Problems And Achievements Of The Nigerian Health Care System

Problems And Achievements Of The Nigerian Health Care System

Chapter one

preface

Background of the Study

Health is an important index to measure development. It’s indeed a prerequisite for development. No society can develop if the health of its population is poor. thus, any nation that seeks to develop should pay attention to health issues. Good health is one of the abecedarian mortal rights everybody is entitled to enjoy. And the burden of evidence is on the health care system to give health services in the three situations of government( civil, state and original government). A health system can also be seen as an association of people, institutions and coffers that give health care services to meet the health requirements of target populations. The planning of the health system, and should be distributed among request actors, governments, trade unions, charities, religious or other associations coordinated to give planned health care services targeted to populations( Frenk, 2010). easily, health has been included in the metamorphosis program of the gregarious government of Nigeria. also government officers hailed their own sweats and achievements in relation to the docket of metamorphosis while public opinion differs explosively. Although, a metamorphosis took place in the health sector, but it isn’t relatively clear to the general public especially those in pastoral areas, because it’s negligible. thus, the delivery of health care is still considered by numerous as the poor.

Primary health care service has come a dream come true for the first time in Nigeria in 1975 when Yakubu Gowon, Nigeria leader blazoned the Basic Health Services Program( BHSS) as part of the Third Plan public Development( 1975- 1980). The program objects were to increase the proportion of the population entering health care between 25 and 60 percent, correct imbalances in the position and distribution of health installations and give the structure for all preventative health programs similar as control of transmissible conditions, family health, environmental health, nutrition and other and establish a health care system stylish suited to original conditions and the position of health technology( Sorungbe, 1989). The thing of primary health care( PHC) was to give accessible health for all by the time 2000 and further. Unfortunately, this has not yet been reached in Nigeria appears to be unrealistic in the coming decade. The SSP aims to give people in the world with the introductory health services. Although the PHC centers were established in pastoral and civic areas in Nigeria with the intent of fairness and fluently accessible, unfortunately, the pastoral population of Nigeria are underserved compared to their civic counterparts.

In addition, the Nigerian public plans, commitments and programs in recent decades have reflected the government understands that the introductory health of Nigerian citizens is essential for growth and substance. While total per capita health spending has not increased proportionally to the growth of the country’s GDP, it has nonetheless increased 103 from$ 102 in 2000 to$ 207 in 2013. The fiscal walls to watch seems to drop; the chance of women who reported problems penetrating care because of cost, for illustration, fell by 56 in 2008 to 42 in 2013. still, it was noted that the provision of health care in Nigeria is a concurrent responsibility of the three situations of government in the country. The civil government has the onerous functions for the direction of policy, planning and specialized backing, collaboration of perpetration at the state of the public health policy and establishing systems of health operation information systems. also, the civil government reserves the right to complaint surveillance, medicine regulation, vaccine operation and experts in the training of health. The civil government also coordinates the business of education, psychiatric and orthopedic hospitals and also manages some medical centers.

In Nigeria, the delivery of health care can not be bandied without a proper understanding of the public health care delivery strategy. The provision of health services is the responsibility of civil, state and original and religious associations and individualities( National Population Commission, 2000). This means Nigeria operates a three- league health care system. The first position is the tertiary health care is in the field of both civil and state governments. This position of care provides largely technical reference services to both the first and alternate situations( primary and secondary) health care delivery system. The alternate position is in the area of state governments. It’s the secondary care. It offers technical services to cases appertained by primary health care. The third position is the primary health care. This is in the area of original government, but with the support of the Ministry of Health. It basically provides health care for people at the base. Over the times, the public government has developed several programs and programs; all aimed at perfecting health care services in the country. The Fourth National Development Plan( 1981 – 1985) established a government commitment to give acceptable and effective primary health care was creation, protection, forestallment, form and recuperation of the entire population by the time 2000. Accordingly, the Nigerian government in 1988 espoused a public health policy to give a formal frame for the operation of the country’s health system( Obionu, 2007). The policy was approved by the service to power in 1987 Governing Council and launched in 1988. Its ideal was to give the population with access not only to primary health care, but also secondary and tertiary care, as needed by a functional reference system. It was revised in 1997. The revised public policy includes affiliated programs of the major health problems similar as health operation information against HIV/ AIDS, malaria, tuberculosis, reproductive health,etc., easily, primary health care has come a major element of the public health policy. In fact, current public health programs for primary health care as frame for achieving better health for the population. With this focus, we can say that the public health policy becomes apprehensive of the health requirements of both civic and pastoral peoples.

still, installations operation and health programs is a function participated by the ministries of health, recommendations sanitarium operation of the state and original government areas. Specifically, the state governments run secondary health installations( general hospitals), occasionally tertiary hospitals and primary health care installations. The training of nursers, midwives, health technicians,etc. is the responsibility of the State. States also give specialized backing and support to health programs and original government installations. Original governments are in charge of the operation of primary health care installations in their areas of capability. The 774 original governments in Nigeria in specific terms insure the provision of introductory health services, community health hygiene and sanitation. The deplorable situation of the public health system in the country has led to the emergence of private health sector as well as traditional and spiritual healers.

The general health status in the country was set up to have fallen below the norms of the WHO agreed. According Oyebanji( 2013), the state of health in Nigeria is deplorable. He argued that the most common conditions in Nigeria are malaria, Guinea worm, pneumonia, measles, gonorrhea, typhoid, tuberculosis, funk spell, diarrhea, polio and more lately AIDS. He said that while cases of significant conditions were about1.78 million in 1991, this figure rose to about2.06 million by 1995. According to WHO( 2002), malaria, diarrheal conditions, vaccine- preventable conditions and acute respiratory infections are responsible for roughly 95 of morbidity and nearly 90 of mortality in children under five in Nigeria. WHO( 2014), said that malaria accounts for 30 of child mortality. He added that AIDS, lower respiratory infections and diarrheal conditions are among the leading causes of death in the country. According to the report, the most recent numbers for motherly mortality and under- five child mortality is 630 per 100,000 live births and 124 per 1000 live births independently. There are large difference in health status across the countries and geopolitical zones in Nigeria. Etiology of the complaint is linked to social determinants similar as socioeconomic status, education, gender inequality, and poor access to water, sanitation and hygiene( WHO, 2014).

The poor state of Nigerian healthcare system is generally attributed to several factors similar as association, leadership, structure, backing and delivery of health services( Federal Ministry of Health, 2000). The below problems have been compounded by other socio- profitable factors and environmental programs.

also, Umeha( 2015 1) shortly presented the problems of the Nigerian health sector in the following lines – They range from the lack of backing by the government, which are reflected in the shy or in some cases, lack of outfit and installations in hospitals across the country, unhealthy contest between the croakers and other professionals leads to a lack of artificial harmony to the brain drain. Some judges say that the area was literally brought to their knees by transnational professional quarrels and fighting for supremacy. While croakers say that, by virtue of their training and liabilities, they’re the natural leaders of the sector, other health care workers, including nursers, druggists, laboratory technicians technologists, radiologists and nearly all other members of thenon-medical staff say the contrary. As this contest enthusiasms, the provision of health care is the worst for it. Another major challenge for the Nigerian health sector is the acute deficit of good health care providers. This unattractive situation is generally due to shy structure and poor remuneration. The Federal Ministry of Health( FMOH) lamented that the major challenge its ugliness is how to insure the vacuity and retention of acceptable pool of professed mortal coffers. The deficit of health workers were wide, health professionals and other service providers are shy; the unstable distribution of professed health workers deprives a large number of services and the migration of health workers exacerbates the situation of health( FMOH, 2007). In a affiliated development, there’s a challenge of applicable incitement schemes for health labor force.

This largely gets frustrated and thus, a negative impact on productivity. In utmost cases, the unmet health workers show an unattractive geste which include among others –

Lack of courtesy to cases.

Failure to turn up at work on time and high position of absenteeism.

Failure to conduct proper case examination and failure to treat cases in timely manner( Nnamuchi,

).

In 2000, according to World Health Organization( WHO), the performance of the overall health system in Nigeria was ranked 187th among the 191 positions of the Member States. Primary Health Care( PHC), which is the base of the public health system, remains in a coma due to gross under backing, mismanagement, corruption and lack of capacity at original government position.

Nigeria as a country has a pluralistic health care delivery system( delivery orthodox and traditional health care systems). Orthodox health care services are handed by private and public sectors. still, the provision of health care in the country remains the functions of the three situations of government civil, state, and original government. The primary health care system is managed by 774 original government areas( LGA), with support from their separate Ministries of Health State and private medical interpreters. The secondary health care system is managed by the Ministry of Health at the state position. Tertiary primary health care is handed by tutoring hospitals and technical hospitals. The secondary and tertiary situations, are also working with levies andnon-governmental associations and private interpreters( Adeyemo, 2005). In 2005, the Federal Ministry of Health( FMOH) estimated a aggregate of23.640 health institutions in Nigeria, of which85.8 are primary health care, secondary and tertiary 140.2. 38 of these installations are possessed by the private sector, which provides 60 of health care in the country. Despite the vacuity of this large number of health installations and the progress of technology in the health sector in Nigeria has witnessed colorful turbulent supported with negative goods. As stated Obansa and Orimisan( 2013), with the bulging population of the country now further than 150 million, it’s still dealing with the provision of introductory health services. And according HERFON( 2006), health installations( health centers, staff and medical outfit) are inadequate in the country, especially in pastoral areas. Of course, that easily explains the high rate of motherly mortality in children, and indeed grown-ups over the times.

Nearly fifteen( 15) percent of Nigerian children don’t survive to their fifth birthday. The main causes are malnutrition representing fifty- two( 52) percent of deaths, the malaria thirty( 30) percent and diarrhea twenty( 20) percent( Federal Ministry of Health( FMOH), 2004). motherly mortality is reported to be extremely high. In 2008, between 3 million and3.5 million people were estimated to be living with HIV/ AIDS. Nigeria has the fourth largest number of TB cases in the world, with a 2004 estimated 293 new cases per 100,000 and 546 per 100 000 Total number of cases( Obansa & Orimisan, 2013). Another crucial issue related to health pointers in Africa is poverty and Nigeria, the prevalence of poverty is wide. Between 2003-2004, a ménage check was conducted by the government and the results showed that54.4 percent of Nigeria’s population is poor, with a advanced poverty rate of63.3 percent in pastoral areas. further than half of the population lives below the poverty line, on lower than$ 1 a day and so can not go the high cost of health care( HERFON, 2006).

In the Ward Minimum Health Care Package( WMHCP)( 2001); Global Health Initiative( GHI)( 2010 – 2015) and the National Strategic Health Development Plan( NSHDP)( 2010 – 2015) the under listed fancies to sustain the Nigeria health care system were projected

Attainment of Health For All Nigerians through the Primary Health Care

Strengthening the public health system through the primary health care( PHC) approach

adding profitable productivity

Sustaining public development and gender equivalency

Improving access to goods

Strengthening hookups and exploration for health as the structure blocks of a functional health system

Statement of the problem

Anyhow of taking way to prioritize and ameliorate health care, still, and has endured unknown growth over other lower middle income countries of the region, the health issues at the public position in Nigeria are fairly poor. For illustration While Nigeria’s under- five mortality rate has bettered since 2000, it nevertheless remains veritably high( at 109 per 1,000 live births in 2015). The median U5M rate insub-Saharan Africa is 80, and the Sustainable Development thing target is< 25 U5M rate by 2030. Adult mortality fromnon-communicable conditions in Nigeria has remained largely unchanged in the last decade; it was 22 in 2000 and 20 in 2012. DPT3 immunization content of 66 in 2014 falls well short of the 90 content the UN called for during its 27th Session). Women entering the recommended four prenatal care visits declined5.5 from 2011 to the 2013 rate of56.6 – far from the SDG target of universal access to reproductive health care services.

It’s anticipated that further worrying is the poor overall performance of the healthcare system in Nigeria, especially compared with other lower rich countries in Africa. For illustration, in 2005, Uganda has allocated 11 of its total budget to health care, while Nigeria, in 2006, only5.6 calculated. Despite its high chance of HIV citizens, Uganda was ranked 149 of 191 countries and 39 came ahead of Nigeria to187/191 in the 2000 World Health Report.

Low position of health care spending per capita in Nigeria seems to count it short of the SDGs 4 and 5, wherein the effective perpetration of the strategy IMNCH bear a lesser commitment from all situations Nigerian health care system.

still, Obansa and Orimisan( 2013) linked the following among others as factors that affect the overall performance of the Nigerian health care system shy health installations structure; deficit of essential medicines and inventories; shy supervision of the healthcare system; Poor mortal coffers, operation, remuneration and provocation; Lack of fair and sustainable health care backing with veritably low per capita health spending; unstable profitable and political relations; Theneo-liberal profitable programs of the Nigerian state and corruption; High out- of- fund expenditure in health by citizens and Absence of community- grounded intertwined system for complaint forestallment, surveillance and treatment. It has come veritably necessary to reflect and propose plans and strategies that Checkmate the over mentioned factors militating against effective health care system in the country. Obansa and Osrimisan( 2013) stressed some strategies among others that will help meet the challenges of the health sector in the country as follow bettered access to primary healthcare; Strategic and purposeful leadership in health delivery services; Increase fund to manage the health sector

The menial failure of public health care system in Nigeria has led to commentary and review from original and public situations. The provision of acceptable health care services for citizens, especially those abiding in pastoral areas left important to be asked . Despite the propaganda of the media and the current reforms of the health sector by the government, the public health care system in Nigeria is still hamstrung in all ramifications. It’s thus argued that the problems faced by the public health care system in Nigeria could be attributed to poor perpetration of the public health policy and other health- related programs and programs. In addition, the perpetration of public health policy and the ongoing reforms in the health sector are called upon to break the imperishable problems inflicting the development of public health care in Nigeria. The study further argues that it’s only when the government ensures that health is regarded as the right of all citizens of the country, irrespective of status that the public health care system is said to be developed in Nigeria. It’s egregious that poor perpetration of health care programs and programmes is the major constraint to the achievement of asked pretensions in public health care provision in Nigeria, particularly at the original government position. For better enhancement, the exploration suggests the need for political commitment as well as elimination of regulatory backups in public health care provision in Nigeria.

Points And Objects

The study aimed at assessing the problems and achievements of the Nigerian health care system Specifically the study sought to

Assess Nigerian health care system versus SDGs

Investigate problems defying Nigerian health care system.

Establish possible measures to ameliorate the trend.

Exploration Question

Does Nigeria’s champaign care system achieve or about achieving the SDGs?

What are the problems defying health care system in Nigeria?

What have the system achieved in the last 15 times?

How are other measures going to be used to ameliorate health care delivery in Nigeria?

exploration thesis

For the purpose of testing, the null thesis is indicated by Ho, while the indispensable thesis is represented by Hi

Hi Nigeria’s champaign care system has achieved the SDGs

Ho Nigeria’s champaign care system has not achieve but about achieving the SDGs

Hi There are major problems defying health care system in Nigeria

Ho There are no major problems defying health care system in Nigeria

Hi The Nigeria’s health care system has achieved so much in the last 15 times

Ho The Nigeria’s health care system doesn’t achieve so much in the last 15 times

Significance of the study

Health care systems are designed to meet the health care requirements of target populations. There are a wide variety of health care systems worldwide. In some countries, the health care system evolved and wasn’t anticipated, while in others, a combined trouble was made by governments, trade unions, charities, religious or other associations coordinated give planned health care services targeted to the populations they serve. still, the result of this study will help the government reform health sector programme as well as passage of National Health Bill before the National Assembly to enable Nigeria to successfully revamp its primary health care system and apply the integrated motherly, invigorated and Child Health( IMNCH) strategy and move closer to achieving SDgs 4 and 5 so to lead to sustainability. The result of this work will also help in illuminating the recrimination of poor health care system in Nigeria so that utmost decision makers will understand the good prospect of diving the issue. It’s held that the scheme from this exploration will help the government as well as the health care providers ameliorate the Nigerian health care system.

compass of the Study

The main focus of our concern is the question if Nigeria’s champaign care system has achieved or about achieving the SDGs. To have this done efficaciously, a serious assessment of the former successes in Nigeria’s champaign care system will be done, indicating out their achievements and earnings, not forget the challenges girding the delectation. Since this exploration is aimed at assessing the problems and achievements of the Nigerian health care system, consideration will be paid to the measures going to be used to ameliorate health care delivery in Nigeria as to keep down the unrealistic deed.

Limitations of the study

Challenges that may hang this study are as follows;

Fund to be suitable to estimate online accoutrements

fiscal constraints in terms of codifying the work

Collection and reclamation of documents from records, libraries and indeed those from attestation.

Time constraints due to other academic pressure