Medical Sociology
Medical Sociology
Medical Sociology
COURSE
GUIDE
NSS 409
MEDICAL SOCIOLOGY
Department of Sociology
University of Ilorin
Ilorin Nigeria
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NSS 409 COURSE GUIDE
Abuja Office
No. 5 Dar es Salaam Street
Off Aminu Kano Crescent
Wuse II, Abuja
Nigeria
e-mail: centralinfo@nou.edu.ng
URL: www.nou.edu.ng
Published by:
National Open University of Nigeria
Printed 2008
ISBN: 978-058-916-3
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NSS 409 COURSE GUIDE
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CONTENTS PAGE
Introduction ………………………………………………..……. 1
Assessment……………………………………..…………………. 4
Tutor-Marked Assignment ……………………..………………… 4
Final Examination and Grading…………………..…………….….. 5
Summary ……………………………………..…………………… 5
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Introduction
This course guide tells you briefly what to expect as you read this
material. Medical Sociology may be divided into two separate but
interrelated areas: sociology in medicine and sociology of medicine.
Sociology in medicine is concerned with how sociology collaborates
directly with the role of the physician and other health personnel in an
attempt to study the social factors that are relevant to a particular health
problem. This aspect of medical sociology is intended to be directly
applicable to patient care or to the solving of a particular health problem.
The sociology of medicine on the other hand, deals with such factors as
the organization, role relationships, norms, values and beliefs of medical
practice as a form of human behaviour. The emphasis is upon the social
processes that occur in the medical setting and how these help our
understanding of medical sociology in particular and social life
generally.
Course Aims
The aim of this course is very clear and simple. The course aims at
providing those social factors that are crucial to our understanding of the
social dimensions of health and ill-health.
NSS 409 MEDICAL SOCIOLOGY
Course Objectives
In addition to the general aim above, this course is also set to achieve the
following specific objectives. So that you should be able to:
• to understand the meaning of health and illness especially as it
relates to social structure;
• know the structure and dynamics of medical organizations as well
as their processions;
• understand the evolution and development of the
professionalization of medicine;
• appreciate the traditional and modern forms of health delivery
systems in Africa as well as their respective uses and social
effects;
• know and appreciate the role of politics in health; and
• appreciate the hospital as a social system and the mental hospital
as a total institution.
This course requires that you devote some time to read. Medical
Sociology as a discipline is broad as it cuts across several disciplines in
the behavioural and non-behavioural sciences, and breaking the content
of this material into units would assist you to put into your mouth a little
that you can bite for easy assimilation. Of course, the role of discussing
with your peers at tutorials cannot be under-stressed in this course.
Course Material
Study Units
Module 1
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NSS 409 MEDICAL SOCIOLOGY
Module 2
Module 3
Module 4
The first unit in the course explores the field of Medical Sociology and
explains what Medical Sociologists do.
The third unit brings to focus the relevance of theories in health studies.
Four different theories in Medical Sociology that have been proven and
tested are discussed.
The sixth unit explains the theory and concept of health and disease.
The eighth unit explores the sick role and process of seeking medical
care.
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NSS 409 MEDICAL SOCIOLOGY
Assessment
There are two components of assessment for this course. The Tutor-
Marked Assignment (TMA) and the end of course examination.
Tutor-Marked Assignment
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you by your facilitator and returned after you have done the assignment.
Summary
This course intends to impart some basic knowledge of the social action
and social factors in illness and illness related situations. Through the
course you will also be able to appreciate the social processes that occur
in the medical setting. By the time you complete studying this course,
you will be able to answer the following questions:
Best wishes.
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NSS 409 MEDICAL SOCIOLOGY
MAIN
COURSE
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NSS 409 MEDICAL SOCIOLOGY
Abuja Office
No. 5 Dar es Salaam Street
Off Aminu Kano Crescent
Wuse II, Abuja
Nigeria
e-mail: centralinfo@nou.edu.ng
URL: www.nou.edu.ng
Published by:
National Open University of Nigeria
Printed 2008
ISBN: 978-058-916-3
vii
NSS 409 MEDICAL SOCIOLOGY
CONTENTS PAGE
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NSS 409 MODULE 1
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Definition of Sociology and how it is related to Medicine
3.2 Definition of Medical Sociology
3.3 Major Approaches in Medical Sociology
3.4 Major Concerns of Medical Sociology
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
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4.0 CONCLUSION
This unit has equipped us with the knowledge of what Sociology really
is and its relationship to medicine. Medical Sociology as a branch of
Sociology considers non-medical factors, which are crucial to illness
and diseases. In this unit, it has been explained that the incidence of
illness is largely determined by social and cultural factors. This explains
the importance of Medical Sociology to therapeutic efforts.
5.0 SUMMARY
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 What Medical Sociology Entails
3.2 What Social Medicine Entails
3.3 Relationship between Medical Sociology and Social
Medicine
3.4 Differences between Medical Sociology and Social
Medicine
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
• explain what social medicine is, and define the field of medical
sociology
• distinguish between medical sociology and social medicine
• appreciate the “commonness” between medical sociology and
social medicine.
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Social medicine is concerned with what is real with man by virtue of his
being part of society or group life. Social medicine is concerned with
two broad aspects:
Both medical sociology and social medicine are related in that the thrust
of medical sociology tends to overlap with the field of social medicine.
Both of them deal with the role of social factors in the aetiology, course
and management of illnesses.
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4.0 CONCLUSION
5.0 SUMMARY
In this unit, we have learnt that:
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Medical Sociology and Theorizing
3.2 Types of Theories in Medical Sociology
3.3 System/Structural Functional Theory
3.4 Marxian Paradigm (Theory)
3.5 Middle-range Theories
3.6 Other Theories Sandwiched between one or two above
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
This study unit contains material on the role of theories in health studies.
The major differences and similarities between medical sociology
theories are highlighted. The problems and prospects of theoretical
formulation in the study of illness and health relations also form part of
this unit.
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Apart from these sociological theories outlined above, there are other
theories within the confines of medical sociology, which are very useful
in the study of health issues. Prominent among these has been the Health
Belief Model propounded first by Rosenstock (1966). This theory places
emphasis on the role of norms and values and culture generally as major
determinants of health behaviour. The future of theories in medical
sociology depends on the extent to which sociology generally can
continue to use scientifically objective criteria to measure symptomatic
and non-symptomatic phenomena.
4.0 CONCLUSION
5.0 SUMMARY
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MODULE 2 SPECIALIZATIONS,
PROFESSIONALIZATION AND
THEORIES IN MEDICAL SOCIOLOGY
CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 The need for Specializations in Medical Sociology
3.2 Sociology in Medicine and Sociology of Medicine
3.3 Modern specializations in Medical Sociology
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
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Medical sociology in the 50s was divided by Robert Straus into two
separate but interrelated areas: Sociology in Medicine and Sociology of
Medicine.
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4.0 CONCLUSION
5.0 SUMMARY
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 What is a Profession?
3.2 Attributes of a Profession
3.3 Profession and Medicine
3.4 Medicine and other Paramedical Occupations
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
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4.0 CONCLUSION
Medicine occupies the apex of the health industry largely because the
practice of other paramedical occupations depends on the knowledge
that is produced in medicine and the other workers do not enjoy as much
control over the work situation or the medical division of labour as
physicians.
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5.0 SUMMARY
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Definitions of Health and Disease
3.2 Medical Model of Disease
3.3 Psychological Theories of Disease
3.4 Culture Bound Theories of Disease
3.5 Socio-environmental Theory of Disease
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
However, there are other specific theories that try to explain disease
within the context of medical sociology. These theories are:
Psychological, Medical model, Sociocultural, etc.
2.0 OBJECTIVES
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This study unit contains material on the need for theorizing in medical
sociology and the major theories of disease. The unit also contains
material on the definitions of health and disease.
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This theory highlights the interplay between culture and disease. Today
it is known that many culture-bound syndromes and conditions can be
managed more effectively through an informed knowledge of their
cultural contexts and the patients’ background. It is reported that Lambo
(1955) of Nigeria and Yap (1951) of Hong Kong did some tremendous
works among their peoples on the cultural dimension of health and
ill-health. According to the scholars health and disease are, to a great
extent, determined by culture in Africa. The incidence of disease is
therefore usually attributed to witch-craft, sorcery and mystical forces.
4.0 CONCLUSION
There is hardly any aspect of illness and disease today which cannot be
explained by one theory or the other in medical sociology. Theories
provide clear frameworks and analytical tools for understanding several
aspects of the disability or infirmity and discomfort in human beings.
This unit has brought to the fore some of these theories that are relevant
to our understanding of health and disease generally. It must be
appreciated however that no single theoretical framework fully explains
the incidence of disease. Each of them simply explains some aspects of
the etiology of disease better than others.
5.0 SUMMARY
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Definitions of Health Institutions
3.2 Development of the Hospital
3.3 Types of Hospitals
3.4 Functions of the Hospital
3.5 Hospitals-Patient Role
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
Health institutions are healthcare organizations that have set goals.
Healthcare institutions vary to one or other degree both in structure and
functions across cultures; they include organizations like the hospitals,
basic health centres, maternity centres, pharmacies etc. These vary in
scope, size and function. The levels of healthcare institutions are not the
same but each of them to one degree or the other provides some form of
care to the patients.
2.0 OBJECTIVES
At the end of this unit, you should be able to:
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After the Renaissance and the Reformations, there was still much to be
desired in public hospitals with respect to their potentials to provide
welfare services for the poor. Towards the 14th Century however in
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One major factor for this change was the fact that medicine had become
a science in terms of employing the scientific method for the acquisition
of accurate medical knowledge. Also, the discovery and use of antiseptic
measures in the hospitals to help curtail infection has been a good
development. There has also been a significant development in the
quality of hospitals personnel in modern times, not only in Euro-
American societies, but also in many developing economies of the
world.
The occupational growth in the hospitals setting and those who perform
most healthcare tasks in the hospital wards are the nurses and auxiliary
nursing worker. Nurses are responsible to the physicians for carrying out
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4.0 CONCLUSION
5.0 SUMMARY
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 The Concept of the Sick Role
3.2 The Specific Aspects or Attributes of the Sick Role
3.3 The Patient-Physician Role Relationship
3.4 The Process and the Need for the Sick to Seek Medical
Care
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
One major expectation about the sick is that they are unable to take care
of themselves. The sick have some unique behavioural characteristics in
most societies. According to Talcott Parsons (1951), being sick is an
undesirable state and the sick wants to get well. Getting well involves a
process in which the sick is a major stakeholder.
2.0 OBJECTIVES
This study unit contains materials on the concept of the sick role,
specific aspects and characteristics of the sick person as well as the
relationship between the patient and the physician. This unit also
contains relevant materials on the process of seeking medical care by the
sick.
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The concept of the sick role represents the most consistent approach to
explaining the behavioural pattern of sick people. According to Talcott
Parsons (1951), being sick is not a deliberate choice of the sick person
even though illness may occur due to exposure to infection or injury.
The sick person usually is unable to take care of himself, and this is why
it is necessary for him to seek medical advice and cooperate with
medical experts
i. The sick person is exempt from “normal” social roles. The sick
has an exemption from normal role performance and social
responsibilities because of the state of his health. Usually, in
many societies the more severe the illness, the greater the
exemption.
ii. The sick person is not responsible for his or her condition. A sick
person’s illness is assumed to be beyond his or her own control.
iii. The sick person should try to get well. Since being sick is an
undesirable condition, the sick individual must have the desire to
regain normal health.
iv. The sick person should seek medical advice and cooperate with
medical experts. The desire to get well by the sick person must
inevitably lead to his being desirous to cooperate with the
physician and other health workers.
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3.4 The Process and the Need for the Sick to Seek Medical
Care
In the previous section we saw the need for the patient to seek medical
care. Reasons for seeking medical help and advice by the sick include
that:
It is not yet fully known the exact processes involved in making decision
to obtain medical care, however, research findings have revealed some
social factors which tend to encourage or discourage a person from
seeking medical care. These factors include socio-demographic
variables including age and sex, ethnicity, economic status and
education.
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Ethnicity
Economic Status
Education
There are studies that have confirmed the positive correlation between
education and healthcare services utilization. In most developing
countries; many people through ignorance and low level of awareness
tend to underutilize health services even when they can afford the cost.
4.0 CONCLUSION
5.0 SUMMARY
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i. The sick person is not responsible for his or her condition. A sick
person’s illness is assumed to be beyond his or her own control.
ii. The sick person should try to get well. Since being sick is an
undesirable condition, the sick individual must have the desire to
regain normal health.
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 The Development of Nursing as an Occupation
3.2 Nursing Education
3.3 The Doctor-Nurse Relationship
3.4 Other Health Practitioners
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
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In some advanced societies like the United States, the licensed registered
nurse rank second in status only to the physician as a health provider.
Males have been known historically to perform nursing tasks but the
social role of the nurse has been profoundly affected by its identification
with traditionally feminine functions (Davis 1966, Strauss 1966). As a
result of the rise of Christianity in the Western world, the practice of
nursing as a formal occupation was significantly influenced by the
presence of large numbers of nuns who performed nursing services
under the auspices of the Roman Catholic Church (Cockerharm, 1982).
Before the 19th Century, hospitals were mostly regarded as places for the
poor and lower social classes. Patients who could afford it were usually
cared for at home. Nursing activities therefore, were viewed as acts of
charity since they were usually done under difficult and unpleasant
situations. Nursing as at this time was regarded by the church as a means
by which those persons providing the services could obtain salvation as
they were regarded as people helping the less fortunate.
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4.0 CONCLUSION
5.0 SUMMARY
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Healthcare Organizations
3.2 The Need for Seeking Medical Care
3.3 Levels of Healthcare
3.4 Channels for Receiving Healthcare Services
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 Reference/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
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In Nigeria, the services in the public system are organized under the
auspices of the federal and state ministries of health and the local
government authorities. The private healthcare service in Nigeria
consists of solo practitioners and partnership/group practitioners. Their
services are rendered in the facilities that are built by corporations and
voluntary agencies like Christian and Muslim missions. The private
health providers also include traditional healers, chemists and patent
medicine sellers.
To the extent that illness and disease are health burdens while treating
the normal functioning of the body system, it becomes crucial therefore,
for the sick individuals to seek medical care and in good time. Illness
militates against the performance of one social role and disability and
discomfort and therefore, can become worrisome. Although, factors
such as cost of medical bills, proximity to health facilities, and
accessibility to health facilities and personnel can create major obstacles
for patient’s seeking medical care, effort should be intensified to
overcome these challenges because “health is wealth.”
There are three main levels of healthcare, namely the tertiary, secondary
and comprehensive (primary). A tertiary healthcare institution performs
several functions which include research and teaching e.g. teaching and
specialist hospitals. The secondary is next and it performs services that
are next to those being performed by the tertiary ones. These institutions
provide medical, surgical or the psychiatric care for the sick (Erinosho,
2005). The comprehensive or primary healthcare institution is of a lower
order. These institutions are mainly for ambulatory care. They are
sometimes described as comprehensive, cottage or community health
institutions. Patients, through a well defined referral network can have
access to health facilities and services at any of the healthcare levels.
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between the private and the public health system. The two are off-shoots
of orthodox medicine. In Africa south of the Sahara, this is a bit
different. A good number of patients tend to utilise the services of
traditional healers before seeking help from western-style health
workers and facilities. Next to this is, the services of western-style care
agents such as specially practitioners, patent medicine sellers and
pharmacists. Quite often, there is a simultaneous use of both modern and
traditional medicine by patients among indigenous Africans.
4.0 CONCLUSION
5.0 SUMMARY
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Types of Health Services: Preventive and Curative
3.2 Preventive Health Services
3.3 Curative Health Services
3.4 Factors Affecting the Preventive Health Services
Utilization
3.5 Factors that Affect Curative Health Services Utilization
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
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2.0 OBJECTIVES
This unit contains materials on the need for healthcare utilization, types
of health services and the various factors in the utilization of health
services.
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4.0 CONCLUSION
5.0 SUMMARY
Define preventive health services. How is this different from the other
health services known to you?
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 The Concept of Traditional Therapeutics
3.2 Traditional Practitioners and Practices
3.3 Perceived Advantages and Efficacy of Traditional
Medicine
3.4 Perceived Disadvantages of Traditional Medicine
3.5 Traditional and Orthodox Medicine: Challenges of
Integration
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
This unit examines the concept of traditional medicine and the different
types of traditional medicine practitioners and practices. It also dwells
on the advantages and disadvantages of traditional medicine and the
challenges of integration between orthodox and traditional medicine.
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These are healers endowed with the special skills of divination. They
proffer reasons for the cause of problems
These are versed in the art of “fixing” fractured bones with special
reference to the hand and leg bones.
These are mostly women who have special skills in the management and
delivery of babies. They specialize in both pre-natal and post-natal
services.
v. Psychiatrists
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vi. Massagers
These healers possess the special knowledge and skill to rub the body
and dislocated bones of patients. They can also reposition the foetus in
the womb
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4.0 CONCLUSION
5.0 SUMMARY
i. General practitioners;
ii. Psychiatrists; and
iii. Bone setters
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 The Concept of Culture
3.2 The Relevance of Culture to Health
3.3 Some Aspects of Nigerian Culture that are Beneficial to
Health
3.4 Some Aspects of Nigerian Culture that are not Beneficial
to Health
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
Culture plays a very important role in health and illness. It can be argued
that the health status of a society is a function of the norms and values of
that society. Culture and health cannot be separated because each
represents, to some extent, different aspects of the same coin.
2.0 OBJECTIVES
The main thrust of this unit is the concept of culture, the relevance of
culture to health and some aspects of Nigerian culture which are
beneficial to health. It also contains materials on non-beneficial aspects
of Nigerian culture with respect to health.
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4.0 CONCLUSION
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5.0 SUMMARY
• concept of culture;
• relevance of culture to health;
• beneficial aspects of Nigerian culture with respect to health; and
• non-beneficial aspects of Nigerian culture with respect to health.
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Defining Mental Illness
3.2 Theoretical Models of Mental Illness
3.3 Major Types of Mental Illness
3.4 Social Epidemiology of Mental Illness
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
Some scholars have argued that mental illness is clearly not an “illness.”
Reasons for this view include the assumption that only symptoms with
demonstrable physical lesions qualify as evidence of disease and that
mental symptoms result from problem in living. It is also argued that
physical symptoms are objective and independent of sociocultural
norms, but mental symptoms are subjective and dependent on
sociocultural norms (Scasc, 1974). However, Ausubel (1951) has
disputed this view, arguing that mental symptoms do not have to be
physical before it can be defined as disease and that psychological
symptoms can be classified as essence of disease if they impair the
personality and adversely affect behaviour. The subject of mental illness
therefore, till date, is still not absolutely known and explicit.
2.0 OBJECTIVES
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4.0 CONCLUSION
5.0 SUMMARY
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CONTENTS
1.0 Introduction
2.0 Objectives
3.0 Main Content
3.1 Definitions of Health and Politics
3.2 Historical Perspective of Health development in Nigeria
3.3 Relationship between Politics and Healthcare Delivery
4.0 Conclusion
5.0 Summary
6.0 Tutor-Marked Assignment
7.0 References/Further Readings
1.0 INTRODUCTION
2.0 OBJECTIVES
This unit contains materials on the definitions of health and politics, the
historical perspective of health development in Nigeria and the
relationship between politics and healthcare delivery.
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4.0 CONCLUSION
The relationship between politics and health has been brought to the fore
in many ways. A country that ignores the theoretical models in politics
in health planning is bound to fail. Planning process in health, as in
other sectors are affected by political systems.
5.0 SUMMARY
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