Structure of Health Service Delivery in Nigeria

 

Structure of Health Service Delivery in Nigeria


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.

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