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
The Naira continued to depreciate in the review week. At the parallel market, naira exchanged for N498/$ on January 27, 2017 and N500/$ on February 3, 2017. Despite the weekly sales of forex to BDCs and the significant improvements in the external reserves, the naira has continued to lose value to other currencies. The pressure on the naira has been triggered by escalating scarcity of forex in the spot market, likely due to forex hoarding. However, in the preceding week, the CBN sold $660 million in forwards contract in an attempt to manage liquidity and stabilize the naira. In the face of growing speculation in the parallel market, the monetary authority should institute mechanisms that would discourage excessive forex hoarding among licensed BDC operators. An initiative that monitors transaction dealings in the parallel market would go a long way in detecting erring BDC operators.
This brief examines Budget 2012 and highlights key structural and institutional challenges that have been militating against the achievement of inclusive growth and employment generation as listed in the budget.
Nigerias external reserves improved in 2017. The reserve stood at approximately $39 billion as at the end of December 2017, up by about 50 percent from the $26 billion at the beginning of the year 20172. The surge in reserve was particularly boosted by increased capital importation, and crude revenue earnings prompted by a relatively higher crude oil price and improved domestic production. Given that the recent uptick in external reserves is still largely associated with improved crude oil price, efforts should be geared towards conserving current reserve gain so as to cushion future external shock. In the medium term, there is need to diversify export earning away from oil so as to mitigate the effects of volatility in crude oil prices.