high, contraceptive use remains low, and women continue to marry at young ages. The mortality declines of the oil boom years are threatening to reverse, as economic crisis hits health services. Although there is some evidence of rising contraceptive knowledge and use in the south, certain features of Nigerian family structures militate against fertility decline. This situation is likely to change only through education and the transformation of women's status.

From 1989 onward a research program based at Ondo State University, Nigeria, investigated the social and behavioural context of the sexually transmitted disease and AIDS epidemics (Orubuloye et al. 1994). Between 1989 and 1993 the researchers reached the conclusion that premarital and extramarital sexual activities were on a sufficient scale in Ondo State to maintain an STD epidemic and possibly to maintain an AIDS epidemic. The reason for caution with regard to AIDS arose from an awareness of the current relatively low seroprevalence levels in Nigeria and the demonstration by the program that much of the premarital and extramarital sexual activity was not with prostitutes but diffused more widely. The researchers also concluded that the economic returns to young women from commercial sex were so substantial and the current and later social sanctions so weak that no government intervention was likely to reduce the inflow of recruits to the occupation sufficiently to stem the STD epidemic or reduce the risk of a major AIDS epidemic. Clearly something would be achieved by a program aimed at increasing the practice of safe sex, especially the use of condoms, by everyone participating in sexual networking, particularly prostitution. There was little evidence that specific planned intervention was already achieving much, although some evidence that government and media AIDS publicity was raising the level of condom use in prostitution. There also seemed to be a need for STD education and curative interventions on a much greater scale. Nevertheless, until the achievement of decisive biomedical breakthroughs to halt the AIDS epidemic, the research increasingly suggested that the best chance of halting the AIDS epidemic and mitigating the impact of STDs was a change in male sexual behaviour.

The nine papers which constitute this forum examine what is understood when the term "health" is used. They contend that an understanding of what health is, must be a necessary prerequisite of any discussion about whether it can be improved. Cooperation between all the players including governments, planners, researchers, health care workers, educators and individuals seeking or needing health care is addressed.