The
National Health System is decentralized into three tiers structures with
responsibilities at federal, state and local government levels. Currently the
three levels are involved to some extent in all the major health system
functions, stewardship, financing and service provision. The fluid arrangements
allow one level of the system to provide services at any of the other two
levels despite holding a primary responsibility. However it is expected that
the National Health Bill when signed into law would streamline and more
properly delineate duties. These three tiers offer tertiary, secondary and
primary care services respectively.
Federal Level of Health Care Service Delivery
At the federal level is the Federal Ministry of Health which
is responsible for developing and implementing policies and programmes, along
with other necessary actions that will improve and maintain a national health
system capable of delivering an effective, efficient, affordable and quality
service, and to foster an improved quality of life for all of Nigeria. It
relates on behalf of the Nation with international bodies, provides guideline
for National Health management information system as well as sees to the
provision of tertiary care through specialist/teaching hospitals. These
hospitals handle complex health problems/cases either as referrals from general
hospitals or on direct admission to its own. It has such features as accident
and emergency unit, diagnostic unit, wards units, treatment unit and outpatient
consultation unit. Teaching hospitals also conduct researches and provide
outcomes to the government as a way of influencing health policies.
Agencies under the Federal Ministry of Health include:
National Primary Health Care Development
Agency (NPHCDA)
National Agency for Food, Drug
Administration and Control (NAFDAC)
National Health Insurance Scheme (NHIS)
National Primary Health Care Development
Agency (NPHCDA)
National Institute for Pharmaceutical
Research and Development (NIPRD)
National Institute for Medical Research
(NIMR)
National Agency
for the Control of AIDS (NACA)
State level of Healthcare service delivery
The
State ministries are responsible for secondary care (through the general
hospitals) , for regulation and technical support for local Government level.
Secondary health centers are involved with not only Prevention but also with
all treatments and management of minimal complex cases. However, the more
complicated cases are referred to the tertiary or specialist hospital. General
hospitals have provisions for accident and emergency unit and diagnosis unit
etc. They should have a minimum of three doctors who are to provide medical,
surgical, pediatric and obstetric care .It should be supported by beds and
bedding for minimum of 30 patients. There should also be ancillary facilities
for proper diagnosis and treatment of common ailments.
Local Government Level of Health Care Delivery
The
local Government level has the responsibility of primary health care services
which are organized through the wards. They are involved in record keeping,
case reporting and patients referral to higher tiers. Primary healthcare centre
refer complicated cases to secondary general hospitals. Primary health centre
are also to undertake such functions such as health education, diagnosis and
treatment of common ailments, through the use of appropriate technology,
infrastructure and essential drug list. It is the chosen frame work in the
National policy for achieving health for all Nigerians. Primary health centers
are known within the system in the context of health centre, maternity
home/clinic and dispensaries. In addition each local Government should have at
least one comprehensive health centre that offers Primary Health Care services
and a limited number of secondary clinical services.
Moreover
it must be noted that there exist a variety of collaboration with non-
governmental and private agencies, especially religious bodies, which provide
health care including both curative /preventive services alongside the
government bodies in an integral feature of the national health system.
The National Health System is decentralized into three tiers structures with responsibilities at federal, state and local government levels. However the fluid arrangement allows one level of the system to provide services at any of the other two levels despite holding a primary responsibility.