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
Recent data from the National Bureau of Statistics (NBS) shows that the value of capital imported to Nigeria declined by 54.34 percent; from $1.56 billion 2015Q4to $710.97 million in 2016Q11. This is the lowest value since the data was first released in 2007. Huge declines in Portfolio Investment (71.54 percent) and other Investment (44.84 percent) were the major drivers of the trend within the period. A myriad of factors have contributed to the decline in investments. The plunge in crude oil prices, and the resultant negative signals on investors confidence, was a key factor. This was exacerbated by the FOREX restrictions and delays in the assentation of 2016 Appropriation Bill. While the slight increases in oil prices and the recent signing of the budget into law could improve the general economic prospects, monetary authorities need to proffer solutions to the negative effects of the current FOREX restrictions on investments.
Available data from Nigeria Bureau of Statistics shows a decline in the Nigeria Aviation sub-sector (Transport Sector) real growth rate in 2017Q1. Compared to the preceding quarter, the sub-sector declined significantly by 9.6 percent, due to decline in the number of passengers and movement of aircrafts this may be connected to the closure of the Abuja airport for infrastructural development during the period. To ensure a near-optimal performance of the aviation sector, the government should also make efforts to improve aviation safety and security, establish a national carrier, and improve aircraft maintenance to world class standards.
The monthly monetary survey by the CBN shows a decline in money supply for the month of August 2017, relative to July 2017. Narrow and broad money supply dropped by 4.2% and 1.5% to N9,891 billion and N21,851 billion respectively. The continuous monetary contraction witnessed over the past months may be associated with aggressive sale of treasury bills by the CBN through open market operations. This act is capable of mopping up liquidity in the economy, reduce loanable funds in the banking system, and constrain the easing of lending rates in the near term.