Commentary: The necessity for a health systems reform in Nigeria

Abstract

DefinitionA health system is an organizational framework for the distribution or servicing of the health care needs of a given community. It is a fairly complex system of inter-related elements that contribute to the health of people -in their homes, educational institutions, in work places, the public (social or recreational) and the psychological environments as well as the directly health and health-related sectors. The organization of health services in NigeriaThe health system in Nigeria is structured along the now universal three levels of the primary, secondary and tertiary levels of care. The system is run concurrently such that all the three levels of government -local, regional/state and national/federal, even though they hold primary responsibility for only one level of the system each, can exceed it and provide services at any of the other two levels of care. One of the effects of this fluid system, in the face of the many social and infrastructural problems facing the nation, is that the pursuit of the politically attractive tertiary health care can remain the only attractive area of the health system, to the detriment of the other levels of care. The neglect of the primary health care system, its maldistribution as well as the secondary health care, will result in an inverted health care pyramid. This will not produce any health for the people but will always have the threat to collapse on itself.

Informal payments for healthcare: Differences in expenditures from consumers and providers perspectives for treatment of malaria in Nigeria

“…The PHCs are the main source of healthcare for people in the rural communities [7]. However, the system is run concurrently such that all the three levels of government -local, regional/state and national/federal -even though they hold primary responsibility for only one level of the system each, can exceed one level and provide services at any of the other two levels of care [8]. In addition to the government providers, healthcare is provided by various private providers that range from patent medicine dealers (PMDs) to large scale hospitals.…”

Perceived Management Challenges in Tertiary Health Facilities in Calabar, Southern Nigeria

“…This agrees with the findings of earlier workers that health manpower distributions in Nigeria favours the urban population, where tertiary health facilities are located, at the expense of the hard-to-reach rural areas for the singular notion that the educated, the rich and powerful live in urban areas. 4,5 It is noteworthy, that none of the respondents was familiar with the work place policy manual. When this deficiency is combined with the fact that the heads of these health facilities lack the requisite management training skills as found by Block in 1988 and Attah in 1995, then there is little wonder why majority of the respondents reported frequent work place conflicts.…”

“…This agrees with findings by other workers. 4,6,7 Provision and maintenance of basic infrastructure and equipment have been recognised as key challenges to health managers worldwide. This fact, identified by earlier workers 8,9,10 has been corroborated by findings in this study.…”

Understanding the Introduction and Use of a Mobile Device‐Supported Health Information System in Nigeria

“…These 36 states are further subdivided into approximately 776 recognised Local Government Areas, with some of them having a population approximately less than 80,000 (DfID HSRC, 2000). Since inheriting a weak colonial health system at independence in 1960, Nigeria has gone through phases of unsuccessful plans to develop its health system (Asuzu, 2004). Notably, it was only in the late 1970's, when a primary health care (PHC) system was decided at the international conference on PHC in Alma-Ata that the country's health system started heading for reform.…”