PERCEPTION OF HEALTHCARE WORKERS ON THE EFFECT OF ECONOMIC RECESSION UNDER PRESIDENT TINUBU

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Economic recessions are complex and periodic events that have significant ramifications for the global political and social structure. The interplay of economic, political, and societal factors does not have a universally accepted definition. However, according to the World Bank and International Monetary Fund, recessions are defined as either 'at least two consecutive quarters of decline in national output' or 'a decline in a country's real (inflation-adjusted) gross domestic product (GDP)' (Claessens et al., 2019). The US National Bureau of Economic Research (Hale et al., 2023) provides a more extensive definition that includes a substantial decrease in economic activity that affects various sectors of the economy, lasting for more than a few months, and is evident in real GDP, real income, employment, industrial activity, and wholesale-retail sales.

Exploration of the effects of recessions on population health and health systems has only lately commenced. Unemployment is widely recognised as a significant influencing factor, since it has been associated with a rise in suicides and mental health disorders during an economic decline (Reeves et al., 2022). Recessions in both high-income and low- and middle-income nations have been associated with an upsurge in diseases linked to poverty and destitution, such as TB, malnutrition, and diarrhoea (Reeves et al., 2022). Importantly, economic recessions have been demonstrated to have an effect on the social determinants of health (Marmot, 2017), worsening social and health disparities among communities (Bacigalupe and Escolar-Pujolar, 2018).

However, the policy reaction of governments is sometimes accused of exacerbating the decline in population health and health systems during economic downturns. In both high-income and low-income environments, austerity measures and structural programmes have frequently been used to address reduced tax revenues. These strategies involve reducing expenditure on health and social security or restructuring services to improve efficiency. Extensive research, both empirical and theoretical, has been carried out to examine the connections between economic recessions, austerity measures, health, and health systems in certain nations. In their study, Walters et al. (2023) established a connection between the economic consequences of the recession and many factors such as unemployment, earnings, social protection, and health during Indonesia's crisis in the 1990s. Suhrcke et al. (2017) examined the economic consequences, factors influencing them, and the spread of infectious diseases during periods of economic decline. Thompson et al. (2019) have gathered and analysed data from research and policy institutes to examine and compare the health systems and policies of different nations throughout Europe's most recent economic crisis.

Like workers in other industries during an economic downturn, healthcare professionals experience a mix of job insecurity, diminished ability to buy goods and services, and limited job prospects in the labour market (Thompson et al., 2019). Furthermore, it has been proposed that these impacts are frequently intensified by the curtailment of social assistance and salary reductions resulting from the stringent policies implemented by governments, particularly in the major expenditure areas such as healthcare, as part of their efforts to achieve budgetary equilibrium and minimise deficits (Bash et al., 2021). Economic contractions and austerity policies have several negative effects on health workers. These include reductions in salaries and job losses, which further contribute to the desire to migrate. Additionally, motivation decreases, unwanted organisational changes occur, and there is an increase in the inclination to participate in profit-generating activities that may compromise the quality of service provided (Thompson et al., 2019). 

The economic recession in Nigeria during President Bola Ahmed Tinubu's administration has significantly affected the country's economy and the operations of its healthcare system (Bola et al., 2024). President Bola Ahmed Tinubu took office in May 2023, with an economy burdened by several difficulties like as soaring inflation, a declining currency, and significant national debt.  (Akam, 2024). The economic measures enacted by his government, with the goal of stabilising and revitalising the economy, have yielded varied outcomes. While several initiatives have been praised for their possible long-term advantages, others have been criticised for their immediate negative impact on the people (Deji, 2024). The healthcare industry, which is especially susceptible to economic swings, has seen numerous obstacles during this period. The system has been under strain due to direct repercussions such as funding cuts, rising costs of medical supplies, and delayed pay (Deji, 2024). Healthcare professionals, who are at the forefront of providing medical services, are in a unique position to offer valuable insights into how these economic situations are impacting their work and the overall delivery of healthcare. Therefore, the necessity for doing this investigation arises.

1.2 Statement of the Problem

Economic recessions have extensive repercussions across all sectors, with the healthcare business being especially susceptible. The healthcare sector in Nigeria has faced exacerbated challenges and encountered new obstacles due to the recent economic slump during President Bola Ahmed Tinubu's government. The economic recession has had a dual impact on both the financial viability of healthcare institutions and the healthcare personnel who are responsible for providing frontline services.

Healthcare professionals in Nigeria have encountered a multitude of challenges as a result of the economic decline, such as postponed salaries, decreased allocation of funds for medical resources, and worsening working conditions (Phil et al., 2024). These issues may have impaired their capacity to deliver high-quality care, thereby affecting patient outcomes and the overall state of public health. The burden on resources and morale among healthcare workers gives rise to worries over the long-term viability of healthcare services and the welfare of the workforce (Stefan et al., 2024). When hospital workers and health care professionals do not receive their compensation, including pay, salary, incentives, and allowances, their motivation to deliver high-quality service is usually reduced. The main cause for healthcare workers to occasionally engage in frequent and ongoing strikes is this. 

Ogunbanjo (2018) observed that increased remuneration and greater working conditions are key elements that contribute to industrial action among healthcare personnel. At times, the compensation and bonuses offered may not be in line with the job duties of employees, which could potentially affect their job performance. To foster the development of an efficient healthcare system, it is crucial to offer healthcare providers with appropriate incentives, such as higher remuneration, especially during periods of economic downturn (Ijimakinwa et al., 2023). If this issue is not resolved, it could result in neglecting tasks, developing a negative attitude towards clients, responding inadequately to emergencies, experiencing a higher occurrence of corruption and fraudulent operations, and so forth.

Although healthcare professionals play a crucial role in sustaining the health system, their opinions and experiences during economic recessions are sometimes overlooked. Gaining insight into their perspectives is essential for formulating efficient tactics to assist them and guarantee the uninterrupted provision of high-quality healthcare services notwithstanding economic downturns. This study aims to evaluate the attitude of healthcare professionals regarding the impact of economic recession during President Tinubu's tenure.

Objectives of the study

The primary objective of this study is to critically assess the perception of healthcare workers on the effect of economic recession under President Tinubu. Specific objectives of this study are to:

Assess healthcare workers’ perception on the extent economic recession has affect the quality of lives in Nigeria.

Assess healthcare workers’ perception on the extent economic recession has affected food security and affordability in Nigeria.

Assess healthcare workers’ perception on the extent economic recession has affected access to basic essential services in Nigeria.

Assess healthcare workers’ perception on the extent economic recession has affected living standards in Nigeria.

1.4 Research Questions

The following research questions which are in line with the objectives of this study will be answered in this study:

What is the perception of healthcare workers on the extent economic recession has affect the quality of lives in Nigeria?

What is the perception of healthcare workers on the extent economic recession has affected food security and affordability in Nigeria?

What is the perception of healthcare workers on the extent economic recession has affected access to basic essential services in Nigeria?

What is the perception of healthcare workers on the extent economic recession has affected living standards in Nigeria?

1.6 Significance of the study

Gaining insight into the perspectives of healthcare workers is essential for policymakers to develop strategies that bolster the healthcare industry during periods of economic decline. The results of this study will establish a fundamental reference point for policymakers, health professionals, the general public, students, and scholars. 

Perception studies can provide policymakers with valuable insights into the preferences and requirements of healthcare workers during periods of economic decline. This information can help guide decisions on how to allocate resources and implement policy reforms that aim to enhance the healthcare system. The results of this study can support attempts to advocate for healthcare policy reforms that aim to improve the preparation, resilience, and sustainability of the healthcare system during economic difficulties.

In addition, healthcare workers are at the forefront of managing health issues that are worsened by economic recessions. Gaining an understanding of individuals' perspectives allows for valuable insights about the level of resilience exhibited by the healthcare system in times of economic decline. The viewpoints of healthcare professionals can provide insight into the impact of an economic downturn on the provision of services, quality of patient care, availability of medical supplies and equipment, and ultimately, the outcomes and accessibility of healthcare services. Healthcare personnel may experience emotional and psychological strain during economic recessions as a result of heightened workloads, diminished resources, and personal financial difficulty. Gaining insight into individuals' perspectives is beneficial for effectively dealing with employee morale, preventing burnout, and implementing initiatives to retain staff.

 In addition, the perspectives of healthcare professionals can shed light on the public health consequences of an economic downturn, including shifts in illness patterns, trends in healthcare utilisation, and the efficacy of public health measures implemented during President Tinubu's tenure.

Furthermore, future researchers will utilise it as a thorough examination of the current body of literature. Consequently, other students with an interest in studying this subject will have the opportunity to utilise this work as reliable knowledge that can be comprehensively evaluated. 

1.7 Scope of the study

Broadly, this study focus is to critically assess the perception of healthcare workers on the effect of economic recession under President Tinubu.

Geographically, the study will be carried out among healthcare workers in FMC, Asaba, Delta State.

1.8 Limitations of the study

Like in any human attempt, the researchers encountered several small limits during the investigation. The primary constraint was the scarcity of comprehensive literature on the topic, as there is a paucity of data regarding the perception of healthcare workers on the effect of economic recession under President Tinubu. Therefore, a substantial investment of time and effort was required to find the suitable materials, books, or information and collect data. 

Moreover, this study is limited by its limited sample size and restricted geographical reach, namely concentrating just on Nigeria. Hence, the findings of this study cannot be extrapolated, thereby necessitating additional research. 

Furthermore, the researcher's limitations were predominantly attributable to budgetary restraints, as they are a student and lack a means of financial support. The research location's transportation charges were difficult to afford due to the exorbitant cost of transportation, which is directly impacted by the current inflation in Nigeria.

In addition, the researcher encountered a time limitation as a result of having to conduct this research while simultaneously meeting the responsibilities of attending lectures and engaging in other educational pursuits.

1.9 Definition of terms

Economic recession: Economic recession as: "a significant decline in economic activity spread across the economy, lasting more than a few months, normally visible in real GDP, real income, employment, industrial production, and wholesale-retail sales

Inflation: Inflation is the rate of increase in prices over a given period of time. Inflation is typically a broad measure, such as the overall increase in prices or the increase in the cost of living in a country.