ABSTRACT
This research work assessed the Healthy Care Financing
in Nigeria, using primary health care financing of Ebonyi State as a case
study. This was done with a view to finding out the impact of such funding in
the health sector. It aimed at finding ways of alleviating health care problems
in Ebonyi State; moreover, it focused on the pursuance of federal government assistance
to ensure a conscious and consistent policy in providing health needs of people
of Ebonyi State.
The researcher in order to bring this work to bear collected both primary and secondary data was collected and analyzed using the method of Chi-Square to test the hypothesis. The researcher observed that health care financing has no significant effect on Nigeria economics growth. This was because resources are not adequately provided for running the primary health care service. As a result of poor financing of the primary health care in the areas, there is rapid increase in the frequency of children and maternal mortality. For that reason; adequate funding should be made available to run primary health care programmes in the areas. Policy on the criteria and mechanism for allocating the extra budgeting funds as regards to health care financing to local government areas should not be over looked.
The researcher in order to bring this work to bear collected both primary and secondary data was collected and analyzed using the method of Chi-Square to test the hypothesis. The researcher observed that health care financing has no significant effect on Nigeria economics growth. This was because resources are not adequately provided for running the primary health care service. As a result of poor financing of the primary health care in the areas, there is rapid increase in the frequency of children and maternal mortality. For that reason; adequate funding should be made available to run primary health care programmes in the areas. Policy on the criteria and mechanism for allocating the extra budgeting funds as regards to health care financing to local government areas should not be over looked.
TABLE OF CONTENT
Title page i
Approval page ii
Dedication iii
Acknowledgement iv
Abstract v
Table of contents vi
CHAPTER ONE
1.0 Introduction 1
1.1 Background
1
1.2 Statement of problem
4
1.3 Objective s of the study
7
1.4 Statement of Hypothesis
8
1.5 Significance of the study
8
1.6 Scope and limitation the study
7
1.7 References
8
CHAPTER TWO Review of Related
Literature 9
2.1 Concept of Health and Health Care Delivery 9
2.2 Concepts of Health Care Delivery 13
2.3 Components of Health Care Delivery System in Nigeria 14
2.4 Concepts of Primary Health Care 16
2.5 Primary Health Care Financing in Nigeria 19
2.5.1 Health Financing by the
National Primary Health
Care
Development Agency (Nphgcda) 22
2.5.1 Human Resources of the
Primary Health Care (PHC) 24
References
26
CHAPTER THREE:
Research Design and Methodology 27
3.1 Collection of Data 27
3.2 Techniques for Data
Collection 27
3.3 Sources of Data 28
3.4 Design of the
Questionnaire 29
3.5 Location of the Study 29
3.6 Population of the
Study
30
3.7 Sample Size Determination
30
References 34
CHAPTER FOUR: Data
presentation and analysis of result 35
4.1 Characteristics of the Sample 35
4.2 Test of Hypothesis
45
CHAPTER FIVE:
Summary, Conclusion and
Policy Recommendation 50
5.1 Summary of findings 50
5.2 Conclusion 52
5.3 Recommendations
References 54
CHAPTER ONE
INTRODUCTION ONE
1.1
BACKGROUND OF THE STUDY
The basic needs in rural development include certain
essential services provided by and for the community at large such as safe
drinking water, sanitation and health services. Health care implies the
provision of conditions for normal, mental and physical development. It
includes health protection measures, promotion of health, prevention of
sickness using curative and preventive medicine in all its ramification,
Onokerhoraye (1995) noted that health like foods, shelter and clothing is a
basic human need. Good health, therefore, constitutes an essential aspect of
socio-economic development, since it is a major component of the quality of
life as well as a pre-requisite for high levels of productivity.
Nigeria began the process of
reorganizing her health care (PHC) approach following the Alma Ata declaration
of 1978, with the aim of achieving health for all (Obionu, 2007:11).
Monekosso (1992), observed that
primary health care is the first level of contact of individuals, the family
and the community with national health system, thereby bringing health care as
close as possible to where the people live
an work. Because of the need to administer sound health to the people to
ensure economic growth and development, the State government assumed some
specific notes which include amongst others, health care financing, training of
personnel, technical assistance, supervision, planning and evaluation of
primary health care.
Therefore, health care financing is a
term used to refer to the funding of health care system in a particular society.
Funding health care in Nigeria is from a variety of sources that include
budgetary allocations from government at all levels. International literature
precisely United States of America identifies three sources of health financing
to include public source, Quasi-public source and private sources. Health care
financing, particularly since 1980s, has been very low.
Government health care funding is
only about 0.2 percent of GDP (UNDP 2000). This amounts to $2 per capital as
health care subsidy whereas health care expenditure per capital is $ 15. in
other wards, the government is responsible for only about 13 percent of the
entire health are expenditure in the economy. This implies that social safety
nets for less advantage members of the society are virtually non-existent.
Meanwhile, the Federal government is
not unmindful of the crucial rate of the health sector in national development.
The problems of allocating scarce resources has always made it very difficult
to allocate and satisfying the minimum requirement in terms of health sector
financing. In order to save this drastic situation, government should be given
serious consideration for the establishment of the National Health Insurance
Scheme (NHIS) and the National Health Development Bank (NHDB). The development of health care in the grass
roots has been immeasurable. The support giving in both the Local and
International Sources of funding has been tremendous. It has made a great
impact on the basic health nutrition, water and sanitation, immunization
materials and child health nutrition, health education, family planning and
education guinea worm as well as man power development.
The introduction of several projects
and programmes added a bit towards the alleviation of health situation in
Nigeria. The allocation of funds from various sources and agencies enable them
to carry out some of their desired programmes. Health financing in Nigeria has
actually developed up to a commendable stage. Primary health agencies have been
able to carry out their activities to several levels ranging from the federal Level
to the Local Government Level. Special attention will have to be given to the
services carried out in different local government areas with financial
assistance of other different bodies.
Primary health care in the local
government area which is the main target areas, has achieved a lot. Therefore,
most attention is needed in rural areas concerning their health situation so as
to increase the life expectation of the people in the area.
1.2 STATEMENT
OF THE PROBLEM.
Health care financing implies the sponsoring
of necessary conditions that guarantee normal, mental and physical development
and functioning of human being individually or collectively. It entails the
provision of curative and protective medicine for the populace in a particular
area.
Enugu State still lays behind in
primary health care financing compared to other States in Nigeria. This trend
is attributed to poor budgetary allocations assessment over the years. Health
institutions are not given priority in the scheme of things. Government on
their own has not been constant in coming to the aid of the council areas
Another major obstacle to the
adequate health care financing is lack of medical experts particularly in the
rural needs of the people in the rural areas. Enugu State lacks a good number
of highly trained medical personnel, the few in service are not resident in the
communities where they serve. rather, they visit intermittently to the health centers.
Onuora (1999:120), has observed that the number of problem this has generated
was better imagined than explained
The problem of insufficient modern facilities in
health establishment in the rural communities in Enugu State is yet a serious
threat.
Ugbaja (1996: 86) , observed
that there is the problem of
non-availability of drugs prescribed to the patients. most of the times, patients
are told that the drugs prescribed for them are out of stock. the resultant effects
of this ugly development is that the patients would resort to any source to
obtain drugs in order to survive.
Moreover, the location of the health
centers are not within the reach of the people in various communities. In most
cases, the sitting of the health centers experiences bureaucratic bottleneck. It
is very unfortunate that in those communities, transport system is not easily
attainable.
It is pertinent to note that the
above issues can be dissolved in a good number of ways. Here, there should be strict
adherence to budgetary provisions to health institutions to ensure that
adequate supplies and sponsorship are made as when due. The research will at
the same time look into the shortage of supply of medical-experts in various
communities and to ensure availability of drugs in a health centre in various
localities.
The above problems gave rise to the
following research questions:-
(i)
To what extent
has inconsistency by government and non-governmental agencies affect the level
of financing of primary health care in Enugu State?
(ii)
How does lack of
professional medical experts contribute to poor performance of primary health
care in Enugu State?
(iii)
To what extent
does insufficient modern facilities contribute to the establishment of health
centers in Enugu State?
(iv)
How has
non-availability of prescribed drugs affected the performance of primary health
care in Enugu State?
(v)
To what extent
has non-incorporation of community leaders in decision making process affected
health care financing in Enugu State?
1.3 OBJECTIVES
OF THE STUDY
This research work aims at investigating the ways in
which primary health care receives financies in Nigeria that is how primary
health care is being funded in Nigeria. Specifically, this work tends:-
1.
To find out the
impact of such funding on primary health care sector.
2.
To find out
ways of alleviating health care problems in Enugu State.
1.4 STATE
OF HYPOTHESIS
H0:
Health care financing has no
significant effects on the primary health care administration in Enugu State.
H1: Health care financing has significant
effect on the primary health care administration in Enugu State.
1.5 SIGNIFICANCE
OF THE STUDY
The study would be significant to Enugu State in
particular and Nigeria in general, as they would use the findings and
recommendations to improve on their contributions as it concerns health care
funding.
The study would be significant to
various rural communities in Enugu state as it would show them how they could
be mobilized to realize the health policy objectives of local government
councils in the state.
Finally, the study would be of high
significance to potential researchers in this area of study since it would
provide them with a possible search in for future study as far as health care
financing is concerned.
1.6 SCOPE
AND LIMITATION OF THE STUDY
The scope of the research study covers the whole
primary health care centers in the state. The study is to cut across all
section of the (17) local government areas, as they would constitute the
necessary population. This research covers the period between 1985-2010.
The
major constraint to this research work include:
i.
Time: the time
allotted for this study was short. This is a study that would have taken a year
for a more comprehensive study to be attained
ii. Finance: This sis another constraint to the study.
This study required the researcher to visit all the relevant health centers or
clinics in Enugu State. This meant a substantial amount of money was to be
provided for transportation, photocopy of document, production of copies of
questionnaires to mention just a few.
REFERENCES
Onokerhonaye
Andrew, G. (1995), Population growth and Provision
of Social Services in Nigeria, the Benin Social Science Series University of Benin.
Morekosso,
G. L. (1992), An Organizational frame work for Achieve
Health for all Developing Countries, International Journal of Health, Primary and Management vol7, 3-23.
Obionu,
C. N. (2007) , Primary Health care for Developing Countries. 2nd Edition, Institution for Development
studies University of Nigeria,
Enugu Campus.
Federal
Ministry of Health (1986), National Policy FMOH, Lagos