Publication: Toward Synergy and Collaboration to Expand the Supply of and Strengthen Primary Health Care in Nigeria’s Federal Context, with Special Reference to Ondo State
Loading...
Published
2013-01
ISSN
Date
2013-05-06
Author(s)
Editor(s)
Abstract
This study examines an innovative example of the expansion of supply and the strengthening of primary health care to improve key health-related Millennium Development Goal, or MDG indicators through synergy and collaboration between the federal Government of Nigeria (FGN) and state governments in an extreme federal context, and with particular reference to Ondo State. That is, the Nigerian Federal Constitution grants the federal government only very limited and indirect influence or control over the fiscal and financial affairs of state and local governments, such that 'plans, budgets, accounts and procurements are not subject to federal control and scrutiny'. Nor must the lower tiers account to the federal level for how funds transferred to them from the central level are used. The rest of case study is organized as follows. Section two describes the design of the HCP, including its interaction with the rest of the health system; section three discusses the targeting, identification, and enrolment system; section four examines the management of public funds within the HCP; section five analyses the management of the benefits package; section six reviews the information environment and monitoring systems of the HCP; section seven summarizes and analyses the evidence on the key theme of the study, which is the extent to which the HCP is expanding access to, and strengthening, primary health care within the federal system; and section eight looks at the pending agenda for action, drawing on the lessons learned and challenges for the HCP's future. The annexes present the country and health system context; a general overview of health system financing and delivery; a brief description of primary care and key supply-side efforts; and key data on Ondo State, including a description of the state's health system.
Link to Data Set
Citation
“Atim, Chris; Bhatnagar, Aarushi. 2013. Toward Synergy and Collaboration to Expand the Supply of and Strengthen Primary Health Care in Nigeria’s Federal Context, with Special Reference to Ondo State. UNICO Studies Series;No. 3. © World Bank. http://hdl.handle.net/10986/13306 License: CC BY 3.0 IGO.”
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Timor-Leste Health Sector Review : Appendices(Washington, DC, 2006-10-06)The Timor-Leste health sector review describes the accomplishments made by the government of Timore-Leste in the health sector since it separated from Indonesia, and analyzes the challenges still facing the government moving forward. Infant and maternal mortality, and malnutrition, are still important battles. Underutilization of services, and poor quality of services when available, are also reasons for the poor health quality indicators. Improving the quality or effectiveness of health services is difficult. However, now that most of the basic health care infrastructure is in place, the time is right for the Ministry of Health (MOH) to develop a system to monitor and upgrade the quality of health care services, starting with public sector services. One initiative put forth is health education delivered through various channels, which would make households better aware of the risks associated with certain health conditions or symptoms and the importance of using the available health services from government and NGO facilities. A second type of potential intervention is the introduction of conditional cash transfers, whereby the Government pays a subsidy to households in exchange for certain behaviors beneficial to society, such as having their children immunized. Carrying out the various interventions described above would require that the Government increased its spending on health services further.Publication Handshake, No. 3 (October 2011)(International Finance Corporation, Washington, DC, 2011-10)This issue includes the following headings: integrated health systems: Lesothos pioneering model; access to healthcare for the poor: lessons from Ghana, India, and Mexico; and cost efficiency: Singapores secret to healthcare.Publication Maternal and Child Mortality Development Goals : What Can the Transport Sector Do?(World Bank, Washington, DC, 2006-08)The reduction of child mortality and the improvement of maternal health are two of the Millennium Development Goals. Child and maternal mortalities continue to represent severe burdens in many developing countries. Every year, 527,000 women in developing countries die of pregnancy-related complications and nearly 4 million children die during their first month (accounting for 40 percent of all deaths under 5 years of age) with nearly all (98 percent) of them in developing countries. The risks of dying from pregnancy-related complications and a child dying under the age of five are highest in Sub-Saharan Africa. The risk of a mother or an infant dying can be significantly reduced by a continuum of basic care, which should include preventive measures and a skilled attendant during childbirth with access to the necessary equipment, drugs, and other supplies for effective management of any pregnancy-related complications. Yet, many women spend excessive time trying to reach a health facility with the capacity to treat obstetric or infant complications. It is estimated that 75 percent of maternal deaths might be prevented through timely access to essential emergency childbirth-related care. This paper focuses on the ways in which transport and road infrastructure play key roles in the overall delivery of and access to health services, and in the effectiveness of the health referral process. Many households do not have the reliable, suitable, and affordable transport services that are essential for access to care during the critical peri-natal and neonatal periods. Emergency access to care is also critical because many childbirth-related complications are unpredictable and the majority of births in developing countries continue to take place at home.Publication The Nuts & Bolts of Jamkesmas, Indonesia’s Government-Financed Health Coverage Program for the Poor and Near-Poor(World Bank, Washington DC, 2013-01)This case study describes and assesses Jamkesmas, Indonesia's government-financed health coverage program for the poor and near-poor. It provides a detailed description of the scope, depth, and breadth of coverage provided under Jamkesmas, and highlights ways in which the program interacts with the rest of Indonesia's health system. It also summarizes and discusses evidence on whether Jamkesmas is attaining its stated objectives of removing financial barriers and improving access to health care by the poor and near-poor, what could be improved, and what lessons can be learned from the experience of Jamkesmas that could help inform Indonesia's quest for universal coverage. The primary theme underlying the study is that supply-side constraints and supply-side subsidies have not been leveraged to increase the effectiveness of the Jamkesmas program. There are significant geographic deficiencies in the availability and quality of the basic benefits package, especially for those living in relatively remote and rural locations of the country, and this limits the effective availability of benefits for many Jamkesmas beneficiaries. The remainder of the case study is organized as follows. Section two provides general background and information on health system outcomes in Indonesia. Section three is an overview of health care financing and delivery. Section four describes the institutional architecture of Jamkesmas. Section five highlights the process of targeting, identification, and enrolment of beneficiaries under the program. Section six focuses on the role of public financing. Section seven outlines the basic benefits package. Section eight provides an overview of the information environment of Jamkesmas. Section nine discusses the special theme of supply-side constraints and supply-side subsidies that dilute the effectiveness of the Jamkesmas program. Section ten discusses the pending agenda around some of the architectural and operational features of Jamkesmas in the context of universal coverage.Publication Health, Nutrition, and Population in Madagascar 2000-09(World Bank, 2011-07-05)With an income per capita US$400 in 2008, Madagascar is one of the poorest countries in the world. Poverty is widespread but with significant urban-rural differences (52 percent versus 74 percent). Health, nutrition, and the fight against communicable diseases and HIV/AIDS are key goals of the country's poverty reduction strategy, the Madagascar Action Plan 2007-2012. The National Health Sector and Social Protection Development Plan 2007-2011 was developed to strengthen the health system and improve service delivery to reduce neonatal, child and maternal mortality, address malnutrition and control communicable illnesses. The health sector has benefited from increasing investment over the last years, and a number of studies and surveys have been carried out, providing a wealth of information that is yet to be analyzed in a complementary way. This Country Status Report (CSR) seeks to capitalize on all of the existing data in the health sector, compare Madagascar to countries of similar income levels and assess the results achieved by the health system. The CSR provides an analysis of the population's health and nutrition status by linking health outcomes, household/individual behaviors, community factors, government interventions, and service provision. Although Madagascar is performing beer than the SSA average of 645 per 100,000 live births, the maternal mortality rate has stagnated over the last decade and in 2008/09 was estimated at 498. Health care seeking behavior for preventive child health services at the health facility level is improving. Complete immunization coverage stands at 62 percent in 2008 (for children 12 to 23 months), but there are still large differences in coverage across regions, place of residence, and income groups.
Users also downloaded
Showing related downloaded files
Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication World Bank East Asia and Pacific Economic Update, October 2022(Washington, DC : World Bank, 2022-10)Growth in most countries in the East Asia and the Pacific (EAP) region rebounded in the first half of 2022, but China lost momentum. In much of the region, domestic demand revived after the distress of the COVID-19 Delta wave. In China, the public health measures to contain outbreaks of the highly infectious Omicron variant inhibited consumption. Most of the region is projected to grow faster and have lower inflation in 2022 than other regions. Beyond the end of 2022, three factors could be a drag on growth: global deceleration, rising debt, and policy distortions. Current measures to contain inflation and debt are adding to existing distortions in the markets for food, fuel and finance in ways that could hurt growth. In each case, more efficient measures could address current difficulties without undermining longer-term objectives.Publication Compendium of International and National Legal Frameworks on Domestic Violence(World Bank, Washington, DC, 2019-01-15)Domestic Violence (DV) is a universal phenomenon that affects millions of women of all social strata worldwide. It is the most pervasive, common, under-recognized, underestimated and under-reported type of violence against women. It reflects discriminatory social norms, stereotypes, impunity and gender inequality. It is all too often considered as a “private, family issue”, widely accepted and minimized although it impairs the full enjoyment of life and fundamental rights and freedoms by victims and survivors who are overwhelmingly women. Domestic Violence (DV) is a development challenge and has a high economic and social cost, including health and medical costs, death, suicide, depression, lost productivity, lost income, , psychological consequences and trauma, increased stress, reactive violence, reduced ability to study or find and hold a job, judicial and prison costs, economic insecurity and abuse, debt, housing instability, homelessness, inter alia1. Beyond data and statistics, DV undermines autonomy and represents an enormous loss in terms of wellbeing not only for the women affected but also for the men who share their lives, for their children, their families and their societies. The Compendium on International and National Legal Frameworks on Domestic Violence (the “Compendium”) provides a survey of the key international and regional instruments as well as national legislation as they relate to domestic violence.Publication The good, the bad, and the ugly(Taylor and Francis, 2023-05-05)Different views of corruption are discussed in the literature, ranging from theories highlighting a positive role of corruption (to ‘grease the wheels’ of an economy) to negative (acting as ‘sand in the wheels’) or even destructive effects of corruption on economic outcomes. The empirical evidence in this context is mixed, with alternative theories being supported by different studies, typically relying on different data sources, time periods, and measures of corruption. In this paper, we assess several alternative views of corruption simultaneously in a single empirical framework. Specifically, we test six prominent hypotheses regarding the role of corruption for government revenues using a comprehensive country-level panel dataset covering 194 countries in the period 1996–2019. Our results help to shed light on the factors that are empirically important in explaining the link between corruption and government revenues, including the role of governance, autocracy, fragile states, and natural resources.Publication Twenty Reasons Sustainable Tourism Counts for Development(World Bank, Washington, DC, 2017)The focus of this paper is on sustainable tourism’s wider benefits, it is important to acknowledge that there are tradeoffs involved. Like other economic activities, tourism both gives and takes from communities and travelers. When it is poorly planned, tourism can negatively impact cities, parks, and historic monuments, and put severe pressure on local infrastructure, resident communities, and their resources. When properly planned and managed, sustainable tourism can contribute to improved livelihoods, inclusion, cultural heritage and natural resource protection, and promote international understanding. The goal of this paper is to build the case for this type of sustainable and inclusive tourism development. In support of sustainable tourism, United Nations has designated 2017 as the International Year of ‘Sustainable Tourism for Development’. Sustainable tourism is identified as a vital component to ensure the achievements of the Sustainable Development Goals (SDGs) 8, 12, and 14 and the 2030 Agenda for Sustainable Development. This makes it an ideal moment to update and reaffirm the evidence case behind tourism as a development tool. UNWTO (the United Nations agency responsible for the promotion of responsible, sustainable and universally accessible tourism) outlines the five pillars of tourism for development shown. Drawing from these pillars, this paper identifies 20 reasons sustainable tourism counts for tourism destinations, people who live there, and travelers. The following reasons are only a starting point for integrating a holistic approach to sustainable tourism into development projects.