FACULTY OF THE SOCIAL SCIENCES
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Item 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.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.