Browsing by Author "Lawanson, A. O."

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Banking and Insurance
(Federal Ministry of Information, Abuja, Nigeria, 2014) Lawanson, A. O.
Banking and Insurance
(Federal Ministry of Information, Abuja, Nigeria, 2014) Lawanson, A. O.
Comparative analysis of non-medical consumption pattern between insured and uninsured people in Ekiti State, Nigeria
(2017) Adeyemi, F. O.; Lawanson, A. O.
Health Insurance (HI) brings about welfare improvement through improved health status and maintenance of non-medical consumption by ensuring that medical expenditures are smoothened over time. Notwithstanding, available data show that less than 4% of the Nigerian households are covered by national health insurance scheme.This implies weak ability to smoothen consumption over time whenever there is ailment. This paper aims at studying and evaluating the spillover effect of health insurance on non-medical consumption in Ekiti state. A propensity score matching estimation model was adopted to 1500 households across Ekiti state. This is the mean effect of an intervention through the mean difference in the outcomes of the treated and the control groups. The mean expenditure on non-medical consumption was N6947.03. In addition to that, the sign of the coefficient of the effect of health insurance on non-medical consumption is positive, showing that health insurance increases expenditure of insured households on non-medical consumption. Having recognized that insured households can be financially protected against unforeseen medical bill, federal government should encourage the expansion of health insurance by encouraging state government, local government and private sector to enroll their employees in health insurance programme. The paper concludes that health insurance is consumption increasing and therefore be expended to more people at local government areas to further redistribute income from the healthy to the sick.
Consumption and income over the lifecycle in Nigeria
(Union for African Population Studies, 2011-04) Olaniyan, O.; Soyibo, A.; Lawanson, A. O.
This paper utilises National Transfer Accounts framework to estimate age profiles of consumption and income over the lifecycle in order to determine actual period of dependency in Nigeria. The paper quantifies inter-age monetary flows of consumption and labour income and subsequent economic lifecycle deficit and the implications this will have for social policy and human capital development. The results indicate that given the profiles of consumption and income over the lifecycle in Nigeria, child dependency is for the first 33 years of life while old-age dependency occurs from 63 years upwards. The period of lifecycle surplus span 30 years from 33-63 years. The structure of consumption and income flows reveals that Nigeria has a lifecycle deficit of N3.5 trillion in 2004. Since the population is highly skewed towards children, inter-generational flows are heavily skewed downwards. The deficits must then be covered through age reallocations of transfers and asset income.
Cost burden of malaria: evidence from Nigeria
(2016-08) Osakede, U. A.; Lawanson, A. O.
This paper provides findings on cost burden of malaria in Nigeria. Cost computations were extrapolated to monthly income fraction and GDP lost to the illness. Results of the study are shown across different employment groups. Computations for indirect and direct costs were conducted using the Human capital and Bottom up approach respectively. The results show that one in two persons employed in the labour force will experience loss in labour contribution as a result of malaria with indirect cost of about N5,532.59($37.16) and N4,828.73 ($32.43) per person per day for the patient and care giver, respectively. Individuals spend approximately N2,730.46($18.34) on the average for treatment of one bout of the illness which translates to approximately 3% of monthly income. Overall, indirect and direct costs related to one episode of malaria in Nigeria sum up to approximately N1, 906.08 billion ($12,801.07 million) implying about 8% of GDP. GDP fraction lost to malaria is higher for the informal sector particularly self-employment in agriculture. Strategies to enhance welfare, labour contributions and economic output in Nigeria should focus on adequate measures to reduce malaria prevalence or complete eradication.
Cost-effectiveness analysis of mectizan treatment programme for onchocerciasis control: operational experiences in two district of Southern Nigeria
(Dept. of Physiology, College of Medicine of the University of Lagos, Lagos, 2009) Osungbade, K. O.; Olumide, E. A. A.; Lawanson, A. O.; Asuzu, M. C.
Objectives: This study analyze the operational costs of two Mectizan treatment strategies in relation to their effectiveness. Methods: The study was conducted in 24 communities located in Irewole and Egbeda districts of Osun and Oyo State, Nigeria respectively. Cost-effectiveness analysis included retrospective analysis of cost of treatment, review of records of distributors, estimation of overall cost-effectiveness ratio of treatment and distribution, calculation of mean cost-effectiveness ratios and statistical comparison of the mean cost-effectiveness ratios. Results: Overall cost of treatment per person through mobile distribution was N27.39 (USD1.16) while the corresponding overall cost through community-directed distribution was N14.35 (USD0.61). Overall cost of distribution per tablet through mobile distribution was N20.97 (USD0.89) while the corresponding overall cost through community-directed distribution was N8.39 (USD0.36). The difference between the mean cost-effectiveness ratios for treatments through mobile distribution, 56.79, and community directed distribution, 32,53, was not statistically significant (p=0.120265). Similarly, the difference between the mean cost-effectiveness ratios for distribution of tablets through mobile distribution, 40.83, and community-directed distribution, 19.17, was not statistically significant (p=0.167249). Treatment coverages were 59% and 80%, and 2,376 and 4,148 tablets were respectlveIy distributed, Conclusion: Distribution of Mectizan tablets by community-directed distributors was more cost-effective than by mobile health staff, but the differences in cost ere not statistically significant. However, this could ensure self-reIiance and sustainability of treatment programmes, which are prerequisites for decision making on treatment strategies.
Demographic transition, demographic dividend and economic growth in Nigeria
(Union for African Population Studies, 2012-11) Olaniyan, O.; Soyibo, A.; Lawanson, A. O.
Changes in age structure that results from demographic transition have economic consequences. This paper identifies the period of potential window of opportunity or demographic dividends created by Nigeria’s demographic transition. This is done by simulating the period of the demographic window of opportunity in Nigeria. In a simulation covering 1950 – 2050 our results reveal that Nigeria entered the window of opportunity in 2003 and will last beyond year 2050. The highest benefit will accrue in years 2032 and 2033 when the dividend can account for more than 10% of the growth of GDP per capita even if the current performance scenario continues to exist. However, the paper notes that the demographic dividend is not automatically realized and Nigeria needs to embark on strategies that will develop her human capital and position her towards not only capturing the first dividend but the second dividend as well.
An econometric analysis of capital flight from Nigeria: a portfolio choice approach
(The African Economic Research Consortium, Kenya, 2007-05) Lawanson, A. O.
Economic growth experience of West African region: does human capital matter?
(Center for Promoting Ideas (CPI), USA, 2015-12) Lawanson, A. O.
This paper empirically investigates the relevance of educational and health components of human capital to economic growth, using a panel data from sixteen West African countries over the period 1980 to 2013. GDP per capita is linked to health and education capital while accounting for population growth, physical capital, trade openness, and other growth control variables. To correct for endogeneity and other estimation problems this paper employs Diff-GMM dynamic panel technique. Empirical findings indicate that coefficients of both education and health have positive statistically significant effects on GDP per capita. The paper affirms the strong relevance of human capital to economic growth of West Africa. It is recommended that increased resources and policy initiatives to motivate and enhance access to both health and education by the population should be pursued by policy makers.
Efficiency of health systems in Sub-Sahara Africa: a comparative analysis of time varying stochastic frontier models
(2016-06) Lawanson, A. O.; Novignon, J.
The purpose of the current study was to estimate efficiency of health systems in sub-Sahara Africa (SSA) and to compare efficiency estimates from various time-varying frontier models. The study used data for 45 countries in SSA from 2005 to 2011 sourced from the Word Bank World Development Indicators. Parametric time varying stochastic frontier models were used in the analysis. Infant survival rate was used as the outcome variable, while per-capita health expenditure was used as main controllable input. The results show some variations in efficiency estimates among the various models. Estimates from the ‘true’ random effect model were however preferable after controlling for unobserved heterogeneity which was captured in the inefficiency terms of the other frontier models. The results also suggest a wide variation in the efficiency of health systems in sub-Sahara Africa. On average health system efficiency was estimated to be approximately 0.80 which implies resource wastage of about 0.20. Cape Verde, Mauritius and Tanzania were estimated to be relatively efficient while Angola, Equatorial Guinea and Sierra Leone were among the least performers in terms of health system efficiency. The findings suggest that the omission of unobserved heterogeneity may lead to bias in estimated inefficiency. The ‘true’ random effect model was identified to address the problem of unobserved heterogeneity. The findings also suggest a generally poor performance of health systems in terms of efficiency in the use of resources. While resource commitment to the health sector is critical, it is important to also ensure the efficient use of these resources. Improving the performance of institutions in the health sector may go a long way in improving the general health status of the African population.
Entrepreneurial interest and academic performance in Nigeria: evidence from undergraduate students in the University of Ibadan
(Sage, 2017) Osakede, U. A.; Lawanson, A. O.; Sobowale, D. A.
Entrepreneurial interest among the youth population is a panacea for unemployment especially due to high turnout of educated individuals in the labour force. This paper provides findings on the factors that determine entrepreneurship interest among the youth population in Nigeria using the University of Ibadan as a case study. Empirical results on whether engagement in entrepreneurial activities interferes with academic performance; extent of involvement and gender differences are also presented. The logit and multinomial logit models were used to examine the factors that influence entrepreneurship interest and interference with academic performance, respectively. Descriptive statistics and the T test were employed in examining the extent of involvement and whether there is a statistically significant difference across gender. The results showed that subjective norm, perceived behavioural control and family business background significantly predicts students’ interest in entrepreneurship. Engagement in entrepreneurial activity has no significant effect on students’ academic performance. Findings suggest relatively low entrepreneurial engagement among students with significant differences across gender.
Equity in healthcare financing in Nigeria
(Sciedu Press, 2016) Lawanson, A. O.; Opeloyeru, O. S.
Using both graphical and geometric analyses, this paper examines the extent of inequity in healthcare finance among the Nigerian population. One of the acclaimed plans in healthcare in this teeming community is the mix method of financing but the system in practise is dominated with Out-of-Pockets (OOPs) meanwhile the degree of income inequality still remain high. Using the Nigerian Living Standard Survey (NLSS) data conducted in 2004, the framework for this study relies on Kakwani Progressivity Index (KPI). A decomposition of the groups into lower and upper bound however, reveal that health payment for lower bound is regressive while payment for upper bound is progressive. Although, the upper bound result dominates the entire result which finally suggests a progressive system arising from the spending habit of the rich in seeking for healthcare services abroad.
External debt accumulation and economic growth: evidence from West African countries
(Faculty of The Social Sciences, University of Ibadan, Ibadan, 2015-03) Lawanson, A. O.
This paper investigates how indebtedness has affected the growth of 14 West African countries directly, and via investment and fiscal balance mechanisms, using data from 1970 to 2012. This task was approached through a standard growth framework through which debt indicators were incorporated. Two econometric specifications (linear and non-linear.) were used, and evaluated with the fixed effects and GMM estimation techniques on the relationship between debt and growth. The hypothesis that external debt affects growth is well-supported by the results. All debt variables have the expected signs and were statistically significant. The results reveal that debt appears to have a non-linear effect on growth. The debt overhang hypothesis is affirmed, given the existence of a threshold beyond which debt negatively contributed to growth. The average impact of debt on per capita growth becomes negative for debt levels above 60% to 74% of GDP. Thus, increasing debt beyond this threshold yields a negative marginal contribution to growth. There is a pressing need to take measures to not only stabilize external debts, but to place them on a downward trajectory in the future.
Health care financing in Africa: what does NHA estimates do reveal about the distribution of financial burden?
(College of Medicine, University of Ibadan, and University College Hospital, Ibadan, Nigeria, 2013-04) Lawanson, A. O.
This paper, utilized National Health Accounts framework to profile the health financing situation in Sub- Saharan Africa countries. While Africa accounted for less than 0.9 percent of global health spending, the region carried over 43% of global burden of communicable diseases. Thus financing of healthcare remained a core issue to most African countries. The highest burden of healthcare financing is shouldered by households, which accounted for between 72% and 99% of private sources. The public and external sources accounted for around 33% and 30% of total health expenditure, respectively. With high poverty incidence in the continent, households are easily exposed to catastrophic spending risk. Health financing reforms that emphasis pooling mechanism, especially social health insurance is therefore required. Deviance to the Alma Alta Declaration, which laid precedence on preventive healthcare, curative healthcare generally, dominated the allocation of healthcare resources. This has implication on the efficiency and effectiveness of healthcare delivery in African countries. Public facilities played a dominant role in the provision of healthcare, which is arguably supported by the need to achieve greater equity in healthcare delivery. However, with the growing wave of public-private partnership initiatives, it may be intuitively wise and efficient to increase private participation in healthcare provision.
Health care financing in Nigeria: national health accounts perspective
(2014-04) Lawanson, A. O.
The paper investigated the funding pattern of healthcare in Nigeria based on the National Health Accounts framework. Two rounds of National Health Accounts estimation covering the eight-year period, 1998-2005 were analyzed in this paper. The first round covering 1998-2002 was funded by donors and characterized by limited access to data, which accounted for its seeming underestimation. The second round funded by Federal Ministry of Health enjoyed access to wider data set, and allowed for state level sub- National Health Accounts estimates covering 17 out of 36 states of the federation. The estimates generally revealed that the households constitute the main source of financing healthcare in the Nigeria, accounting for over 66% of Total Health Expenditure, while government contributes average of 29%. Though resource pooling through health insurance appreciably grew over the years, it is still at its infancy, contributing minimally to Total Health Expenditure. While the private facilities dominates in the provision of healthcare service in the first round, the second round estimates shows that more than half of health care services were provided in the public facilities. Despite preventive care through Primary Health Care being the pillar of the National Health Policy strategy, curative care continued to dominate Total Health Expenditure in the country. The process of second round estimation accorded the issue of institutionalization a priority place, which resulted in the identification and training of state focal persons for possible integration of regular National Health Accounts data collection into public service practices. The absence of continuity in funding by government is threatening the ownership of the process. While the Nigeria Total Health Expenditure is highest in Africa, her per capita Total Health Expenditure and as percentage of GDP is well below figure for some African countries.
Health economics research: prospects and challenges in Nigeria
(The Nigerian Economic Society, 2013-07) Soyibo, A.; Olaniyan, O.; Lawanson, A. O.
This paper traces the evolution and development of health economics as a research and academic discipline in Nigeria. The emergence of research in health economics as a discipline in Nigeria in the 1980s through the international funding agencies’ activities predates its teaching. The funding was basically channelled to support capacity building in health policy research and training in the country. The subsequent critical mass of trained health economists produced went on to initiate the teaching of the discipline in Nigerian universities, from which Masters and Ph.D graduates have been produced. The course is mainly taught at the postgraduate level in the few Nigerian universities offering the discipline. Furthermore, the estimation of the two rounds of NHAs for the country has been facilitated by the domestic capacity in health economics, with domestic and foreign financial support. The paper identified two classes of health economics research in Nigeria: the research type, based on university or research institute, and the demand- driven research or consultancies. These are anchored by two main axes of university and/or research institute-based health economics research in Nigeria: Ibadan axis and Enugu axis. As a follow-up to the global and regional associations of health economists, the paper points to the emergence at national level of the Nigerian Health Economics Association which provides a platform for collaboration among health economists in the country. Despite the progress thus far, a number of challenges confront the research landscape of health economics in Nigeria, which include poor data availability, and reluctance to release data, as well as limited number of trained health economists. There is therefore the need for the political will to fully implement the health management information system project, enforce the Freedom of Information Act; and the provision of funds needed to support postdoctoral research in health economics.
Health expenditure and child health outcomes in Sub-Saharan Africa
(Porthologos Press, 2017-06) Novignon, J. N.; Lawanson, A. O.
This study sought to understand the relationship between child health outcomes and health spending while investigating lagged effects. The study employed panel data from 45 Sub-Saharan African countries between 1995 and 2011 obtained from the World Bank’s World Development Indicators. Fixed and Random effect models were estimated. Under-five, infant and neonatal mortality were used as child health outcomes while total health spending. The effects of one and two period lags of expenditure were estimated. The results show a positive and significant relationship between health expenditure and child health outcomes with elasticities of -0.11 for infant mortality, -0.15 (under-five mortality) and -0.-8 (ne0natal mortality). Public health expenditure. Positive and significant lagged effects were also estimated between health expenditure and child health. The findings suggests that, while health expenditure is crucial for the improvement of child health, it is equally important for this expenditure to be sustainable as it has delayed effects.
Health expenditure and health status in Northern and Southern Nigeria: a comparative analysis using National Health Account Framework
(African Health Economics and Policy Association (AfHEA), 2013) Lawanson, A. O.; Olaniyan, O.
Introduction: The financing of healthcare by government in Nigeria is complemented by contributions from the household, donor agencies, and the private sector. This paper examines the disparity in healthcare financing flows between the northern and southern regions of Nigeria and the implication for health outcomes. Methods: The paper uses data from the latest round of Sub-National Health Accounts for 17 states in Nigeria, from 2003 to 2005. The methodology was structured to give a complete accounting of all spending on health, regardless of the origin, destination, or object of the expenditure. Results: The paper found that healthcare financing in the north is relatively lower, accompanied by significant poor health status, with heavy dependence on the households in both regions. The share of households in the north was proportionally disproportionate, because of the high poverty incidence vis-a-vis public providers. This raises equity concerns as those least able to pay were made to bear more burden. Conclusion: The stewardship role of the government has to increase in terms of funding health care, in the light of low income of majority of the people, especially in the north, if the health status of the populace is to improve. Without government being directly involved in the provision of healthcare services, attempt should be made to subsidise the private sector health services to the citizenry. The pooling mechanism approach is identified to be an appealing alternative to finance healthcare.
Health financing and expenditure in Nigeria
(The Nigerian Economic Society, 2013-07) Soyibo, A.; Olaniyan, O.; Lawanson, A. O.
Health care financing policy has a significant impact on the structure and organization of health care delivery. The choice of a particular health care financing approach has implications for economic incentives to patients and the providers, variations in the extent of access to health care for particular population groups, and the organization of health care delivery. This paper addresses the concept and various methods of health financing, as well as the criteria for the choice of different health financing policies. It also analyzes Nigeria's health expenditure based on two rounds of estimates from the National Health Accounts of Nigeria (NHA), 1995 to 2002 and 2003 to 2005. While each of the major financing methods: government revenue, social and private insurance, user fees, and community financing has its own strengths and weaknesses, the choice a nation is largely dependent on its history, culture, and current institutions, and on whatever tradeoffs regarding objectives that nation is willing to make. The paper analysis health expenditure patterns in Nigeria, using the National Health Accounts, based on estimates from Soyibo (2005) and Soyibo et al. (2009). Total health expenditure, as a percentage of GDP over period 1998 to 2003 ranged between less than 5 per cent and 7.5 per cent, while the households account for the bulk (average of 66%) of financing health care in Nigeria, which is not sustainable. Government, who relies on tax revenue contribute less than 23 per cent of the country's total health expenditure, while industrial private sector and the donor agencies play a minimal role. To ensure sustainability of the funding of health expenditure in the country, there is a need for a gradual and progressive shift to risk pooling mechanism, which not only appears more viable and sustainable, but also tend to lighten the burden on the households. Government in addition should wake up to her stewardship role in funding health care to improve the general welfare of Nigerians.
Healthcare financing in Nigeria: the analysis of the inequity perspective
(2019) Lawanson, A. O.; Opeloyeru, O. S.
The volume and quality of healthcare needs vary from one individual to another but promoting access to the use of healthcare is germane to reduce/eliminate inequity in healthcare. This paper examines the extent of equity in healthcare financing in Nigeria, and determine the relative progressivity of each source of healthcare financing in the country using waves 2 and 3 of the General Household Survey. Kakwani and Modified Kakwani (MDK) indexes were used to estimate progressivity of out of pocket payment (OOP) and social health insurance. Overall result indicates a vertical inequity favouring the non-poor (pro-rich), OOP as a source of financing was regressive and social health insurance was moderately progressive. Given that a more progressive healthcare financing approach tends to promote welfare and improve health status of the population, Nigeria will be better off promoting health insurance as a means of eliminating inequity in healthcare financing.