nigerian healthcare services
TRANSCRIPT
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NIGFIXI
PRI A BGL
6th M
ERIANNG T
ATE Research
rch 2012
HEALE HE
ECTO
& Intellig
THCALTHC
R PARnce Repo
E SERE C
ICIP
rt fo r a H
VICEALLE
TION
ealth Ca r
: GES
Mandate
HRO
GH
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NIGERI
PRIVA
Accordi
2009,
averag
surge i
decadebillion
includi
deman
50% of
from it
about
human
Globall
Ministr
care pa
provid
and inc
The pri
In a re
player.
50% of
of the
increas
funnel
N HEALT
E SECTOR
ng to a st
nly a few
of US$35
n foreign
. The study N3.7 trillio
g hospital
s of SubS
SubSahar
s largely p
1% of the
and financ
, almost 5
y of Financ
ckage is ab
s a huge o
rease finan
vate sector
gion wher
About 50
total healt
egions po
ed attentio
billions of
HCARE SE
ARTICIPA
dy conduc
ountries i
US$50 (N5
assistance
estimated n N4.5 tr
, clinics, a
haran Afri
n Africas
or people
orlds po
ial costs d
% of the d
e reported
out N3,84
portunity
cing and th
already d
public re
o health
expendit
or people,
n from ext
ollars to h
VICES: FI
ION
ted by the
SubSaha
,250 N7,
from seve
that over tillion) in n
nd distribu
ca. The Wo
otal health
. It is ther
ulation acc
spite com
eaths of ch
that the re
.00 (US$2
to leverage
e quality o
minates th
ources are
are financi
re goes to
both urba
ernal dono
elp combat
ING THE
IFC with
an Africa
00) per ye
ral multila
e next dew investm
tion ware
rld Health
expenditu
fore unde
ounts for a
anding le
ildren und
sources av
.65) per c
the privat
healthcar
e healthca
limited, t
ng in Afric
private he
and rural,
rs has res
the worst
HEALTHC
ssistance f
re able to
ar per per
teral agen
ade (2010 ent will be
ouses, to
rganisatio
re is financ
rstandable
bout 24%
ss than 1%
r five take
ailable for
pita. Low
e sector in
goods and
re sector in
e private
comes fr
lthcare pr
rely on pr
lted in so
health sco
Rese
ww
RE CHALL
rom McKin
expend th
on on heal
ies and d
2020), USneeded in
eet the
n (WHO) e
d by out
that SubS
f the globa
of global
place in Af
elivering t
ublic spen
ways that
services th
Africa
ector is al
m private
viders sinc
ivate healt
e remark
rges of th
rch and Int
w.bglgrou
ENGES T
sey & Co
WHOdet
lthcare des
onors duri
$25 billion healthcar
rowing he
timates th
f pocket p
aharan Afr
l disease b
ealth expe
rica. In Nig
he essenti
ding on he
ill improv
roughout
ready a si
sources, an
e the vast
h care. In
ble initiati
region, H
lligence
ng.com
ROUGH
pany in
rmined
pite the
ng that
US$30 assets,
althcare
t about
yments
ica with
rden in
nditure.
ria, the
l health
althcare
access
frica.
nificant
d about
ajority
ddition,
es that
IV/AIDS,
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tuberc
facilitie
The re
worlds
perfor
further
to affo
HealtIndicatGovt. EPrivateNo. of No. of No. of No. of
Source:
The Ni
Infrastr
sector
system
centres
expend
capital
Key HeLife ExMaterBirth AUnder PrevalMalari
Source:
losis (TB),
s necessar
ion also fa
health wo
ance in Su
in the regi
dable heal
Expenditurors xpenditure Expenditur
Physician (PNurses & MiDentist (Per Pharmacist (
HO Health S
erian heal
ucture dec
characteris
have suffe
is estima
iture. How
expenditur
alth Statistiectancy at al Mortality
ttended by 5 Mortality nce of HIV i Mortality HO Health S
and mala
to provide
ces a seve
rkers depl
bSaharan
on. Hence
hcare servi
e and Reso
n Health ( on Health r 10,000 Pe
dwives (Per 10,000 peoper 10,000 tatistics 2011
hcare sect
ay, brain
e healthca
red. In 201
ted at N2
ever, only
e in spite o
cs
irth (Yrs) Rate (Per killed Persoate (per 10
n Adult (15ate (Per 10tatistics 2011
ia. Howev
and delive
re shortag
yed in Sub
Africa mea
here is a
ces in Afric
rce Adequa
of total) % of total) ople) 10,000 peole) eople)
or shares t
rain, ince
e services
1, national
04 billion;
N20.25 bil
insufficien
0,000 Birth)nnel (% of B00 Birth) 9yrs) ,000 Birth)
er, most o
r minimal l
of traine
Saharan
ns that de
ajor role f
a.
cy Nig
36634.
le) 160.1.
e same at
sant work
in Nigeria
spending
approxim
lion (10%
t medical
irth)
f the area
vels of he
medical p
frica. Furt
and for h
r the priv
ria A
Av.7 .3 0 .1 3 3
tributes wi
rs strikes
Collective
n teaching
tely 79%
of total ho
quipment.
Nigeri54
84039
1383.6146
Rese
ww
lacks the
lth service
ersonnel,
ermore, i
althcare is
te sector i
frica erage
I
9.8 0.2
2.3 0.9
0.3 0.8
h its Afric
and low i
ly, all tiers
hospitals a
of the go
spital expe
a A
Av
rch and Int
w.bglgrou
infrastruct
s and prod
ith just 3
proving e
poised to i
n enhancin
Low to Midcome Coun
Average45.4 54.6 10.1 16.8 0.9 3.5
n peers
nvestment
of the he
nd federal
vernment
nse) is all
rica rage
54 20
48 33 .7
94
lligence
ng.com
ure and
cts.
of the
onomic
ncrease
g access
dle tries
in the
althcare
medical
health
tted to
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The str
Public
and te
health
health
change
and di
general
teachin
Inadeq
hospit
The tar
The ab
workerwho c
hospita
operati
medica
providi
Nigeria
Accordi
worst i
progre
indicat
bench
that a
govern
cture of N
ealth care
tiary facilit
facilities in
care faciliti
d significa
pensaries
hospitals
g hospitals.
uate infras
ls
get areas
sence of p
s have resun afford t
ls, physical
onal as a r
l professio
g consulta
n Health i
ng to the F
the worl
s towards
rs in Nige
arks due t
purposeful
ent, thus,
igerias pu
delivery s
ies. In 200
Nigeria o
es. 38% of
tly since t
spread th
nd matern
tructure a
or mass p
oper facili
lted in the em side
facilities
sult of po
nals are
ncy service
dicators a
ederal Min
. Nigeria s
achieving
ria have la
weaknes
reform o
initiated a
lic healthc
stem in N
5, the Fed
which 85.
these facil
en. Prima
oughout t
ity centres
d poor st
ocuremen
ies and in
coexistency side wit
re often d
er challen
ften foun
s in private
e very poo
istry of He
oulders 1
the 2015
rgely rema
es inheren
the Nati
process th
are syste
igeria cons
ral Minist
5% are pri
ities are o
y care wa
he countr
while terti
aff morale
of medic
dequate r
e of privath the pub
ecaying, a
es. The iro
d in publi
ly funded f
lth, the he
% of the g
targets fo
ined belo
t in the sys
nal health
at led to t
is multi la
ists of a n
y of Healt
mary, 14%
ned by th
largely p
. Seconda
ry care is h
lead to p
l equipme
munerati
lyowned lic healthc
d equipm
ny howeve
c employ
rms or in t
alth indica
lobal disea
the MDG
country t
tem. Henc
care deliv
e develop
Rese
ww
ered
twork of p
estimate
secondary
e private s
ovided thr
ry care is
andled thr
or service
t are the
n of publi
ospitals wre centres
nt is eithe
r, is that th
ent but
eir own p
ors for Nig
se burden
s on heal
rgets and
the gover
ry system
ent of th
rch and Int
w.bglgrou
rimary, se
a total o
and 0.2%
ector. This
ough healt
provided
ough the u
delivery i
teaching h
sector he
hich cater . In public
r obsolete
e few highl
re almost
rsonal clini
eria are a
and is mak
hcare. Th
internatio
ment is c
is necess
National
lligence
ng.com
ondary,
23,640
tertiary
has not
h clinics
through
iversity
public
ospitals.
althcare
o those funded
or non
y skilled
always
cs.
ong the
ng slow
health
allyset
nvinced
ry. The
trategic
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Health
manne
But t
The NS
improv
(US$26
period.
develo
Organi
More i
Nation
a majo
be kno
finance
value;
additio
Over t
require
the tot
budget
Bill up
govern
guaran
expend
already
bad sta
Developme
in 2010.
e Nationa
HDP 2010
e the heal
.6 billion)
Funding
ment part
ations (NG
mportantly
l Health Bi
paradigm
wn as the
d from the
ith grants
nal funding
e 6 year
ment is N6
al health
s
and less t
n which t
ent reso
eed alloca
iture to th
eight mo
rt and is un
nt Plan 20
Strategic
2015, deve
th status
ould be re
sources a
ners via O
Os) and Phi
, significa
ll currently
shift in he
National
consolidat
by interna
.
implement
66.16 billi
ector budg
an half of
e spendin
rces conti
ion that is
sector in
ths into it
likely to de
02015 (N
ealth Dev
loped to s
f Nigerian
uired to r
re limited
fficial Deve
lanthropist
t funding
awaiting P
lth financi
rimary He
d fund of
tional don
ation peri
n . Unfortu
et is
only
the require
g is based
nues to m
proposed i
the future.
first impl
liver result
HDP) whic
elopment
rengthen
, estimate
position t
largely t
lopment A
s.
of the pl
esidential
g in Nigeri
alth Care
he Federa
r partners
d of the
nately, in t
257.87 bi
d annual s
is yet to
ake it diff
the bill as
The plan
mentation
as intend
h was deve
lan 2010 2
he nationa
s that a t
e Nigerian
governm
ssistance (
n is expe
assent. The
a through t
evelopme
ion, at an
and funds
NSHDP, th
he first ye
llion. This
ending. In
ecome la
icult for a
well as po
as deliver
year. The
d.
Rese
ww
loped in a
015 has no
l health sy
tal amou
Health syst
ent spend
DA) and
ted via th
National
he establis
t Fund. T
mount no
from other
estimate
r of imple
epresents
addition, t
. The risi
y sector t
ential incr
ed in Augu
efore the
rch and Int
w.bglgrou
ighly parti
t taken off
stem and
t of N3.9
em over th
ing at all
Non Gover
e recently
ealth Bill p
ment of a
he Fund w
less than
sources se
annual s
entation
5.75% of
t
he Nationa
g competi
o get the
ase in gov
st 2010 w
plan alread
lligence
ng.com
cipatory
yet
o vastly
trillion
e 6 year
levels,
mental
passed
roposes
Fund to
ould be
% of its
rving as
pending
in 2011,
he total
l Health
tion for
kind of
rnment
ich was
y had a
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Even t The Na
to imp
establi
schem
cost sh
the fin
quality,
in 2005
In 201
(3.73%
individ
employ
level o
univers
povert
Unstab
Anothe
of Afric
to 201
outloo
unsust
play a
The sec
e National tional Heal
ove access
hed the s
is designe
aring arran
ancing of
more org
.
, five full
of the po
als workin
ed. Even i
progress
al enforce
and low le
le global e
r source o
as health
. The chall
suggests
inable sou
igger role i
tor require
Health Insh Insuranc
to quality
heme whi
d to facilit
gements f
ealthcare
nised priv
ears into
ulation) w
g in the fo
the form
expected.
ent of t
vel of awa
onomic ou
financing
are expen
enging glo
dwindling
rce of heal
n the devel
s provision
rance Sche Scheme (
healthcare
h is a fed
te fair fin
r individua
in Nigeria,
te sector p
the schem
ere benefi
rmal secto
l sector, it
he factor
e scheme,
eness.
tlook migh
or healthc
iture was
al econo
aid in th
hcare fina
opment of
of physica
me has nNHIS) is on
for the Ni
erally fund
ncing of h
ls. The sch
thereby e
roviders. T
, it was e
ing from t
leaving la
is arguabl
responsib
, inadequa
t affect fut
re is dono
inanced di
ic scenari
e coming
cing. This
the health
assets an
t deliveree of severa
gerian peo
ed social h
ealthcare c
eme has e
ncouraging
he implem
stimated t
he scheme
ge gaps a
e that the
le for its s
cy of med
ure donor
r assistanc
ectly by
d
in recent
years ma
suggests a
sector in Ni
training o
Rese
ww
optimally l attempts
ple. In 199
ealth insu
osts throu
ormous p
the devel
ntation of
at only 5.
, the majo
ong the p
scheme ha
low growt
ical faciliti
ssistance
. Overall,
nor aid
in
times as w
ing donor
need for th
geria.
additiona
rch and Int
w.bglgrou
by the gov
9, the gov
ance sche
h risk poo
tential to
opment of
the schem
3 million
rity of whi
oor and in
s not achie
include t
es in man
o healthca
approxima
he decade
ell as the
aid a po
e private s
l health w
lligence
ng.com
rnment
rnment
e. The
ling and
mprove
higher
e began
igerians
h were
ormally
ved the
he non
areas,
re
ely 10%
of 2000
nstable
tentially
ector to
rkers
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The bi
sector
the exi
nurses,
from e
distrib
facilitie
The pri
Existin
public
social
both f
individ
the ricprofit a
the po
sector
as adva
Fundin
need f
Obviou
govern
persist.
labour
fiscal p
private
gest area
physical a
sting base
and com
xisting me
tion and
s will also b
vate sector
elements
ntities tha
nterprises.
rmally an
al medicin
, but the nd social e
r and rur
requently
nced medi
challeng
r private s
sly, fundin
ent even
The wellb
force will
olicy regim
participati
for privat
ssets. A lar
especially i
unity hea
dical colle
etail syste
e strong.
has been i
of the priv
t include f
Individual
informall
e sellers al
pposite is nterprises,
l populati
rovides se
al equipm
is limitin
ctor parti
g the hea
as clamou
eing of the
e more p
e, and an
n in the p
sector in
e number
n under se
th worker
es and tr
ms and f
volved in
te sector i
rprofit co
public sec
y, and an
so exists. T
often the play an im
ns unders
rvices or p
nt and pro
g govern
ipation lthcare sys
rs for incr
citizenry s
oductive a
increasing
ovision of
volvement
of addition
rved areas
required
aining inst
r pharma
every facet
volvemen
mmercial
tor health
informal h
he private
ase. In facortant soc
rved by t
roducts th
cedures.
ents prov
tem in Ni
ases in h
hould be v
nd will aid
illingness
ritical infr
will be in
al hospital
. In additi
exceeds th
itutions in
eutical an
of Nigeria
in the hea
ompanies,
workers pr
ealth sect
sector is o
t, private sial role i.e.
e public s
t might ot
ision of h
geria has
alth work
ry import
economic
of the pre
structure
Rese
ww
building
beds will n
n, the nu
e number
Nigeria.
medical
s healthca
lthcare sec
non profit
ovide priv
r of heal
ten percei
ctor provimeeting th
ctor. In a
erwise no
althcare s
become b
rs remune
nt to any l
growth. Gi
sent gover
uch as hig
rch and Int
w.bglgrou
nd impro
eed to be a
ber of ph
that will g
emand fo
supply pr
e sector
tor consist
organisati
te sector
rs, midwi
ed as serv
ders, inclue medical
dition, the
be availa
ervices; he
rdensome
ration con
eader, as a
ven the ti
nment to
ways and
lligence
ng.com
ing the
dded to
sicians,
raduate
better
duction
of non
ns, and
ervices,
es, and
ing only
ing foreeds of
private
le, such
nce the
to the
inue to
healthy
htening
mbrace
irports,
-
8/12/2019 Nigerian Healthcare Services
8/15
we rec
health
Nigeria
been c
In Mar
where
FCTA a
the PP
healthc
more r
Succes
Partne
the heinvest
operati
the he
technic
incenti
Partne
able to
PPPs c
implem
and ti
respon
the pa
private
mmend a
ector.
s experie
nsidered s
h 2007, th
a concessi
d NISA M
model wo
are servic
liable med
ful implem
ing with th
lth sector. ents of sc
onal efficie
lth sector,
al or man
es), and sp
ing can als
manage co
an be ben
ented, and
ely manne
ibilities, ri
tners in a
partners a
applicati
ce with P
uccessful
e PPP mo
n agreeme
dical Grou
uld have n
s provide
ical diagno
entation o
e private s
Potential brce public
ncy, and b
partnerin
agement
urring tech
o reduce o
sts and sch
eficial for
monitore
r. PPPs sh
k allocatio
vance. In
nd, in so
n of the p
blicPriva
el was suc
nt for its
after a co
merous u
, updated
is and trea
PPP arran
ector can
enefits inclfunds are
etter man
can also
xpertise (
nology tra
r better all
edule over
the healt
, including
uld includ
, and othe
that regar
e cases, b
ublicpriva
te Partner
cessfully i
anagemen
mpetitive
sides for t
medical f
tment pro
gements c
ave subst
ude reduceliminated,
gement o
be particul
for examp
sfer, all of
ocate risks
uns.
sector
being adj
welldefin
r transacti
, the quali
tween pa
e partners
hip (PPP)
plemente
t and oper
idding pro
e country
cilities, inc
ess.
uld be be
ntial bene
d governmgreater ef
hospital s
arly valuab
le, perfor
which can
since the
hen they
sted when
ed objecti
n element
ty of cont
tners and
Rese
ww
ip approa
in the hea
at the Ga
tion was s
ess. Sect
including: i
reased sta
eficial to
its for the
nt spendiiciency fro
ervices an
le as a me
ance base
lead to qua
rivate par
are well j
necessary
es, clear di
s to be agr
acts betw
third parti
rch and Int
w.bglgrou
h to the c
lthcare se
rki Hospit
igned bet
rwide ado
mproved q
ff efficienc
igeria
public par
g as large private p
infrastru
thod of le
d monitor
lity improv
ner may b
ustified, p
, in an app
ivision of r
eed upon
en the pu
s is critica
lligence
ng.com
ountrys
tor has
l Abuja,
een the
ption of
uality of
and a
ner and
pfront artners
ture. In
eraging
ing and
ements.
e better
epared,
ropriate
les and
etween
blic and
l to the
-
8/12/2019 Nigerian Healthcare Services
9/15
succes
experie
Howev
Levera
govern
Collabo
may n
involve
proces
Theref
Accordi
require
stemmineed t
separa
accredi
provid
Approp
import
indicat
upfron
public
needed
to ope
quality
perfor
of a PPP.
nce to the
er, there a
ing partne
ents face
rations ma
t be the
s careful r
es and res
re careful
ngly, an a
d to appr
ng from in be addre
e reform
tation syst
rs perfor
riate moni
nt in he
rs, targets
, built into
artner ha
. External
ate a facili
standards)
ance.
ost impor
contracting
e also imp
ships and
in health
y take a l
most effec
view of t
onsibilitie
evaluation
ccurate u
priately d
adequate rsed either
underta
ms, updat
ance.
toring and
lthcare P and outp
contracts,
sufficient
versight m
ty or a spe
in ensurin
tantly, all p
process.
rtant risks
ollaborati
are today
ng time to
tive or eff
e allocati
, and the a
of the con
front eva
sign and
egulatory through s
en by th
ing patient
manage
Ps. Monit
ts, as well
and refine
capacity f
ethods can
cific health
continuit
arties in a
to conside
ns with th
may not
establish
icient opti
n of finan
pplicable r
itions for
luation of
ro activel
ramework ecial prov
e govern
rights poli
ent of qu
oring and as any pe
at the pil
r oversigh
also be uti
technolog
in the mo
PPP should
r
private se
e easy. P
nd bring t
n availabl
cial risks
gulatory a
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