scholarly works
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Item 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.Item 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.Item National health accounts estimation: lesson from the Nigerian experience(2012-12) Lawanson, A. O.; Olaniyan, O.; Soyibo, A.Objective: This paper seeks to summarize the estimation of two rounds of Nigeria’s National Health Accounts (NHA), 1998-2002 and 2003-2005 and draw some lessons on the NHA methodology and health financing policy challenges towards enhancing government stewardship role in the health sector. Method: The paper uses the results of the two rounds of NHA estimations for Nigeria as basis for analysis. In each round of estimation, three matrices were estimated. Additional three matrices of sub-National Health Accounts were also estimated for 17states in the second round. Results: With Nigeria’s per capital Total Health Expenditure (THE) increasing from US$9.39 in 1998 to US$55,04 in 2005, the THE represent about 5% of GDP. The households accounted for around 68.6% of THE, while government shoulders about 25%. Major lessons learnt relate to skewed spending, challenges of record-keeping and data collection at the federal and state levels, and commitment of government and other stakeholders in ensuring institutionalized procedures for collection, reporting, and retrieval of health financing data. Conclusion: Though NHA results indicate increase in spending on health over time, there is a very high burden on households. Besides, there are institutional challenges inhibiting the estimation process. There is need for government to lessen burden on households to improve its stewardship by increasing its contribution. The institutional capacity need to be strengthen to collect and analyse health expenditure data and interpret results in terms of their policy implication, while government takes ownership of the process to ensure the institutionalization and sustainability of the estimation process.Item 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.Item 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.Item National health accounts of Nigeria: results from second rounds of estimation(2010-09) Lawanson, A. O.; Olaniyan, O.; Soyibo, A.Nigeria Health Accounts (NHA) tracks the flows of health spending from financial sources to end users. This paper uses the framework to capture the general health expenditure and updates the earlier NHA for Nigeria by providing estimates for 2003-2005. The estimates were prepared in line with the WHO’s guide to the NHA estimation. Our estimates reveal that households are the major source of health funds in Nigeria. Government funding accounts for a quarter of the health funds and but the main incidence still lies with households. These funds were spent about equally in private and public health facilities. Although resource pooling is not widespread, health insurance show promise as a significant potential option in health care financing. Given health as a public good, the implication is that there is need for government focus on the responsibility to lessening the burden of health expenditure on poor households if its stewardship role is not to be called to question.Item National health accounts: structure, trends and sustainability of health expenditure in Nigeria(African Journals Online, 2007) Soyibo, A.; Olaniyan, O.; Lawanson, A. O.This paper explored the structure of the contribution of different stakeholders to the financing of health care in Nigeria. The analysis was based on the National Health Accounts (NHA) 1998 to 2002 estimates for Nigeria. The main objective was to assess the viability of each stakeholder as a sustainable means of financing health provision in Nigeria. About two-thirds of health expenditure in Nigeria was directly financed by households, while public sector funding was less than half the amount committed by households. Third-party payment through health insurance represented a minuscule portion. A comparative analysis of the trend in the sources of income of households and revenue of government, revealed a wide disparity that suggested possible non-sustainability of their respective roles in health financing in Nigeria. Apart from the fact that the contributions of NGOs’ were very small, they were dependent on donor funds whose vagaries can significantly affect sustainability. Though, health insurance contributed minimally to health financing in Nigeria, its prospect in assuming a significant role appeared to be very bright. The progressive growth of health insurance contributions was an indication of the prospect of the recently introduced National Health Insurance Scheme (NHIS) in Nigeria. The NHIS represents a viable means of pooling resources in such a way that the burden of both the government and the households can be greatly relieved. Thus, the sustainability of financing health care in Nigeria may strongly depend on the extent to which the populace was covered by the health insurance plan.Item The structure of generational public transfer flows in Nigeria(Edward Elgar Publishing Limited, Cheltenham, UK, 2011) Soyibo, A.; Olaniyan, O.; Lawanson, A. O.