Tuesday, 18 August 2015


1.0.0                                                   INTRODUCTION
It is an indisputable fact that a healthy population and indeed work force are indispensable tools for rapid socio-economic and sustainable development the world over. Despite this indisputable fact, in Nigeria, like most African Countries, the provision of quality, accessible and affordable health care remains a service problem.

This is because the health sector is perennially faced with gross shortage of personnels, inadequate and outdated medical equipment, poor funding, policies inconsistence, and corruption. Evidence shows that, only 4.6 percent of both public and private Gross Domestic Product (GDP) in 2004 was committed to the sector. Other factors that impede quality healthcare delivery in Nigeria include inability of the consumer to pay for healthcare services, gender bias due to religious or culture beliefs, and inequality in the distribution of healthcare facilities between the urban and rural areas1. Sequel to the aforementioned, the country is continually ranked low in healthcare delivery by international organizations. In 2000 WHO report on healthcare delivery ranked Nigeria 187 out of 191 Countries; eight years later, Human Development Report 2007/2008  ranked the Country 158 out of 1772.  In 2005 only 48 and 35 percents of the children within the ages of zero-to-one year old were fully immunized against Tuberculosis and Measles respectively.
Between 1998 and 2005, 28 percent of the children within the ages of 5 years who suffered from diarrhea received adequate treatment.
Between 1997 and 2005 only 35 percent of births in Nigeria were attended by skilled health personnel. Further, between 2000 and 2004, only 28percent of Nigerians in every 100,000 persons had access to physicians. While the situation in the health sector persists, Nigeria continually loses her professionals to other countries. It was reported in 1986 that more than 1500 health professionals left Nigeria to other countries. 1996 UNDP report revealed that 21,000 medical personnels were practising in the United States of America and UK, while there was gross shortage of these personnels in the Nigerian health sector1.
The health situation in the country shows that only 39percent in 1990 and 44 percent of Nigerians in 2004 have access to improved sanitation. In 1990/92 and 2002/2004, 13 percent and 9 percent of Nigerians were undernourished respectively1. HIV prevalence in Nigeria within the ages of 15 to 49years was 3.9 percent in 20051 In an attempt to address the precarious and dismal situation in the health sector, and to provide universal access to quality healthcare services in the country, various health policies by successive administration were made, including the establishment of primary healthcare centres, general and tertiary hospitals. But the establishment of these health constitutions alone cannot solve the perennial health problems of the country, hence the decision of their Head of State, General Abdulsalam Abukakar to sign into law the National Health Insurance scheme (NHIS) decree No.35 of 1999, with the aim of providing universal access to quality healthcare to all Nigerians1.
More than four years of NHIS existence in Nigeria opinion is polarized among Nigerians on the efficacy of the scheme in addressing the health problems in the country, because of the disheartening reports in the continual health situation. World Bank 2008 survey on the scheme shows that only One Million of people in Nigeria or 0.8 percent of the population are covered by NHIS, while many persons have to pay for medical care out of their pockets or do without healthcare. The Report further reveals that many low-income persons would not benefit from NHIS for at least another 10 years1

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