Unfortunately, the success of a robust and functional financing regime for the sustainability of the health sector and the achievement of an efficient healthcare delivery hinges on the balance that a country is able to achieve between its current health financing needs and health spending.
Of course, the rich and the wealthy who could pay feel only safe by getting treatment abroad. But where does that leave the poor whose poverty puts them in mortal health risk, and even eventual death? At this juncture, we arrive at the most important question at the heart of the successful institutional reform of the Nigerian health system: how does the government create the fiscal enablement that translates into an increased and sustained resource flow into the healthcare system? In principle, there are four possible avenues open for the government to operate.
Yet, we must not discount the need for a sound political judgment and strategizing moderated by a strong policy intelligence that will counteract some of the negative consequences of some of these options. This implies giving utmost priority to certain crucial factors in public health funding: i) ensuring equitable, efficient and sustainable financing; ii) developing effective and equitable risk pooling and prepayment mechanisms; iii) improving regulatory capacity to deal with market failures; iv) ensuring appropriate governance arrangement; v) getting better value for money through allocation and technical efficiency gains; vi) targeting financing to the poor and vulnerable; and vii) learning...
So, with this we clearly see why in the LIC, the citizens are left to fend for themselves while in the HIC, the government takes the burden of health financing. This is because the size of formal sector employment which contribution makes up health insurance fund compared to the informal sector constitute less than 15-20% of total employment.
Charting a way forward for institutional transformation of the health system and the health sector in Nigeria requires firming up the statutory brief of the existing health institutions. At the very top of this institutional imperative is the budgetary allocation to the health sector. We have seen earlier that this is very low.
Since the budgetary allocation is already small, the pressure must be placed on the ministries of health to strengthen their administrative capacity for public expenditure review and tracking surveys within a stakeholders-driven process. Such reviews would not only analyze cost effectiveness of health investments, they will assess the level and composition of health spending, intersectoral and intrasectoral allocations.
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Source: GuardianNigeria - 🏆 1. / 94 Read more »