Health care provision in Nigeria is a concurrent responsibility of the three tiers of
government in the country.[1]
Private providers of health care have a visible role to play in health care
delivery.
Contents
- 1 Health infrastructure
- 2 Issues
- 2.1 Regulation of pharmaceuticals
- 2.2 Geographic inequality
- 2.3 Emigration of healthcare workers
- 2.4 Commercialisation of public health service delivery
- 3 Health status
- 3.1 Life expectancy
- 3.2 HIV/AIDS
- 3.3 Endemic diseases
- 3.4 Maternal and child healthcare
- 4 Health dynamics
- 5 See also
- 6 References
- 7 External links
Health
infrastructure
The federal government's role
is mostly limited to coordinating the affairs of the university teaching
hospitals, Federal Medical Centres (tertiary health care) while the
state government manages the various general hospitals (secondary health
care) and the local government focus on dispensaries (primary
health care),[2] which are regulated by the federal
government through the 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%.[3] 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%.[4] Though small, the positive rate of
per capita may be due to Nigeria's importation of food products.
Health
insurance
Historically, health insurance
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.[5]
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.[6]
Cancer
care
A new bone marrow donor program, the
second in Africa, opened in 2012.[7] In cooperation with the University
of Nigeria, it collects DNA swabs from people who might want to help a
person with leukemia, lymphoma, or sickle cell disease to
find a compatible donor for a life-saving bone marrow transplant. It
hopes to expand to include cord blood donations in the future.[7]
Mental
health
The majority of mental health
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.[8]
Water
supply and sanitation
Further information: Water supply
and sanitation in Nigeria
Lagos is one of only two cities in Nigeria that has a sewer
network for part of the city.
Water and Sanitation coverage rates
in Nigeria are amongst the lowest in the world. Access to an improved water
source stagnated at 47% of the population from 1990 to 2006, then increased to
54% in 2010. In urban areas access decreased from 80% to 65% in 2006, and then
recovered to 74% in 2010.[9]
Access to adequate sanitation decreased from 39% of the population in 1990, to 35% in
2010, with a particularly marked decrease in urban areas. 25% of Nigerians have
to use shared sanitation facilities, which are not considered as adequate. 22%
are estimated to use other inadequate facilities and another 22% are estimated
to defecate in the open.[10]
Adequate sanitation is typically in
the form of latrines or septic tanks. Piped sewerage is almost non-existent.
Except for Abuja
and limited areas of Lagos, no urban community has a sewerage system.[11] A 2006 study estimated that only 1% of Lagos households
were connected to sewers.[12]
Issues
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 fake
or sub-standard drugs and to curtail false advertising. However, the section on essential drugs was later amended.[13]
Drug quality is primarily controlled
by the National Agency for Food and Drug
Administration and Control (NAFDAC).
Several major regulatory failures have produced international scandals:
- In 1993, adulterated paracetamol syrup entered into the health care system in Oyo and Benue State, the end result of was the death of 100 children. A year after the disaster, batches containing poisonous ethylene glycol, the major cause of the deaths, could still be purchased.
- In 1996, about 11 children died of contamination from an experimental trial of the drug trovafloxacin.
- In 2008-2009, at least 84 children died from a brand of contaminated teething medication. [1]
Geographic
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 system 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.[14]
Emigration
of healthcare workers
Retaining health care professionals
is an important objective
Migration of health care personnel to other countries is a tasking and relevant issue in the
health care system of the country. From a supply 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.[15]
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 1,529. Retaining these expensively trained
professionals has been identified as an urgent goal. It should be noted that
the Brain drain cut across all healthcare Professionals, thousands of Nigerian
Pharmacists and Nurses are practicing in the UK and USA as well and so on.
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.[16]
Health
status
Life
expectancy
The 2014 CIA estimated average life
expectancy in Nigeria was 52.62 years.[17]
HIV/AIDS
Further information: HIV/AIDS in Nigeria
As of 2012 in Nigeria,
the HIV
prevalence rate among adults ages 15–49 was 3.1 percent.[18] Nigeria has the second-largest number of people living with
HIV.[19]
The HIV epidemic in Nigeria varies
widely by region. In some states, the epidemic is more concentrated and driven
by high-risk behaviors, while other states have more generalized epidemics that
are sustained primarily by multiple sexual partnerships in the general
population. Youth and young adults in Nigeria are particularly vulnerable to
HIV, with young women at higher risk than young men.[20]
There are many risk factors that
contribute to the spread of HIV, including prostitution, high-risk practices among itinerant workers, high prevalence of sexually transmitted infections (STI), clandestine high-risk heterosexual and homosexual
practices, international trafficking of women, and irregular blood screening.[20]
Endemic
diseases
In 1985, an incidence of yellow fever 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.[21]
Maternal
and child healthcare
In June 2011, the United Nations Population Fund 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 the lifetime risk
of death for pregnant women 1 in 23.[22]
Health
dynamics
Traffic congestion in Lagos, environmental
pollution and noise pollution are major health issues.
See
also
- Nigerian Medical Association
- Federal Ministry of Health
References
1.
Rais Akhtar; Health Care Patterns
and Planning in Developing Countries, Greenwood Press, 1991. pp 264
2.
"Federal Medical Centre Abeokuta: A
Case Study in Hospital Management pp 1".
docstoc. Retrieved 13 June 2011.
3.
Ronald J. Vogel; Financing Health
Care in Sub-Saharan Africa Greenwood Press, 1993. pp 18
4.
Ronald J. Vogel; Financing Health
Care in Sub-Saharan Africa Greenwood Press, 1993. pp 1-18
5.
Ronald J. Vogel; Financing Health
Care in Sub-Saharan Africa Greenwood Press, 1993. pp 101-102
6.
Felicia Monye; 'An Appraisal of the
National Health Insurance Scheme of Nigeria', Commonwealth Law Bulletin, 32:3
415-427
7.
McNeil, Donald (11 May 2012). "Finding a Match, and a Mission:
Helping Blacks Survive Cancer".
The New York Times. Retrieved 15 May 2012.
8.
Oyedeji Ayonrinde, Oye Gureje,
Rahmaan Lawal; 'Psychiatric research in Nigeria: bridging tradition and modernisation',
The British
Journal of Psychiatry (2004) 184: 536-538
9.
WHO/UNICEF Joint Monitoring
Programme for Water Supply and Sanitation, 2010 estimates for water
and sanitation
10. WHO/UNICEF Joint Monitoring Programme for Water Supply and
Sanitation, 2010 estimates for water
and sanitation
11. USAID: Nigeria Water and Sanitation Profile, ca. 2007
12. Matthew Gandy:Water, Sanitation, and the Modern City:
Colonial and post-colonial experiences in Lagos and Mumbai, , Human Development Report Office Occasional Paper, 2006
13. National Drug Policy in Nigeria, O. Ransome Kuti. Journal of
Public Health Policy > Vol. 13, No. 3 (Autumn, 1992), pp. 367-373
14. Rais Akhtar; Health Care Patterns and Planning in Developing
Countries. Greenwood Press, 1991. 265 pgs.
15. Darlene A. Clark, Paul F. Clark, James B. Stewart; The
Globalization of the Labour Market for Health-Care Professionals. International
Labour Review, Vol. 145, 2006
16. Wadinga Audu; Commercialization of Public Health Service
Delivery in Nigeria, GDN Research Project, Nigerian Institute of Social and
Economic Research, Ibadan,Nigeria 2009
17. "CIA - The World Factbook Life
Expectancy". Cia.gov. Retrieved 2014-06-24.
18. "HIV/AIDS - adult prevalence
rate" CIA World Factbook (2012) Accessed February 20, 2014.
19. "HIV/AIDS - People Living with
HIV/AIDS" CIA World Factbook (2012) Accessed February 20, 2014.
20. "2008 Country Profile: Nigeria". U.S.
Department of State. 2008. Archived from the original
on 27 June 2014. Retrieved 25 August 2008.
This article incorporates text from this source,
which is in the public domain.
21. Nigerian National Merit Award
22. "The State Of The World's Midwifery". United Nations Population Fund. Retrieved August 2011.