Adequate health financing is a critical element of any strong healthcare system. In Sub-Saharan Africa, financing and payment models for primary, secondary, and tertiary health care can be significant tools for improving issues of access, quality, and equity in care delivery. While much effort is made to understand the financing approaches that may be optimal for health systems at large, little is known about financing mechanisms that may work best considering the dominance of out-of-pocket payment and, more importantly, the impact that unexpected, informal costs for care may have on health-seeking behaviour. The abolition of user fees for public health facilities has become increasingly popular in many low-income countries, with results from numerous studies noting an increase in access and utilization for the poorest populations. However, abolishing user fees often does not remove the cost of many goods and services related to a care episode. Though some patients may pay no initial fees for a basic service such as an initial consultation, there are often treatment-related costs that are unknown to the patient.
September 19, 2019
Payment Patterns in Nigeria’s Public Facilities: Unexpected costs and implications for health-seeking behavior in Nigeria
Nigerias inflation rate remained above CBNs bandwidth of 6-9 per cent. Specifically, the inflation rate increased slightly from 9.55 percent in December 2015 to 9.62 percent in January 20165. The Core sub-index remains the main driver of inflation in Nigeria. The higher prices of items in the Core sub-index such as clothing and foot wears are reflective of higher domestic production costs as a result of the decline in the value of the naira relative to the dollar. However, in the period, the price increase was moderated by the stable price of Premium Motor Spirit (PMS). Going forward, without any sustainable policy measure to prevent the further depreciation of the naira, inflation may exceed the current single digit inflation rate in the near term.
In the third quarter of 2017, NBS report show that Nigeria recorded a marginal quarter-overquarter and significant Year-on-Year increases in the value (in Naira terms) of merchandise (goods) foreign trade. At N5.92 trillion, total merchandise trade increased 3.9 percent over the preceding quarter and 23.9 percent over the corresponding quarter in 2016. Specifically, with exports rising QOQ by 15.2 percent to N3.57 trillion and imports shrinking by 9.4 percent to N2.35 trillion, trade balance amounted to a surplus of N1.22 trillion in 2017Q3- a substantial 142 percentage increase (QOQ) in trade surplus value.
The Executive council recently approved a three-year external borrowing plan (2016-2018) which specifies external borrowing of approximately $30 billion (to be sourced mostly from MDBs) for infrastructure development. Although, the plan is yet to be approved by the Senate, the planned concessional loans for infrastructural development would imply inflows of foreign exchange which could help moderate the exchange rate volatilities in the near term, and offer potential improvement in business productivity and job creation.