1. 1. HEALTH SYSTEMS IN NIGERIA Presented by: WINFRED AKPLAGAH GLOBAL HEALTH
2. 2. OUTLINE Introduction Key health indicators Health needs Healthcare in Nigeria Service delivery Health financing
3. 3. Introduction Political background Nigeria is a Federal Republic composed of 36 States, and a Capital Territory, with an elected President and a Bi-cameral Legislature. The Senate President is the Head of the Federal Legislature. There is a National Assembly made up of the Senate and House of Representatives. At the State level, the Legislature
4. 4. Introduction-Demographics Demographic characteristics Population (millions) UN, 2012, total 166.6 Population annual growth rate (%), 2011 2 Crude death rate, 2011 14 Crude birth rate, 2011 40 Life expectancy, 2011 52 Total fertility rate, 2011 5 Urbanized population (%), 2011 50 Average annual growth rate of urban population (%), 2011 3 Population density (per sq. km), 2010 173.94 Adult literacy rate (%), 2011 61
5. 5. Key Health Indicators Under-5 mortality rate (U5MR), 2011 124 Probability of dying b/n 15&60 m/f per 1,000 pop. 393/360 Total expenditure on health as % of GDP 5.3 Total expenditure on health per capital (US$) 139 Deaths due to HIV/AIDS, 2012 210,000 HIV prevalence (%), 2011 3.7 Annual no. of under-5 deaths (thousands) 2011 756 GNI per capita (US$) 2011 1200 Life expectancy at birth ( m/f years) 2011 52/53 GNI per capita (PPP US$) 2300
6. 6. Health needs Malaria HIV/AIDS Influenza & Pneumonia Diarrhoeal diseases Tuberculosis Stroke Coronary Heart Disease
7. 7. Health risks Alcohol/drinking Tobacco/smoking Obesity Sanitation Access to portable water
8. 8. Healthcare Nigerian health system is pluralistic. It includes orthodox, alternative and traditional health care delivery systems operating alongside each other. The Government recognizes and regulates these three systems. A world health report ranked Nigeria 177 out of a total of 191 countries, on its degree of responsiveness to healthcare
9. 9. The Nigerian healthcare administration is organized in to three (3) tiered of Government namely Federal, State and Local. Health care in Nigeria is administered through three tiers: primary, secondary and tertiary levels. The primary level is run by the local government, the secondary by the state, while the tertiary is run by the federal government (FRN/FMOH, 2000).
10. 10. Organizational Pyramid of the Nigerian Health Services Structure ADMINISTRATIVE LEVELS SERVICE STRUCTURE PERSON IN CHARGE Federal Government Tertiary Health Services Federal Ministry of Health Secondary Health Services State Ministry of Health State Government Local Government Areas Primary Health Services Private Sector Private Services Private Providers
11. 11. CABINET National Advisory Council on Health Inter Sectoral Collaboration Federal Ministry of Health Private sector, NGOs, Traditional/Faith healersTeaching Hospitals, Federal Medical Centres State Ministry of Health General Hospitals Local Government Department for Health Primary Health Clinics and Health Posts
12. 12. Service delivery Nigeria has one of the largest stocks of health workers in Africa comparable to Egypt and South Africa. About 60% of the states in Nigeria, provide rural incentives to health workers that volunteer to serve in the rural areas, while others make rural service a condition for some critical promotion. National Youth Service Corps
13. 13. Total health workers and densities in 2008 Categories Number Density per 1000 population Physicians 55 376 0.37 Nurses and midwives 224 943 1.49 Dentists and technicians 3 781 0.02 Pharmacists and technicians 18 682 0.12 Environ, and public health 4 280 0.03 Laboratory technicians 22 683 0.15 Other health workers 2313 0.02 Community health 19 268 0.13 Total 351 326 2.32
14. 14. Health financing Health care in Nigeria is financed by a combination of: Tax revenue from the sale of oil and gas Out of pocket payments Donor funding Health insurance (private, public, social and community). The TGHE as % of GDP in 2011 was 5.3 Per capita GGHE (2012) was US$ 29.2 Per capita THE (PPP int. $) was 139.3 NHIS in Nigeria covers only the formal sector employees (mandatory). 90% coverage has been
15. 15. NHIS contribution represent 15% of basic salary The employer pays 10% and the employee pays 5% The package covers the contributor, a spouse, and four (4) biological children below age 18. Services under the NHIS are: Out-patient care including necessary consumables. Prescribed drugs. Maternity care up to four (4) live births. preventive care. Hospital care up to 15 days per year. Consultations with specialists Eye examinations A range of prostheses (limited to artificial limbs produced in Nigeria)
16. 16. Thank you