STEWARDSHIP: A Conceptual Imperative For Managerial Effectiveness In The Nigerian Health System

ABSTRACT

Unacceptable health status indicators such as high infant and maternal mortality rates and low life expectancy have continued unabated in spite of government efforts to change it. This paper espouses the concept of stewardship as a selfless, ethical, cost effective and outcome oriented approach to governance. It is believed that through stewardship approach governments would improve the health status of their populations considerably. The paper implores not only government and health care managers but the Nigerian society also to imbibe the concept of stewardship to make the development of a result-oriented health system easy.

INTRODUCTION

From the first national development plan after Nigeria’s independence till present, government has been making efforts to improve on the health status of Nigerians such as in health manpower development and building health infrastructural facilities.

These efforts have not improved the health status of Nigerians to acceptable levels.

Infant and maternal mortality rates are unacceptable and preventable diseases continue to be major causes of morbidity and mortality. In line with World Health Organisation’s initiative, this paper intends to espouse the concept of stewardship and implores all stakeholders in the health system to adopt it in order to attain the acceptable level of health status for Nigerian populations. 

Stewardship is a concept in religious doctrine. Historically God mandated man to tend and keep ‘the garden of Eden’ which consists of God’s creation (Genesis 2:15). The understanding here is that when entrusted with something of value such as population’s health, there is an obligation not only to preserve but also to improve on it.3 The parable of the talents (Matthew 25:14-30); the state of Egypt entrusted to Joseph as steward and how he effectively managed the state to the satisfaction of all concerned in the holy scriptures were significations of stewardship. The value is given in trust to the ‘agent’ and the ‘agent’ preserves and builds trust by responsiveness to legitimate needs and expectations of the population that owns the value. Accordingly in employee grievance settlement procedure the services of stewards were employed for National Federation of Federal Employees in United States of America.4 Identifiable characteristics of these stewards were that they:

Thus stewardship bears strong relationship with governance and administration by which institutions operate, focusing on the "common good" or public interest.

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