Publication | Open Access
Community based healthcare financing: An untapped option to a more effective healthcare funding in Nigeria
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2010
Year
Health ReformHealthcare ProvisionUntapped OptionHealth FundingEffective Healthcare FundingFinancial ProtectionHealth Care FinanceNigerian Health SystemGovernment SpendingPrimary CareHealth FinancingHealthcare FinancingPublic HealthHealth Services ResearchAfrican Public Health PolicyUniversal Health CareAfrican DevelopmentHealth Insurance ReformPublic PolicyHealth PolicyHealth InsuranceHealth EquityHealth SystemsHealth EconomicsGlobal HealthInternational HealthHealth BudgetMedicineFinancing
Context:The Nigerian health system is characterized by chronic under funding. This has resulted in poor performance of the health sector evident from Nigerian's poor reproductive health indices. Objective: This review evaluates healthcare funding in Nigeria with respect to health budget and health expenditure, appraises the national health insurance scheme, and examines community health care financing as a plausible option to a more effective funding of healthcare in Nigeria. Pattern of health funding in Nigeria: Federal Government budget on health ranged from N 4, 835 million-N 17, 581. 9 million from 1996 to 2000. This amount represented only 2. 7%- 5. 0% of the total Federal Government budget. Nigerian's Total Health Expenditure (THE) as a percentage of Gross Domestic Product (GDP) is low ranging between 4. 3 %- 5. 5 % from 1996- 2005. General Government Health Expenditure (GGHE) as percentage of THE is also low ranging from 21. 8 %- 33. 5 %. Private sector expenditure on health as percentage of THE is high ranging between 66. 5 %- 78. 2 % from 19962005, with private households' out of pocket accounting for 90. 4 %- 95. 0 % over the period. Social security fund had no contribution to the general government expenditure over the 10-year period. The National Health Insurance Scheme (NHIS) currently covers only the formal sector of 4. 5 million people ( 3. 2 %) of the population. Community-based healthcare financing (CBHF): Community-based healthcare financing has been recognized as a community-friendly and community-driven initiative that has a wider reach and coverage of the informal sector especially if well designed. Experience with the Anambra State CBHF scheme, and a few other similar schemes in Nigeria indicate high acceptability of the people to CBHF scheme. Conclusion and Recommendations: Government and non-governmental organizations should collective develop various forms of CBHF to reach out widely to Nigerians.