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 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.