Abstract
Introduction
Health inequality is the differences in health status or the disparity in health determinants among a group of people living within a described population. Socio-economic inequality in health is the systematic difference in morbidity or mortality rates between people of higher and lower socio-economic status, as indicated by level of education, occupational class or income level (Mackenbach, 2006) . Street children are children that roam the streets and their environments in search of daily living, deep desires for significant values, acceptance and the quest for worthy existence. This population of children constitute an important socio-economic and public health challenge in low and medium income countries globally. Their social disadvantage casts a shadow of marginalization and vulnerability on them, so much that their present aspirations and hopes for the future appear dim in the light of expected civilization. These children are victims of wrong religious indoctrination, political instability, wars, insurgencies, social deprivation and evidently poor leadership structures. Northern Nigeria comprises of States geographically located in the Sudan and Sahel Savannah part of the country with variable rainfall patterns and high temperatures.
Discussion
Most of the street children in Northern Nigeria are raised in large polygamous families by poor and illiterate parents who have no formal education and are ignorant of family planning measures. As a result of this, they are enrolled in Arabic schools where they are poorly monitored and they are allowed to roam the streets following their daily engagements with religious indoctrinations. The illiteracy passed down to these children makes them vulnerable to many health conditions. For instance, basic healthy habits like regular hand washing, eating balanced diets and wearing clean clothes are far-fetched from this group of individuals. Also, they are more at risk of other conditions like malnutrition, road traffic injury, rape, substance use disorders, depression and other mental health disorders. Street children are significantly more likely than other children to have psychiatric disorders like depression, enuresis, substance use and post-traumatic stress disorder (Abubakar-Abdullateef et al., 2017). Because of the limitations their environments put on them, they may have deficiencies in their personality developments, self-esteem and assertiveness as personality is a blend of genetic inheritance and environmental influence (Harrison et al., 2018).
Accessing the orthodox general medical and mental health care may be expensive for these individuals considering their limiting socio-economic status and lack of adequate health insurance as most healthcare provision in Nigeria is hinged on out of pocket policies. Socio-economic status is known to be a major determinant of mental health throughout life and low socio-economic status is associated with poor mental health outcomes, distress, hunger and deprivation.
In order to improve the social determinants of health among street children in Northern Nigeria, structured educational and health care policies should be promoted through adequate legislative procedures. According to the United Nations’ report in 2019 on sustainable development goals, education enables upward socioeconomic mobility and is a key to escaping poverty and improving optimal mental wellbeing. Formal education should be made free, at least till secondary schools for these individuals. Universal health coverage should also be duly instituted so as to cater for the general medical and mental health needs of these children. These would go a long way in reducing the number of out of school children in Northern Nigeria and will improve their social and health behaviors (Jensen, 2019).
Conclusion
In conclusion, the health inequality from socio-economic deprivation experienced by the street children in Northern Nigeria is multi-factorial in origin and requires inter-sectoral collaboration for effective solutions.
Footnotes
Acknowledgements
The corresponding author is the sole author of the article.
Conflict of interest
The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author received no financial support for the research, authorship, and/or publication of this article.
