Health Care Financing in Nigeria: National Health Accounts Perspective
Keywords:
Total Health Expenditure, Financing Sources, Financing Agents, Out-of-Pocket ExpenditureAbstract
The paper investigated the funding pattern of healthcare in Nigeria based on the National Health Accounts framework. Two rounds of National Health Accounts estimation covering the eight-year period, 1998-2005 were analyzed in this paper. The first round covering 1998-2002 was funded by donors and characterized by limited access to data, which accounted for its seeming underestimation. The second round funded by Federal Ministry of Health enjoyed access to wider data set, and allowed for state level sub- National Health Accounts estimates covering 17 out of 36 states of the federation. The estimates generally revealed that the households constitute the main source of financing healthcare in the Nigeria, accounting for over 66% of Total Health Expenditure, while government contributes average of 29%. Though resource pooling through health insurance appreciably grew over the years, it is still at its infancy, contributing minimally to Total Health Expenditure. While the private facilities dominates in the provision of healthcare service in the first round, the second round estimates shows that more than half of health care services were provided in the public facilities. Despite preventive care through Primary Health Care being the pillar of the National Health Policy strategy, curative care continued to dominate Total Health Expenditure in the country. The process of second round estimation accorded the issue of institutionalization a priority place, which resulted in the identification and training of state focal persons for possible integration of regular National Health Accounts data collection into public service practices. The absence of continuity in funding by government is threatening the ownership of the process. While the Nigeria Total Health Expenditure is highest in Africa, her per capita Total Health Expenditure and as percentage of GDP is well below figure for some African countries.
Â
References
• Berman, P. A. and D. M. Cooper, National Health Accounts Software Manual Partnership for Health Reform Project/USAID. 2000
• Bhawalkar, M. and C. Natasha Hsi, “Comparing Methodologies: National Health Accounts and Financial Sustainability Plansâ€, A PHRplus working paper from a USAID funded project with contract no. HRN-C-00-00-00019-00. 2004
• Garg, C. C. “National Health Accounts (NHA) Importance, Status and Key Issues for Institutionalizationâ€, NHP, World Bank, HDNHE, Washington DC, USA, 2010.
• Lawanson, A. O., “Health Care Financing in Africa: What does NHA Estimates Do Reveal about the Distribution of Financial Burden?â€, Journal of Medicine and Medical Sciences Vol. 4, No. 4, pp 155-166 2013 Available @ http://interesjournals.org/JMMS/Pdf/2013/April/Lawanson.pdf
• Lawanson A. O., O. Olaniyan, and A. Soyibo, “National Health Accounts Estimation: Lesson from the Nigerian Experienceâ€, African Journal of Medicine and Medical Sciences, vol. 41, pp 357-364, 2012
• NBS, “The Nigeria Poverty Profile 2010 Reportâ€, Press Briefing by the Statistician-General of the Federation/Chief Executive Officer, National Bureau of Statistics, held at the Conference Room, 5th Floor, NBS Headquarters, Central Business District, Abuja on Monday, 13th February, 2012.
• NBS, “The Nigerian Statistical Facts Sheets on Economic and Social Developmentâ€, Abuja, national Bureau of Statistics, 2007
• OECD “A System of Health Accounts for international Dataâ€. Paris, OECD, 2000. Available @ www.oecd.org.els.health
• Poullier, J. and P. Hernández, “Estimates of National Health Accounts (NHA) for 1997â€, GPE Discussion Paper Series: No. 27, EIP/GPE/FAR, World Health Organization. Geneva, 2002
• Poullieral, J., P. Hernandez, and K. Kawabata, “National Health Accounts: Concepts, Data Sources and Methodology WHO/EIP/02.47, World Health Organization, Geneva, 2002
• Soyibo, A., O. Olaniyan, and A. O. Lawanson, National Health Accounts of Nigeria, 2003-2005; Incorporating Sub-National Health Accounts of States, Volumes I and II. Report Submitted to Federal Ministry of Health, Abuja. Vol. I. 2009. Accessed from http://www.who.int/entity/nha/country/nga/nigeria_nha_2003-2005_report.pdf on 10 June 2011
• Schwartz, J. B., R. Racelis, and D. K. Guilkey, “Decentralization and Local Government Health Expenditure in the Philippines†Working Paper 01-36, The Measure Project Carolina Population Centre, 2000.
• Sein, T., National Health Accounts: Concepts and Approaches, A Policy Brief of the Regional Office for South-East Asia of the World Health Organisation, 2002.
• Soyibo, A. and F. Ladejobi, “Estimation of Household Health Expenditure in Benue State, Nigeriaâ€, Report sponsored by DFID and submitted to the Benue State Health Fund, 2002.
• Soyibo, A., O. Olaniyan, and A. O. Lawanson, “National health accounts: Structure, trends and Sustainability of health Expenditure in Nigeriaâ€, African Journal of Economic Policy, Vol. 14, No. 1, 83-109, 2007
• Soyibo, A (2005), National Health Accounts of Nigeria, 1998-2002, Final Report submitted to World Health Organisation, Geneva, 2005
• WHO, “Guide to Produce National Health Accounts, with Special Applications for low-income and Middle-income Countries, Geneva: WHO. 2003.
Downloads
Published
Issue
Section
License
- Papers must be submitted on the understanding that they have not been published elsewhere (except in the form of an abstract or as part of a published lecture, review, or thesis) and are not currently under consideration by another journal published by any other publisher.
- It is also the authors responsibility to ensure that the articles emanating from a particular source are submitted with the necessary approval.
- The authors warrant that the paper is original and that he/she is the author of the paper, except for material that is clearly identified as to its original source, with permission notices from the copyright owners where required.
- The authors ensure that all the references carefully and they are accurate in the text as well as in the list of references (and vice versa).
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Attribution-NonCommercial 4.0 International that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
- The journal/publisher is not responsible for subsequent uses of the work. It is the author's responsibility to bring an infringement action if so desired by the author.
