CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF STUDY

The imperative of the association between poverty and health have long been recognized. Until recently the primary focus for social scientists has been on examining the relationships between income (or consumption) poverty and key indicators of health status, such as mortality, morbidity and nutrition. However, the pressure for ‘multidimensional’ and ‘people centred’ understandings of poverty, fueled by the work of Sen (1984), has critiqued such utilitarian measures of poverty and welfare and encouraged a focus on individual capabilities (the means which enable people to function) and more nuanced conceptualisations of poverty. From such perspectives, preventable deaths and ill-health are not merely outcomes of poverty but integral components of poverty itself. Such conceptualisations are reflected in the increasing use of broader measures such as the UNDP’s human development index (HDI) and human poverty index (HPI) that incorporate health indicators in their computation. Health is also measured by a number of indicators with the most common being life expectancy, infant mortality rate and the fertility rate.

In Sub-Saharan Africa, it is estimated that almost (50) per cent of the population live in absolute poverty (Avery, 2016; Rowson, 2011; WHO, 2009). It is significant, however, to mention that the estimate of poverty incidence in sub-Saharan Africa would increase if poverty was seen beyond income poverty (Sahn and Stifel, 2012). The problem of faltering social progress is especially acute in Africa in contrast with other regions that have witnessed more sustained improvements in living standards (World Bank, 2011). Social exclusion, human right abuse and gender inequalities are major dimensions of poverty that deprive most people in Africa of their human dignity other than income differentials. Klasen (2010), Carter and May (2011) attribute South Africa’s poverty situation to apartheid policies and its aftermath that denied equal access to education, employment, social services and resources to the black population in the country. Poverty thus has strong racial, social and

political dimensions with high concentration among African population.

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