CHALLENGES AND SOLUTIONS IN IMPLEMENTATION OF HEALTH MANAGEMENT SYSTEM FINANCING IN NIGERIA

Аннотация

INTRODUCTION financed through a mix of government funding, In Nigeria, the healthcare sector faces donor support, and out-of-pocket payments by significant challenges in terms of financing, individuals (Effiong & Effiong, 2021). However, implementation, and performance. These inadequate funding and inefficient allocation of challenges have implications for the resources remain persistent challenges, accessibility, quality, and efficiency of resulting in limited access to healthcare healthcare services . services, especially for vulnerable populations the challenges of health care management (Aregbeshola & Khan, 2017; Onwujekwe et al., system financing in Nigeria , Healthcare 2020). financing is a critical factor in ensuring This study aims to investigate the performance, equitable access to healthcare services and implementation, and challenges of health care improving health outcomes (Ajayi, 2018). In management system financing in Nigeria By Nigeria, the healthcare system is predominantly https://www.theamericanjournals.com/index.php/tajmei 25 THE USA JOURNALS THE AMERICAN JOURNAL OF MANAGEMENT AND ECONOMICS INNOVATIONS (ISSN- 2693-0811) VOLUME 06 ISSUE05 assessing the effectiveness of existing financing interventions, give appropriate financial mechanisms, the allocation and distribution of incentives to providers and ensure that all funds, and their impact on the accessibility and individuals have access to effective health quality of healthcare services, the study seeks to services (25). provide valuable insights for policymakers, The major sources of finance for the health researchers, and stakeholders involved in sector in Nigeria are the three tiers of healthcare management and funding. government (Federal State and Local Ultimately, the findings of this study will Government), public general revenue contribute to evidence-based decision-making, accumulated through various forms of taxation, leading to improved health care delivery and the health insurance institutions (private and financing in Nigeria and potentially serving as a public), the private sector (firm and model for other countries facing similar households), donors and mutual health challenges. organizations. Table 2.3.3 shows that private Understanding the performance, and household expenditure on health between implementation, and challenges of health care 1998-2002 was the highest with an average of management system financing in Nigeria is 69.1% and 64.3%, while government crucial for identifying gaps and formulating expenditure in the same period was a paltry effective strategies for improvement. Research 20.6%. Donor’s average expenditure in the on healthcare financing in Nigeria has period was 10.3%, while firms input were 4.9% predominantly focused on the national level or respectively (26). specific disease conditions (Effiong & Effiong, Public health facilities in Nigeria are financed 2021; Onwujekwe et al., 2020). primarily by the public through tax revenue. faces challenges in healthcare financing and The federally collected revenue consist of crude service delivery. The country struggles with oil and gas export proceeds, petroleum profit inadequate healthcare infrastructure, shortages tax, royalties and the related proceeds of of healthcare professionals, and limited domestic crude oil sales/other oil revenues, availability of essential drugs and medical companies’ income tax, customs and exercise supplies (Atun, Ayakaka, & Marinho, 2017). duties, value-added tax (VAT), tax on petroleum Additionally, the healthcare system is burdened products, education tax, and other items of by a high prevalence of communicable diseases, independent revenues to the federal including malaria and tuberculosis, as well as government. On the other hand, as part of the the emerging challenge of non-communicable internally generated revenues, states have diseases (Muktar et al., 2020). These challenges rights to capital gain tax, personal income tax underscore the need for a comprehensive excluding those on armed forces, (external assessment of the health care management affairs officers, residents of Federal Capital system financing in Nigeria . Territory and Nigerian police), stamp duties, capital transfer tax, pools betting and betting Health Care Management System Financing taxes, motor vehicle and driver licenses. in Nigeria Similarly, sources of internal revenue for Local Health financing refers to the collection of funds Government Areas are license fee on television from various sources (e.g; government, set and wireless radio and market and trading households, businesses, and donors) pooling fees/licenses. The share of the Federal them to share financial risk across larger Government from the federation account has population groups and using them to pay for created a lopsided budgeting allocation among services from public and private health care three tiers of government and this has equally providers. The objectives of health financ