Pitfalls of Financing Healthcare in Nigeria

Introduction

The 2020 World Bank data estimates Nigeria's population to be about 202 million. Nigeria is also a multi-ethnic federation with 36 states spread across 6 geopolitical regions (North-Central, North-West, North-East, South-South, South-East, and South-West) and the Federal Capital Territory. The country's major source of revenue is oil and gas, with a Gross domestic product (GDP) of 23.4 billion USD. Health expenditure accounts for 3.7% of the total GDP and the total per capital expenditure on health is 217 USD.

Sources of funding Healthcare

Health financing in Nigeria comes principally from the payment made at the point of accessing services from both private and public providers. Although out of Pocket health care financing has reduced by about 5% from 2010, it still accounts for 70% of health financing in Nigeria.

Resource allocation/ Payment systems

Thirteen percent of all non-taxable revenue from oil and gas goes back to all oil-producing states who are mostly located in the south-south region of Nigeria before the National allocation is made. Hence revenue allocation is not based on the principles of equity in Nigeria. Since states are autonomous, they can invest the funds where they deemed fit. This allocation could potentially result in more health investments in south-south regions of Nigeria if there is a political will

Access to care

There is a total of 34, 423 health facilities in Nigeria.  Primary health care facilities account for 88%, secondary health facilities account for 12 %, and tertiary health facilities 0.2 % of all health facilities in Nigeria. However, the distance of   health facilities to users, particularly in the rural areas has been a contributary challenge to  healthcare access in Nigeria. Despite the number of primary health care facilities in Nigeria, evidence has shown that most of the facilities are not fully functional.

Conclusion

In conclusion, the health care financing mechanism of Nigeria is mostly from out-of-pocket payments. This health care funding mechanism is catastrophic, further causing poverty and preventing a good number of the population, mostly in the rural areas from accessing health care. Furthermore, the poor investment in primary health care in Nigeria as a result of limited public funding has resulted in poor quality of care. Additionally, the passive method of paying health care providers and the non-strategic method of allocating funds to facilities has encouraged the inefficient performance of health care workers