Health care in Nigeria
Health care provision in Nigeria is a concurrent responsibility of the three tiers of government in the country. Private providers of health care have a visible role to play in health care delivery.
- 1 Health infrastructure
- 2 Issues
- 3 Health status
- 4 Health dynamics
- 5 See also
- 6 References
- 7 External links
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), 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%. 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.
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. 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.
A new bone marrow donor program, the second in Africa, opened in 2012. 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.
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.
Water supply and sanitation
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.
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.
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. A 2006 study estimated that only 1% of Lagos households were connected to sewers.
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.
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. 
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.
Emigration of healthcare workers
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.
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.
The 2014 CIA estimated average life expectancy in Nigeria was 52.62 years.
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.
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.
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.
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.
- Rais Akhtar; Health Care Patterns and Planning in Developing Countries, Greenwood Press, 1991. pp 264
- "Federal Medical Centre Abeokuta: A Case Study in Hospital Management pp 1". docstoc. Retrieved 13 June 2011.
- Ronald J. Vogel; Financing Health Care in Sub-Saharan Africa Greenwood Press, 1993. pp 18
- Ronald J. Vogel; Financing Health Care in Sub-Saharan Africa Greenwood Press, 1993. pp 1-18
- Ronald J. Vogel; Financing Health Care in Sub-Saharan Africa Greenwood Press, 1993. pp 101-102
- Felicia Monye; 'An Appraisal of the National Health Insurance Scheme of Nigeria', Commonwealth Law Bulletin, 32:3 415-427
- McNeil, Donald (11 May 2012). "Finding a Match, and a Mission: Helping Blacks Survive Cancer". The New York Times. Retrieved 15 May 2012.
- Oyedeji Ayonrinde, Oye Gureje, Rahmaan Lawal; 'Psychiatric research in Nigeria: bridging tradition and modernisation', The British Journal of Psychiatry (2004) 184: 536-538
- WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, 2010 estimates for water and sanitation
- WHO/UNICEF Joint Monitoring Programme for Water Supply and Sanitation, 2010 estimates for water and sanitation
- USAID: Nigeria Water and Sanitation Profile, ca. 2007
- Matthew Gandy:Water, Sanitation, and the Modern City: Colonial and post-colonial experiences in Lagos and Mumbai, , Human Development Report Office Occasional Paper, 2006
- National Drug Policy in Nigeria, O. Ransome Kuti. Journal of Public Health Policy > Vol. 13, No. 3 (Autumn, 1992), pp. 367-373
- Rais Akhtar; Health Care Patterns and Planning in Developing Countries. Greenwood Press, 1991. 265 pgs.
- 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
- Wadinga Audu; Commercialization of Public Health Service Delivery in Nigeria, GDN Research Project, Nigerian Institute of Social and Economic Research, Ibadan,Nigeria 2009
- "CIA - The World Factbook Life Expectancy". Cia.gov. Retrieved 2014-06-24.
- "HIV/AIDS - adult prevalence rate" CIA World Factbook (2012) Accessed February 20, 2014.
- "HIV/AIDS - People Living with HIV/AIDS" CIA World Factbook (2012) Accessed February 20, 2014.
- "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.
- Nigerian National Merit Award
- "The State Of The World's Midwifery". United Nations Population Fund. Retrieved August 2011.
- "'A breakdown of our primary health care system'," Seattle Post-Intelligencer
- 'Asangansi Complex Dynamics in the Socio-Technical Infrastructure: the case of the Nigerian Health Management Information System'
- Health in Nigeria
- Health insurance
- The State of the World's Midwifery - Nigeria Country Profile