International Journal of Medical and Health Research

www.medicalsciencejournal.com
ISSN: 2454-9142
Received: 10-10-2021, Accepted: 24-10-2021, Published: 11-11-2021
Volume 7, Issue 11, 2021, Page No. 20-28

Globalization impact on health in Nigeria: Evidence from Enugu State

Onodugo Ifeanyi Chris1, Uzoechina Uzoamaka2, Ezugwu Lazarus Eneje2
1
Professor, Department of Education, Charisma University, Turks and Caicos Islands, United Kingdom
2
Department of Public Health, Charisma University, Turks and Caicos Islands, United Kingdom

Abstract
The study is an empirical analysis of the impact of globalization on health in Nigeria with evidence from Enugu State. This is
borne out of the problem that globalization is an ambivalent concept and process with its strengths, weaknesses, opportunities
and threats (SWOT) or with costs, benefits and burdens. The objectives of the study are to determine the perception and
attitude of the people to globalization; to determine the positive effects of globalization on health; to determine the negative
effects of globalization on health; to determine how to maximize the benefits and minimize the costs of globalization on health
in Enugu State. Being an empirical development research, the survey research design involving the collection, collation and
use of primary and secondary data from a representative sample population of 323 (three hundred and twenty-three)
respondents was used. Descriptive and inferential statistics with the aid of the Statistical Package for Social Sciences (SPSS)
were used in data presentation, analysis and test of hypotheses in which all null hypotheses were rejected in favour of the
alternate hypotheses which were accepted. The findings are that the people have good understanding and positive attitude to
globalization, globalization has positive and negative effects on health and there are strategies to maximize the benefits and
minimize the costs of globalization on health. The study concludes that globalization has impacted significantly on health in
Enugu State. The recommendations are a robust and effective health policy, programmes and project, improved budgetary
allocation and funding to the health sector, integration of traditional medicine and orthodox medicine and improved
collaboration with donor countries and agencies to achieve desired health outcomes and sustainable human development.

Keywords: globalization, health, human development and health policy

Introduction process, it involves the increasing integration of the world

We live in a globalization and increasingly interdependent into a monolithic entity, or what Marshal Mcluhan (1964)
world. For developing countries, dependence on rich nations called a global village. Ojebode (2004: 40) described
remains a stark fact of economic life. At the same time, the globalization as the process of integrating the nations of the
developed world, which once prided itself on its apparent world in all dimensions of human life.
economic self-sufficiency has come to realize that in an age Thus, Olaywola, et al (2004) view globalization as the way
of dramatically increased capital flows, diminishing natural in which developments in one region, can rapidly come to
and mineral resources, global environmental threats, have significant consequences for the security and well-
accelerated international migration, bourgeoning world being of communities, in quite distant regions of the globe.
trade in manufacturers and services and new forms of As there can be no island of prosperity in an ocean of
geopolitical tension, it is becoming even more economically economic instability, globalization expresses the widening
dependents on the developing world (Todaro and Smith, scope, deepening impact and speeding up of interregional
2009:998). flows and network of interaction within all realms of social
Rich-nation dependence does not centre solely on the need activity from the cultural to the criminal (McGraw, 2000).
for energy and raw materials supplied or on the ability of Globalization is a force that can neither be halted nor
key nations like Brazil, India and China to control their ignored. This implies greater difficulties for countries trying
environmental damage. It is also manifested in the to isolate themselves from the world market place. It offers
importance of LDCs as marked for developed country growth prospects to national economies if they satisfy its
exports. The developing nations accounted for 47 percent in requirements in terms of flexibly and competitiveness,
1985; Moreover, developing nations provided almost 55 which include designing and implementing domestic, which
percent of U. S. imports in 2006, compared with less than include designing and implementing domestic policies to
35 percent in 1995 (U.S. State Department, 2001). The met global requirements (IMF, 1997). It is argued that
economic progress of developing countries now has both a countries can be exposed to new technologies and ideas,
direct and an indirect impact on the economic performance which can create jobs, improve incomes and reduce poverty.
of industrialized nations (Todaro and Smith, 2009:798). This is predicted to have a positive influence on the health
International interdependence is not limited to the economic and nutritional status of people across the world. There is
sphere. It is a broad spectrum with economic, political, the presence of the perpetuation of social vulnerability
social, cultural, technological and environmental dimensions (Bahalla and Lapeyre, 1999). Also, advances in information
(Ojebode, 2004:40). Globalization is therefore both a technology may have profound effects that directly
movement and a process. It is a movement of people, ideas, influence health (Daulaire, 1999). The glamorization of self-
goods, technology and culture across the globe. As a serving and unsustainable lifestyles is one of the effects of

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the spread in information technology, which may negatively poor to tap into economic opportunities of globalization that
effect health status and worsen poverty (Olayiwola, et al, can free them from poverty. The balance of payments
2004). position is highly precarious in the face of huge external
Emerging trends and realities of the continuous shrinking of debt and debt servicing requirements. This tends to limit the
the world into a seemingly homogenous space otherwise amount of resources available to revitalize the collapsing
regarded as a global village are confirming the ambivalence basic social and economic infrastructure. The country has
of globalization as a world phenomenon (Odunlami, also witnessed persistent high rates of inflation in the 1
2007:198). A dialectical nexus exists between globalization 990s. Inflation contributes to the vulnerability of the
and development. Nigeria, being a major player in the population because it undermines investment and impedes
commonwealth and comity of nations, has been influenced economic, growth.
and impacted on in its development trends by the allied The capacity utilization in the manufacturing sector in the
forces of globalization. Enugu State, as part of Nigeria is l990s that hovered around 29 and 39 percent hindered the
also impacted upon by the globalization phenomenon in the employment capacity of the sector. The consequence of this
health sector. is the ballooning informal sector that provides as high as 75
percent of employment in Nigeria. The low level of
Statement of Problem government budgetary allocation to both health and
Globalization is a very uneven process, with unequal education is also a clear indication that priority is not placed
distribution of benefits and gains costs and losses. This on activities that have direct links with health and nutritional
imbalance lends to polarization between the countries and status. Expenditure on health fell from 3.30 percent in 1995
groups that gain that are mostly in the North (more to 2.92 percent in 2000, while the proportion of government
developed countries) and the many countries and groups in expenditure to education also fell from 6.33 percent in 1995
society that lose out or are marginalized, mostly in the South to 3.33 percent in 1999, before it was increased to 5.87
(less developed countries). Globalization, polarization, percent.
wealth concentration, poverty and marginalization are In terms of trade performance, the value of exports that rose
therefore interwoven. Globalization has been a mixed rapidly from US$3.47 billion in 1973 to a peak of US$26.10
blessing to Nigeria, as a member of the less developed billion in 1980 fell drastically to US$12.88 billion in 1999
countries (LDCs) in the South. This study therefore sets out (Oyejide, 2001). However, the value of imports rose from
to investigate the impact of globalization on Nigeria‘s US$6.04 billion in 1980 to a continuous rise of US$8.59
health, with focus on Enugu State. billion in 1999. This clearly shows that globalization had a
more expansionary imports than exports in Nigeria. The
The Objectives of the Study consequence of this development is deteriorating terms of
The overall broad objective of the study is to examine or trade during this period.
determine the impact of globalization on health trends in In order to provide an understanding of the environment
Enugu State of Nigeria. The specific objectives are as within which globalization is taking place in Nigeria, an
follows: overview of the political and institutional developments is
1. To determine the perception and attitude of respondents helpful. This is based on the economic intelligence ranking
to globalizations. of countries between 1993 and 1997, but projected to 2002.
2. To determine the positive effects of globalization on The political environment is based on two major indicators
health in Enugu State. political stability and political effectiveness (Olayiwola,
3. To determine the negative effects of globalization on 2003).
health in Enugu State. Nigeria ranks lowest among the African countries included
4. To determine how to maximize the benefits of in the survey. The country has become politically unstable
globalization and minimize the costs on health in Enugu since 1993 when a presidential election was annulled. The
State. governance outlook of the country took a different turn with
the return to democratic rule in 1999. Nigeria also falls
Research Questions below average in terms of political effectiveness
The research questions which are derived from the research (Olayiwole, 2003)
objectives include the following: In the context of the Human Development Index of UNDP
1. What is the perception and attitude of respondents to (2001), welfare seems to have improved in Nigeria from
globalizations? 0.322 in 1990 to 0.400 in 2000. The level of urbanization
2. What are the positive effects of globalization on health rose from 31 percent in 1985 to over 43 percent in 2000. As
in Enugu State? the urban population increased from 29.6 million in 1985 to
3. What are the negative effects of globalization on health 68.9 million in 2000, the rural population followed suit as it
in Enugu State? increased from 65.6 million to 90.3 million during the same
4. How could the benefit and costs of globalization on period. This trend in urbanization is associated with
health be maximized and minimized respectively in problems of unemployment and lack of basic services such
Enugu State? as water, sanitation and health care (Mabogunje, 1974).
These problems arise because of the obvious mismatch
Review of Related Literature between the growth of the urban population and available
Nigeria’s Position in the Globalizing World resources. The second problem is the character of urban
The dismal picture of Nigeria‘s vulnerability to poverty in growth, as a result of rural-urban migration. For example,
the globalizing era can be illustrated within the context of Lagos city in Nigeria witnessed a remarkable increase in
macroeconomic indicators. The Nigerian macroeconomic population from 53 million in 1985 to 12.89 million in 2000
environment portends a picture that limits the ability of the (Abumere, 2001)[1].

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The indicators of another dimension of globalization, Positive Effects and Impact of Globalisation on
information technology, are also considered. According to Health
the International Telecommunication Union, teledensity was Information Communication Technologies (ICTs) and
34.38 in Europe in 1997, 30.38 in the Americas, 6.02 in Health Information Technologies (HICTs) are the
Asia and 1.85 in Africa. In 1998, Nigeria had the lowest powerhouse and vehicle of globalization, globalization
teledensity (4), compared to South Africa (115), Senegal driven by ICTs have turned the world into a global
(16) and Côte d‘Ivoire (12). Cellular density (as a knowledge economy or an information society. ICTs are the
percentage of total telephone lines) for the Americas was various software and hardware that use microelectronic
6.92 (I8.6 percent), in Europe 4.57 (11.7 percent), in Asia devices to store, retrieve and disseminate information in
1.35 (I 8.3 percent) and in Africa 0.17 (8.4 percent). The large volume to heterogeneous mass of people worldwide at
number of mobile telephones per 1000 people in Nigeria very fast rate. They include the satellite telephone, telex-
was 0.01 in 1998. This number was insignificant compared internet, GSM, digital computer system, microchip, fax,
to that of South Africa (56), Indonesia (5) and Egypt (1). multimedia system, e-mail, internet, CDs, laptop and
The number of personal computers per 1000 persons was desktop computer, in-pad and other electronic devices that
5.7 in Nigeria compared to 47.4 in South Africa, 9.1 in have equally revolutionalized communication and
Egypt and 11. 4 in Senegal (Table 3). As of 2000, the interaction in the world community (Onwe, 2007:154).
number of Internet hosts per 1000 people was the smallest The information technology (infotech) revolution or the new
in Nigeria (0.01) compared to that of the Republic of Korea technologies provide us with the opportunity of obtaining
(60.03), South Africa (39.17), Indonesia (1.0) and even accurate, timely, relevant, appropriate and adequate
Senegal (0.32). In terms of television sets per 1 000 people, information for decision-making in personal and corporate
the Nigeria figure of 66 in 1998 was only better when sphere. The speed, efficiency and reliability of these devices
compared to Senegal (41) whose GDP is less than one-third make them pillar upon which economic and political system
of the country (Olayiwola, 2001). in the international community rest. With the satellite
Nigeria has recorded a rising profile of cyber cafes and television, every part of the world‘s linked to all the
Internet usage. From a mere 17 cafés in 1998, the number happenings in other parts and watched simultaneously and
increased to no less than 1 500 cafés in 2003. There were instantaneously. With the GSM one can make and receive
153 350 Internet users in 2001. Moreover, Nigeria calls anywhere, anytime. With the internet, you can obtain
accounted for the largest Internet usage in 2001 in West information about important events that enjoy network
Africa. Nearly one out of every two West African users of coverage, issues, subjects, organizations speedily, cheaply,
the Internet was a Nigerian. However, Internet penetration and in minute details (Onwe, 2007:154).
was 0.08 percent of the entire population. Access to The information technology (infotech) revolution or the new
electricity is very low in the country. Less than 30 percent technologies provide us with the opportunity of obtaining
of the population has access to electricity. As of 1997, the accurate, timely, relevant, appropriate and adequate
consumption per capita of electric power was 84 kWh in a information for decision-making in personal and corporate
marginal increase from 77 KWH in 1990. But in the context sphere. The speed, efficiency and reliability of these devices
of transmission and distribution loses, the Nigerian figure of make them pillar upon which economic and political system
32 was more than triple that of the Republic of Korea. in the international community rest. With the satellite
In spite of this relatively poor performance when compared television, every part of the world‘s linked to all the
with other countries, overall the country can be said to have happenings in other parts and watched simultaneously and
witnessed significant performance in attracting foreign instantaneously. With the GSM one can make and receive
investment since the advent of representative democracy in calls anywhere, anytime. With the internet, you can obtain
1999, compared to the military dictatorship of the previous information about important events that enjoy network
15 years. In the last four years, a total foreign investment of coverage, issues, subjects, organizations speedily, cheaply,
over N70 billion has come into the country. In the area of and in minute details (Onwe, 2007:154).
Information and Communication Technologies (ICTs), four Health care delivery is the provision of promotive,
global systems of mobile communication operators have preventive, curative and rehabilitative health services to the
provided an additional 2 million lines within two years. people at primary, secondary health institutions.
Although Nigeria‘s cost of mobile calls is one of the highest Information and communication technologies (ICTs) in
in the world because of the poor state of infrastructure, health care delivery refers to a wide range of applications
competition in the market in the next few years is expected and tools that facilitates acquisition and sharing of
to bring down the costs. The number of motor vehicles information and knowledge in health matters (Ajayi, et al,
increased threefold from four to 12 per 1000 people in 1980 2008:259). As noted by Ajayi and Garba (2005), computers
to 1 987, and the number of passenger cars also increased have become most prominent means of assessing a wide
from three per 1000 people to seven per I 000 people. This variety of information. Some of the ICTs that are of direct
was not matched by corresponding kilometers of paved relevance to health care delivery include Electronic Patient
roads, which increased marginally from 3 km per 1 000 km Record (EPR), Electronic Bulletin Board (EBB), intranet
road to 7 km per 1 000 kilometer road. The resultant effect Extranet and Internet, Tele-Medicine and Telecare, and
of this is the increase in traffic accidents from 123 per 1 000 World Wide Web (www). Others as Whatmore (1985)
in 1980 to 732 per 1 000 in 1998. Moreover, the number of outlines include cable television direct broad cost satellite,
air passengers has also decreased tremendously. two-way television, radio, newspapers and global system for
International passengers decreased from 228 516 in 1994 to mobile communication (GSM).
40 166 in 1998. The same situation occurred with domestic Even though none of the ICTs is specifically designed for
passengers; they decreased from about 4.4 to 0.92 million use in health care delivery, they have been found to be
during the same period (World Bank, 2000). useful in health care delivery system. The importance of

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ICTs in contemporary health care delivery is underscored by campaign for faithfulness to one‘s sex partner, and C –
the ever increasing need for speedy, informed, interactive stands for the campaign to use condom if one must have
and integrated service delivery in the health sector. And like sex.
the banking, administration and other sectors of human The broadcast media just like the print media play
endeavour, the health sector is witnessing an increasing significant role in both informing and educating. Infact,
volume of information and applications, to which the ICTs Folarin (2002) says the media are pacesetters and agenda
provide invaluable access (Ajayi, et al, 2008:259). The setters. They largely dictate the course and subject of
internet for example, provides unbeatable access to this discourse and members of the audience largely believe what
rapid and increasing volume of information in the health the media say and do what the media say. Okolie (2005) say
sector (Fraser et al, 1997). the power and role of the mass media exploring that the
ICTs have also enabled the health institutions to provide media are central in the provision of ideas and images which
flexible and more qualitative health care services to patients. people use to interpret and understand a great deal of their
Reinforcing this argument, Afolabi and Adagunodo (2005) everyday experience.
note that the convergence of new ICTs has enabled the Tay-Yap and Al – Howamdeh (2001) argue that paramount
health institutions implement Tele-Medicine, Tele-care and as the need to give patients adequate information is,
on-line health care delivery. Such on-line health care occasions for patient – doctor face-to-face contact for such
delivery can be CD-Ram-based, network-based internet or communication are relatively few and brief, thus inadequate.
internet-based (Ajayi and Garba, 2005). This is due to large patient population and the shortage of
Furthermore, ICTs are relevant to health care delivery from physicians, not to mention specialists and doctor‘s
the paint of diagnosing diseases and ailments to the point of administrative duties. ICTs usage becomes imperative.
caring them. They provide limitless opportunities and access Among ICTs the authors consider is Interactive Health
to vial information that assists in addressing human health Communication (IHC). This refers to communication
problems (Ajayi, et al, 2008:257). between patients and health professionals via internet,
Interestingly, the benefits and applications in ICTs are not telephone (including GSM) or other technologies to receive
limited to the medical doctors and surgeons. They are or send out health information. It is aimed at giving support
equally extended to the paramedical health workers such as or guide to patients, thus facilitating in formed decision –
Nurses, laboratory scientists and technologists, pharmacists, making and enhancing self-cure.
nutritionist, physiotherapists, medical record officers, etc. Academics have continued to call for and support the
This is for the simple reason that all medical fields are adoption of ICTs in developing nations, citing its
interrelated, such that there is a high degree of advantages while highlighting pitfalls to overcome.
interdependency for effective discharge of duties (Ajayi, et Obijiofor, et al, (2005) survey of ICT impact on Africa and
al, 2008: 25:7). Aisa-Pacific Socio-Economic and educational development
In modern society, communication through the medial is reveals that Africans perceives ICT as ―basic tools for
used as a tool of survival. Communication can also be used survival‖, that is, increase efficiency in the workplace as
to report or warm about health related issues such as drug well as facilitates easy and speedy communication. This
abuse. HIV/IDS, tuberculosis, malaria, polio media or ICTs leads to reduction in traveling, transportation and hazard
can be used for aggressive advertising by anti-drug (Shittu, et al, 2008:29).
organizations, like National Agency for Food and Drug Concerning higher education, Nyamjoh (2000), Tiamiyu
Administration and Control (NAFDAC) and National Drug (2002), Obijiofor, et al (2005) agree that ICTs provide
Enforcement Agency (NDLEA) and by other Non- African academics including health professionals the means
governmental Organizations and to promote other health to network wit professional colleagues internationally.
campaigns and public service journalism on air and paper Though this, they can keep abreast of new trends in their
(Olise, 2008). Whatever the case may be, Wilson (2005), disciplines. It affords them access to the latest research
Nwosu (2007) and Nwodu (2007) advise that the materials.
communication messages should deeply rooted in and Nyamyoh (2000) and Tiamiyi (2002) view ICTs as valuable
reflect the cultural sensibilities of the generality of the in medical care. They note that ICTs enhance distance
people. UNICEF (2006) had this in mind in adopting the diagnosis, increase number of doctors having access to
Acada communication model in its polio eradication and quality information on medical technology and diseases, and
routine expanded programme on immunization campaigns thereby raise the efficiency of public healthcare. Individuals
as well as national immunization days campaigns in Nigeria can search directly for medical information and consult
and the rest of the world. As a development communication physicians online, which is cheaper than face-to-face
model (DEVCOM), ACADA model is anchored on three meetings with doctors (Nyamjor, 2000). Also ICTs can raise
strategies: advocacy, social mobilization and programme healthcare through information exchange among
communication (Ojobor, 2007:50). primary and tertiary health organizations, while
The broadcast media, which comprise the radio and facilitating aid to the disadvantaged through faster
television, are involved in persuasive campaigns and access to aid sources as well as ICTs – based
behaviour change communication. According to Ufuophu –
diagnostic and monitoring facilities (Tiamiyu, 2002).
Biri (2008), over the years the broadcast media have dished
The Government of the Federal Republic of Nigeria (FRN)
out information or campaign on how to avoid contacting the
has since 2000 accelerated ICT development projects in the
dreaded HIV/AIDS. Some of the campaign messages are
country. The nations‘ Information Technology (IT) policy
generated, while others are produced and broadcast as part
and an implementing agency – the Nigeria Information
of their social responsibility. These messages according to
Technology Development Agency (ITDA) have been
Imoh (2003)[18], span the ‗ABC‘ of HIV/AIDS. A stands for
established. The country launched the NIGERIAN SAT
campaign for total abstinence from sex, B – means

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satellite into spare in 2003 for environmental monitoring, as paramedical institutions curricular. Other objectives are
well as a communication satellite NIGCOMSAT and rural using ICTs to manage HIV/AIDS, leprosy and physical
telephony/internet project interconnecting local government disabilities through online health educational programmes
areas nationwide in May 2007. In furtherance of the ICTs and conferences for youths and afflicted patients (Federal
implementation, the government and its major ministries Ministry of Science and Technology, 2007:12-14).
and parastatls are online offering some governance service
(Aderinokun and Ugwuodo, 2004). Nigeria IT policy Methodology
statements on health indicate that ICTs will be used in The data collected were presented and analyzed using
improving healthcare delivery, reduce delivery costs, train descriptive and quantitative analytical techniques. These
medical professionals, facilitate research and health included tables, percentages, frequencies, charts and chi-
information dissemination. The strategies for realizing the square. The Statistical packages for Social Sciences (SPSS)
objectives include: establishing internet connectivity among version 10 or 13 was used to test the hypotheses postulated
health care institutions making ICTs skills acquisition
compulsory for all medical professionals, as well as Data Analysis
encouraging the introduction of ICTs courses in medical and

Table 1: Minimizing the costs and constraints of Globalization on Health

Option Frequency Percent (%)
Greater information education and communication (IEC) packages and kits on healthy living 57 20.66
Integration of traditional medicine with orthodox medicine 55 19.92
Improve working environment, health facilities to reduce brain drain 42 15.21
Best practices in the reduction and control of industrial and vehicular pollution 43 15.58
Adoption of best practices in the reduction and control of industrial, road, sea and air accidents and crash 79 28.63
Total 276 100.0
Source: Field Survey, 2011

Table 1 indicate the options for Nigeria to explore and adopt control of accidents and mishaps has the highest frequency.
in minimizing the costs and constraints of globalization. This is illustrated in the figure below.
Adoption of global best practices in the reduction and

Fig 1: Minimizing the costs and constraints of Globalization on Health

Enhancement of Automated System has enhanced the automation of services in the health care is
The position of the respondents as to whether globalization presented in table 4.16.

Table 2: Enhancement of Automated System

Option Frequency Percent
Agree 190 68.8
Strongly agree 68 24.7
Undecided 18 6.5
Disagree 0 0.0
Strongly Disagree 0 0.0
Total 276 100.0
Source: Field Survey 2011

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Fig 2: Enhancement of Automated System

Fig 3: Increase Access to Healthcare Facilities
With only 18 respondents (6.5%) not being sure, the
majority of the respondents (93.5%) posited that It is the opinion of the respondents that globalization has led
globalization has enhanced the automation of the health care to increased access to healthcare facilities in Enugu State.
system in Enugu State. This is evident in the responses of 81.9% of the respondents
who affirmed this assertion.
Increased Access to Healthcare Facilities
The opinion of the respondents on whether globalization has Test of hypotheses
led to increased access to health care facilities is presented The various hypotheses were tested and the results
in table 4.17. presented in this section.

Table 3: Increase Access to Healthcare Facilities Test of hypothesis one

This is restated in the null form
Response Frequency Percent (%)
Agree 108 39.1
Strongly agree 100 36.2 Hi: The impact of globalization on health is not facilitated
Undecided 18 6.5 by ICTs
Disagree 50 18.1
Strongly disagree 0 0.0 Data presented in tables 4.10 and 4.11 was used in testing
Total 276 100.0 hypothesis one, with the Z- test statistics.
Source: Field Survey, 2011

Table 4: One-Sample Kolmogorov-Smirnov Test Result for Hypothesis One

ICTs does not facilitate globalization impact on health
N 276
Normal Parametersa,,b Mean 1,9167
Std. Deviation 1,252,03
Absolute .274
Most Extreme Differences
Positive .274
Negative -.232
Kolmogorov-Smirnov Z 4,555
Asymp. Sig. (2-tailed) .000
a. Test distribution is Normal.
b. Calculated from data.

Decision Rule Table 5: Kendall’s W Rank for Variables in Hypothesis Two

If Z2cal > Z2critical, the responses presented in table 4.10 and Mean Rank
4.11 are normally distributed. Based on this the null Existence of positive effect of globalization on health 1.71
hypothesis should be rejected and the alternative hypothesis Maximizing the benefit of globalization on health 1.76
accepted. Otherwise, the null hypothesis should be accepted Enhancement of automated system in health 2.54
and the alternative hypothesis rejected.
Table 6: Kendall’s W test result for hypothesis two
Decision
N 276
As presented in table 4.3.1, since Z2cal = 4.555 > X2critical =
Kendall's Wa .982
1.96, responses in table 4.10 and 4.11 are normally
Chi-Square 283.500
distributed. Thus, the impact of globalization on health is Df 2
facilitated by ICTs. Asymp. Sig. .000
a. Kendall's Coefficient of Concordance
Test of hypothesis two
This is restated in the null and alternative forms. Decision Rule
If X2cal > X2critical, the responses in tables 4.11, 4.13 and 4.15
H2: Globalization does not have any positive effects and have same proportion of values the null hypothesis should
impact on health in Enugu state be rejected and the alternative hypothesis accepted.
Otherwise, the null hypothesis should be accepted and the
Data presented in tables 4.11, 4.13 and 4.15 was used in alternative hypothesis rejected.
testing hypothesis two, with the kendall‘s W test statistics.

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Decision globe (26.09%), liberation of trade, finance and investment

As presented in table 4.3, since X2cal = 283.500 > X2critical = (18.84%), and change of statusquo (17.03%). In table 4.9,
5.991, responses in table 4.11, 4.13 and 4.15 have the same majority of the respondents are receptive to and embrace the
proportion of values. This agreement among the responses is change that globalization brings with it. This is represented
further emphasized with the Kendall‘s Coefficient of by 53.26%.
Concordance which is extremely strong at. 982. The null However, 35.1% of the respondents need to acquire new
hypothesis should be rejected and the alternative hypothesis skills, like computer and internet literacy and skills to cope
accepted accordingly. Therefore, globalization has positive with the change, while 11.60% of the respondents have a
effects on health in Enugu State. negative attitude or reaction to globalization and the
changes it brings in its wake. This finding is in consonance
Test of hypothesis three with the views of Khor (1981) that globalization is the
This is restated in the null form. defining process of the moment, Nwodu (2007) that the
‗‘buzz word ‘‘in the contemporary global economic,
H3: Globalization dose not have negative effects on health political, cultural and communications environments is
in Enugu State globalization and that the concept straddles virtually all
Data presented in tables 4.13 and 14 were used in testing aspects of human endeavours. However, Scholars like
hypothesis three, with the kendall‘s W Test statistics. Nwodu (2007), Izuogu (2007) and Amadi (2007) have
ambivalent attitudes toward globalization. All scholars are
Table 7: Kendall’s W mean Rank for Variables in Hypothesis of the view that globalization is facilitated by information
Three communication technologies (ICTs).
MeanRank Accordingly, the null hypothesis in hypothesis one which
The negative effect of globalization on health 1.01 states that the impact of globalization on health is not
Minimizing the costs and constraints of globalization of health 1.99 facilitated by ICTs is rejected and the alternate accepted,
since Z2cal = 4.555 > X2 critical = 1.96. Thus, the impact of
Table 8: Kendall’s W Test Result for Hypothesis Three globalization on health in Enugu state is facilitated or
N 276 enhanced by ICTs.
Kendall's Wa .524
Chi-Square 271,000 Positive effects of Globalization on Hhealth
Df 1 A major finding of the study is that there are profound
Asymp. Sig. .000 positive effects and impact of globalization on health in
a. Kendall's Coefficient of Concordance Enugu State. From the respondents‘ responses in table 4the
positive effects of globalization on health include improved
Decision Rule knowledge, attitudes and practice on health, hygiene and
If Z2cal > Z2critical, the responses presented in table 4.13 and sanitation (12.70%); establishment of primary, secondary
4.14 have the some proportion of values indicating and tertiary health care centres and institutions (15.94);
agreement. Accordingly the null hypothesis should be improved provision of safe drinking water and sanitation
rejected and the alternative hypothesis accepted. Otherwise, facilities (7.24%), availability of potent preventive and
the null hypothesis the null hypothesis should be accepted curative drugs and health facilities (11.96%), access to
and the alternative hypothesis rejected. international practices on health diagnosis, treatment and
care facilitated by information technology communications
Decision (ICTs) (15.21%), brain gain and overseas remittances (9.00
As presented in table 4.3.5, since Z2cal = 271,00 > X2critical = %), counterpart funding, grants, loans and other forms of aid
3.841, responses in table 4.13 and 4.14 have the same by donor countries and agencies (18.11%), and adoption of
proportion of values. This agreement is further emphasized the millennium development goals (MDGs) and consequent
by Kandall‘s Coefficient of Concordance which is 0.524. reduction of morbidity, mortality and improved life
Thus, the null hypothesis should be rejected and the expectancy (9.78%).
alternative hypothesis accepted. Therefore, globalization has Again, the second null hypothesis which states that
negative effects on health in Enugu State. globalization has no positive effects and impact on health in
Enugu State, rather than receive empirical support was
Chapter five discussion of findings rejected. The calculated (chi-square (x2) value of 283.500 at
Having undertaken this study, various findings) were 2 degree of freedom and 0.05 level of significance is greater
obtained. These findings are in the data presented in chapter than the critical table value of 5.991 in responses 4.14, 4.16
four in this section, the findings will be discussed under and 4.17, there is agreement among the responses which is
subheadings in consonance with the research objectives. further emphasized with the Kendall‘s Coefficient of
Concordance of 0.514 and so could not gain empirical
Perception and attitude of Globalization support. Thus, globalization has positive effects and impact
The study reveals that the populace of Enugu has basic on health in Enugu State. This finding tallies with the earlier
understanding and knowledge of globalization and also findings of Onwe (2001), Ajayi, Garba (2005), Ajayi et al
disposes a positive attitude toward the phenomenon. This (2008), Ojobor (2007), Obijiofor et al (2005), Shitte et al
knowledge and understanding is exhibited in the responses (2008), Nyamjoh (2000), Tianiyu (2002), FMST (2001)
in tables 4.8 that globalization is a widening, intensifying, Adernokun and Ugwuodo (2004) IDRC (2004) and Tay-
speeding up and growing impact of international Yap and AC – Hawareleh (2001), UNAIDS (2008), GFRN
connectedness and interrelationships (38.04%), a movement (2005, 2009); UNICEF (2008) and World Health (2002) in
of people, ideas goods technology and culture across the the literature review.

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International Journal of Medical and Health Research www.medicalsciencejournal.com

The negative Effects and Impact of Globalization Health effects, benefits and impact and minimize the negative
Author major finding of the study is that there are negative effects, costs, constraints burden and impact for expected
effects and impact of globalization on health. The result of health outcomes and sustainable development.
the study in table 4 indicate that these negative effects are
prevalence of HIV/AIDS pandemic (21.74%) as a result of Recommendations
regional and international tourism and increasing Based on the findings of the study and the conclusion, the
transnational exchanges, transactions and travels, prevalence following recommendations are made:
of non-communicable diseases such as hypertension,  Enugu state government should come up with a robust
diabetes, cancer and osteoarthritis (16.30%) due to imitation health policy, programmes and projects which will be
and adoption of western lifestyle; access to poisonous drugs effectively and efficiently implemented to achieve
and abortion operation (14.86%); water, air, land and noise desired health outcomes as a development objective.
pollution caused by vehicular, industrial and generator  There should be increased and optimal budgetary
emissions and chemical fertilizers (18.12%) which allocation and funding to the health sector to make the
adversely affect the health of the people, accidents and community health centres and urban hospitals. ‘healing
death caused by motor motorbikes and aircraft crashes centres‖ and not ‖ killing centres‘‘ or mere consulting
(14.50%) like the road accidents that occur on Nigeria urban clinics.
and rural roads almost on a daily basis and the recent  Government should set up machinery to integrate
DANA airline plane air disaster that killed all 153 persons traditional medicine and orthodox medicine for
on board; brain drain in the medical and health profession maximum positive benefits and impact.
(10.14%) occasioned mainly by unfavorable and harsh
working conditions and little or no opportunity for The state should strengthen its policy of engagement
professional growth and fulfillment and relegation of partnership and collaboration with donor countries and
tradition medicine practice and erosion of traditional values agencies in the state, such as WHO, UNICEF, DFID, water
on sanctity of life (4.34%) which is fast. resulting in the Aid, Germany Leprosy and Tuberculosis relief centre, to
extinction of indigenous knowledge, armed robbery, achieve desired health and development outcomes.
political killings and hired assassinations, ethnic-religious
violence, violent communal land disputes and kidnapping in References
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