Evaluation of the social determinants of health in communities across the south-eastern region of nigeria

Objectives: Apart from lifestyles and genetic make-ups, a wide range of social, economic and environmental factors may affect personal and population health. Attaining sustainable health for all requires frequent evaluation and tackling these socio-economic and environmental factors. Methods: This cross-sectional study aimed to evaluate the existence of the World Health Organization's (WHO) recognized social determinants health (SDH) in communities across south-east Nigeria. This study recruited 214 leaders in the state ministry of health who were stakeholders in the commission on SDH that attended a conference in Onitsha. Participants were enrolled using a purposive sampling method. Data on parameters of SDH in the communities were obtained on a scale of I to 5 using self-administered WHO-validated questionnaires for SDH. Results: The existence of SDH in communities across the South-Eastern region in Nigeria is poor. Only 9.5- 13.0% and 4.2-7.2% of the respondents respectively reported with high and very high certainty the existence of the parameters of SDH in their respective communities. Employment/job skills centers, police and security, legal aids, insurance policies and substance abuse help centers were the SDH parameters reported commonly as non-existent in most communities. The majority of the respondents reported education 88 (14.1%), employment organizations 58 (9.3%), healthcare 52 (8.3%) and transportation 44 (7.1%) as the health determinant with the strongest presence and greatest impact on lives of community residents, while access to mental health 24 (3.8%), substance abuse treatment 20 (3.2%), personal space 19 (3.0%), insurance 22 (3.5%) and parks 18 (2.9%) for relaxation and leisure were reported as parameters with the weakest presence and least impact on health of community residents. Conclusion: Continued assessment of the SDH in addition to the evaluation of its effects on personal and population health is imperative to deliver equitable healthcare and enhance the quality of life across communities in Nigeria.