Health care in Nigeria
Encyclopedia
Health care provision in Nigeria
is a concurrent responsibility of the three tiers
of government
in the country. However, because Nigeria
operates a mixed economy
, private providers of health care have a visible role to play in health care delivery. The federal government
's role is mostly limited to coordinating the affairs of the university
teaching hospital
s, Federal Medical Centres
(tertiary health care) while the state government manages the various general hospital
s (secondary health care) and the local government
focus on dispensaries (primary health care) , (which are regulated by the federal government through NPHCDA). The total expenditure on health care as % of GDP is 4.6, while the percentage of federal government expenditure on health care is about 1.5%. A long run indicator of the ability of the country to provide food
sustenance and avoid malnutrition
is the rate of growth of per capita food production; from 1970–1990, the rate for Nigeria was 0.25%. Though small, the positive rate of per capita may be due to Nigeria's importation of food products.
in Nigeria can be applied to a few instances: free health care provided and financed for all citizens, health care
provided by government
through a special health insurance scheme for government employees and private firms entering contracts with private health care providers. However, there are few people who fall within the three instances.
In May 1999, the government created the National Health Insurance
Scheme, the scheme encompasses government
employees, the organized private sector
and the informal sector. Legislative wise, the scheme also covers children under five, permanently disabled persons and prison inmates. In 2004, the administration of Obasanjo further gave more legislative powers to the scheme with positive amendments to the original 1999 legislative act.
services is provided by 8 regional psychiatric centers and psychiatric departments and medical schools of 12 major universities. A few general hospitals also provide mental health services. The formal centres often face competition from native herbalists and faith healing
centres.
The ratio of psychologists and social workers is 0.02 to 100,000.
or sub-standard drugs
and to curtail false advertising
. However, the section on essential drugs was later amended.
Drug quality is primarily controlled by the National Agency for Food and Drug Administration and Control
(NAFDAC).
in Nigeria has shown spatial variation in terms of availability and quality of facilities in relation to need. However, this is largely as a result of the level of state and local government
involvement and investment in health care programs and education
. Also, the Nigerian ministry of health usually spend about 70% of its budget in urban areas where 30% of the population resides. It is assumed by some scholars that the health care service is inversely related to the need of patients.
push factor, a resulting rise in exodus of health care nurses may be due to dramatic factors that make the work unbearable and knowing and presenting changes to arrest the factors may stem a tide. However, because a large number of nurses and doctors
migrating abroad benefited from government funds for education, it poses a challenge to the patriotic identity of citizens and also the rate of return of federal funding of health care education. The state of health care in Nigeria has been worsened by a physician shortage as a consequence of severe 'brain drain
'. Many Nigerian doctors have emigrated to North America and Europe. In 2005, 2,392 Nigeria doctors were practising in the US alone, in UK number was 1529 . Retaining these expensively-trained professionals has been identified as an urgent goal.
's definition of health
is not merely the absence of disease but the attainment of a state of physical, mental
, emotional and social well being.
released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Nigeria is 840. This is compared with 608.3 in 2008 and 473.4 in 1990. The under 5 mortality rate, per 1,000 births is 143 and the neonatal mortality as a percentage of under 5's mortality is 28. The aim of this report is to highlight ways in which the Millennium Development Goals
can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Nigeria the number of midwives per 1,000 live births is unavailable and 1 in 23 shows us the lifetime risk of death for pregnant women.
Nigeria
Nigeria , officially the Federal Republic of Nigeria, is a federal constitutional republic comprising 36 states and its Federal Capital Territory, Abuja. The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in...
is a concurrent responsibility of the three tiers
Tiers
Tiers, also known as Ultra Checkers, is a complex variant of checkers that allows players to upgrade their pieces beyond kings. It is played on a standard eight by eight checkers board with two opposing players...
of government
Government
Government refers to the legislators, administrators, and arbitrators in the administrative bureaucracy who control a state at a given time, and to the system of government by which they are organized...
in the country. However, because Nigeria
Nigeria
Nigeria , officially the Federal Republic of Nigeria, is a federal constitutional republic comprising 36 states and its Federal Capital Territory, Abuja. The country is located in West Africa and shares land borders with the Republic of Benin in the west, Chad and Cameroon in the east, and Niger in...
operates a mixed economy
Mixed economy
Mixed economy is an economic system in which both the state and private sector direct the economy, reflecting characteristics of both market economies and planned economies. Most mixed economies can be described as market economies with strong regulatory oversight, in addition to having a variety...
, private providers of health care have a visible role to play in health care delivery. The federal government
Federal government
The federal government is the common government of a federation. The structure of federal governments varies from institution to institution. Based on a broad definition of a basic federal political system, there are two or more levels of government that exist within an established territory and...
's role is mostly limited to coordinating the affairs of the university
University
A university is an institution of higher education and research, which grants academic degrees in a variety of subjects. A university is an organisation that provides both undergraduate education and postgraduate education...
teaching hospital
Teaching hospital
A teaching hospital is a hospital that provides clinical education and training to future and current doctors, nurses, and other health professionals, in addition to delivering medical care to patients...
s, Federal Medical Centres
Federal Medical Centres
In Nigeria, primary health care is to be provided by Local Governments, secondary health care by State Governments and tertiary health care by the Federal Government. In operationalizing this policy, the Federal Government decided to establish at least one tertiary health institution in each State...
(tertiary health care) while the state government manages the various general hospital
General hospital
A general hospital is a type of medical facility which is set up to deal with many kinds of disease and injury.General hospital may also refer to:*General Hospital, an American soap opera broadcast since 1963...
s (secondary health care) and the local government
Local government
Local government refers collectively to administrative authorities over areas that are smaller than a state.The term is used to contrast with offices at nation-state level, which are referred to as the central government, national government, or federal government...
focus on dispensaries (primary health care) , (which are regulated by the federal government through NPHCDA). The total expenditure on health care as % of GDP is 4.6, while the percentage of federal government expenditure on health care is about 1.5%. A long run indicator of the ability of the country to provide food
Food
Food is any substance consumed to provide nutritional support for the body. It is usually of plant or animal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals...
sustenance and avoid malnutrition
Malnutrition
Malnutrition is the condition that results from taking an unbalanced diet in which certain nutrients are lacking, in excess , or in the wrong proportions....
is the rate of growth of per capita food production; from 1970–1990, the rate for Nigeria was 0.25%. Though small, the positive rate of per capita may be due to Nigeria's importation of food products.
Health insurance
Historically, health insuranceHealth insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...
in Nigeria can be applied to a few instances: free health care provided and financed for all citizens, health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
provided by government
Government
Government refers to the legislators, administrators, and arbitrators in the administrative bureaucracy who control a state at a given time, and to the system of government by which they are organized...
through a special health insurance scheme for government employees and private firms entering contracts with private health care providers. However, there are few people who fall within the three instances.
In May 1999, the government created the National Health Insurance
National health insurance
National health insurance is health insurance that insures a national population for the costs of health care and usually is instituted as a program of healthcare reform. It is enforced by law. It may be administered by the public sector, the private sector, or a combination of both...
Scheme, the scheme encompasses government
Government
Government refers to the legislators, administrators, and arbitrators in the administrative bureaucracy who control a state at a given time, and to the system of government by which they are organized...
employees, the organized private sector
Private sector
In economics, the private sector is that part of the economy, sometimes referred to as the citizen sector, which is run by private individuals or groups, usually as a means of enterprise for profit, and is not controlled by the state...
and the informal sector. Legislative wise, the scheme also covers children under five, permanently disabled persons and prison inmates. In 2004, the administration of Obasanjo further gave more legislative powers to the scheme with positive amendments to the original 1999 legislative act.
Mental health
The majority of mental healthMental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...
services is provided by 8 regional psychiatric centers and psychiatric departments and medical schools of 12 major universities. A few general hospitals also provide mental health services. The formal centres often face competition from native herbalists and faith healing
Faith healing
Faith healing is healing through spiritual means. The healing of a person is brought about by religious faith through prayer and/or rituals that, according to adherents, stimulate a divine presence and power toward correcting disease and disability. Belief in divine intervention in illness or...
centres.
The ratio of psychologists and social workers is 0.02 to 100,000.
Regulation of pharmaceuticals
In 1989 legislation made effective a list of essential drugs. The regulation was also meant to limit the manufacture and import of fakeFake
Fake means not real.Fake may also refer to:In music:* Fake , a Swedish synthpop band active in the 1980s*Fake?, a Japanese rock band* Fake , 2010 song by Ai featuring Namie Amuro...
or sub-standard drugs
DRUGS
Destroy Rebuild Until God Shows are an American post-hardcore band formed in 2010. They released their debut self-titled album on February 22, 2011.- Formation :...
and to curtail false advertising
False advertising
False advertising or deceptive advertising is the use of false or misleading statements in advertising. As advertising has the potential to persuade people into commercial transactions that they might otherwise avoid, many governments around the world use regulations to control false, deceptive or...
. However, the section on essential drugs was later amended.
Drug quality is primarily controlled by the National Agency for Food and Drug Administration and Control
National Agency for Food and Drug Administration and Control
The National Agency for Food and Drug Administration and Control is a Nigerian government agency under the Federal Ministry of Health that is responsible for regulating and controlling the manufacture, importation, exportation, advertisement, distribution, sale and use of food, drugs, cosmetics,...
(NAFDAC).
Spatial inequality
Health care in Nigeria is influenced by different local and regional factors that impacts the quality or quantity present in one location. Due to the aforementioned, the health care systemHealth care system
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations....
in Nigeria has shown spatial variation in terms of availability and quality of facilities in relation to need. However, this is largely as a result of the level of state and local government
Local government
Local government refers collectively to administrative authorities over areas that are smaller than a state.The term is used to contrast with offices at nation-state level, which are referred to as the central government, national government, or federal government...
involvement and investment in health care programs and education
Education
Education in its broadest, general sense is the means through which the aims and habits of a group of people lives on from one generation to the next. Generally, it occurs through any experience that has a formative effect on the way one thinks, feels, or acts...
. Also, the Nigerian ministry of health usually spend about 70% of its budget in urban areas where 30% of the population resides. It is assumed by some scholars that the health care service is inversely related to the need of patients.
Emigration
Migration of health care personnel to other countries is a taxing and relevant issue in the health care system of the country. From a supplySupply (economics)
In economics, supply is the amount of some product producers are willing and able to sell at a given price all other factors being held constant. Usually, supply is plotted as a supply curve showing the relationship of price to the amount of product businesses are willing to sell.In economics the...
push factor, a resulting rise in exodus of health care nurses may be due to dramatic factors that make the work unbearable and knowing and presenting changes to arrest the factors may stem a tide. However, because a large number of nurses and doctors
Doctors (BBC Soap Opera)
Doctors is a British daytime television soap opera, set in the fictional Midland town of Letherbridge, defined as being close to the City of Birmingham. It was created by Chris Murray; Mal Young drove its development, and Carson Black was the original producer. The first episode was broadcast on...
migrating abroad benefited from government funds for education, it poses a challenge to the patriotic identity of citizens and also the rate of return of federal funding of health care education. The state of health care in Nigeria has been worsened by a physician shortage as a consequence of severe 'brain drain
Brain drain
Human capital flight, more commonly referred to as "brain drain", is the large-scale emigration of a large group of individuals with technical skills or knowledge. The reasons usually include two aspects which respectively come from countries and individuals...
'. Many Nigerian doctors have emigrated to North America and Europe. In 2005, 2,392 Nigeria doctors were practising in the US alone, in UK number was 1529 . Retaining these expensively-trained professionals has been identified as an urgent goal.
Commercialisation of Public Health Service Delivery
Empirical evidences reveal negative impact of commercialisation of public health service delivery on attainment of the MDGs in Nigeria.Criticism
The World Health OrganizationWorld Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
's definition of health
Health
Health is the level of functional or metabolic efficiency of a living being. In humans, it is the general condition of a person's mind, body and spirit, usually meaning to be free from illness, injury or pain...
is not merely the absence of disease but the attainment of a state of physical, mental
Mind
The concept of mind is understood in many different ways by many different traditions, ranging from panpsychism and animism to traditional and organized religious views, as well as secular and materialist philosophies. Most agree that minds are constituted by conscious experience and intelligent...
, emotional and social well being.
- In 1993, adulterated paracetamolParacetamolParacetamol INN , or acetaminophen USAN , is a widely used over-the-counter analgesic and antipyretic . It is commonly used for the relief of headaches and other minor aches and pains and is a major ingredient in numerous cold and flu remedies...
syrup entered into the health care system in Oyo and Benue StateBenue StateBenue is a state in the Middle-Belt region of Nigeria with a population of about 2.8 million in 1991. Tiv, Idoma, and Igede are spoken predominantly. There are other ethnic groups as well. These include Etulo and Abakwa...
, the end result of was the death of 100 children. A year after the disaster, batches of fake ethyleneEthyleneEthylene is a gaseous organic compound with the formula . It is the simplest alkene . Because it contains a carbon-carbon double bond, ethylene is classified as an unsaturated hydrocarbon. Ethylene is widely used in industry and is also a plant hormone...
glycol, the major cause of the death, could still be purchased. - In 1996, about 11 children died of contamination from an experimental trial drug: trovafloxacinTrovafloxacinTrovafloxacin is a broad spectrum antibiotic that inhibits the uncoiling of supercoiled DNA in various bacteria by blocking the activity of DNA gyrase and topoisomerase IV. It was withdrawn from the market due to the risk of hepatotoxicity...
. Nevertheless, the long delayed action of the government to prosecute the perpetrators is considered another tragedy. - The life expectancyLife expectancyLife expectancy is the expected number of years of life remaining at a given age. It is denoted by ex, which means the average number of subsequent years of life for someone now aged x, according to a particular mortality experience...
of the country is low and about 20% of children die before the age of 5. - The 2000 WHO report on the performance of health care systems rank the country 187 out of 191.
- Traffic congestionTraffic congestionTraffic congestion is a condition on road networks that occurs as use increases, and is characterized by slower speeds, longer trip times, and increased vehicular queueing. The most common example is the physical use of roads by vehicles. When traffic demand is great enough that the interaction...
in Lagos, environmental pollution and noise pollutionNoise pollutionNoise pollution is excessive, displeasing human, animal or machine-created environmental noise that disrupts the activity or balance of human or animal life...
are major issues that the government is faced with. - In 1985, an incidence of yellow feverYellow feverYellow fever is an acute viral hemorrhagic disease. The virus is a 40 to 50 nm enveloped RNA virus with positive sense of the Flaviviridae family....
devastated a town in Nigeria, leading to the death of 1000 people. In a span of 5 years, the epidemic grew, with a resulting rise in mortality. The vaccine for yellow fever has been in existence since the 1930s. - In 2008-2009, at least 84 children died from a brand of contaminated teething medication. http://www.msnbc.msn.com/id/29057225/
Maternal and Child Healthcare
In June 2011, the United Nations Population FundUnited Nations Population Fund
The United Nations Population Fund is a UN organization. The work of the UNFPA involves promotion of the right of every woman, man and child to enjoy a life of health and equal opportunity. This is done through major national and demographic surveys and with population censuses...
released a report on The State of the World's Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Nigeria is 840. This is compared with 608.3 in 2008 and 473.4 in 1990. The under 5 mortality rate, per 1,000 births is 143 and the neonatal mortality as a percentage of under 5's mortality is 28. The aim of this report is to highlight ways in which the Millennium Development Goals
Millennium Development Goals
The Millennium Development Goals are eight international development goals that all 193 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015...
can be achieved, particularly Goal 4 – Reduce child mortality and Goal 5 – improve maternal death. In Nigeria the number of midwives per 1,000 live births is unavailable and 1 in 23 shows us the lifetime risk of death for pregnant women.
See also
- Health care systems
- HIV/AIDS in NigeriaHIV/AIDS in NigeriaIn Nigeria, the HIV prevalence rate among adults ages 15–49 is 3.9 percent. Nigeria has the third-largest number of people living with HIV. The HIV epidemic in Nigeria is complex and varies widely by region...
- Nigerian Medical AssociationNigerian Medical AssociationThe Nigerian Medical Association is the largest professional organization of physicians in Nigeria and in Africa. The NMA has more than 35,000 members from 36 state branches and the branch from the federal capital territory, including those registered in the diaspora...
- Federal Ministry of Health
External links
- "'A breakdown of our primary health care system'," Seattle Post-IntelligencerSeattle Post-IntelligencerThe Seattle Post-Intelligencer is an online newspaper and former print newspaper covering Seattle, Washington, United States, and the surrounding metropolitan area...
- 'Asangansi Complex Dynamics in the Socio-Technical Infrastructure: the case of the Nigerian Health Management Information System'
- Health in Nigeria
- The State of the World's Midwifery - Nigeria Country Profile