Human Development Economics: Healthcare Systems

Human Development Economics

• Examines economic principles related to labor and health economics.
• Seeks government interventions and economic tools to improve societal living standards.

Healthcare Systems

• Aims to explain sources of health information, consequences of poor healthcare, healthcare financing, and challenges.

Objectives

• Understand health information sources.
• Recognize the consequences of poor healthcare.
• Know the nature of healthcare financing.
• Identify healthcare challenges and constraints.

Learning Outcomes

• Identify health information sources.
• Comprehend the threats and consequences of poor healthcare.
• Understand the nature of healthcare financing.
• Explain healthcare challenges and constraints.

Sources of Health Information/Statistics

• Vital registration systems: births, deaths, marriages.
• Hospital records.
• Health ministries/authorities records.
• Records from general/private practitioners.
• Industrial/organizational health records.
• School health records.
• Sample surveys.
• Publications: WHO epidemiological and vital statistics yearbook, UN Demographic Yearbook, UNICEF reports.

Consequences of Poor Health

• Pain and suffering.
• Reduced human energy.
• Difficulty coping with life.
• Reduced human capital.
• Lower returns on learning.
• Impedes entrepreneurial activities.
• Slows economic growth.
• Hinders development.
• Reduced productivity.
• Increased mortality rate.
• Poor health.
• Increased government healthcare expenditure.
• Higher patient-doctor ratio.
• Decreased life expectancy.
• Less attractive to investors.
• Increased death rate.
• Increased disease spread.
• Unemployment.
• Impacts per capita income.

Solutions

• Increased budget allocation.
• Poverty alleviation.
• Anti-misappropriation measures.
• Training/Developing healthcare personnel.
• Personnel motivation.
• Improved quality of services.
• Improved personnel behavior.
• Staff motivation.
• Health education.
• Establish more primary healthcare centers (PHCs).
• Subsidized healthcare costs.
• Eliminate harmful cultural practices.
• Build public confidence through seminars and equipping health centers.
• Health education.

Current Health Situation in Nigeria

• Nigeria lags behind in providing quality healthcare.
• Quality healthcare access is limited compared to developed countries.
• High poverty rates in developing countries with a large population living below the poverty line.
• Nigerian healthcare system faces a heavy disease burden with low healthcare spending.
• The Nigerian government spends only 5.3% of general expenditure on health, well below the proposed 15% target set in 2001 by the Abuja Declaration.

Financing Healthcare

• Out-of-pocket (OOP) private expenditure dominates healthcare financing in Nigeria.
• This financing model hinders access to quality healthcare.
• Over 53% of the Nigerian population live below the income poverty line of $1.90 per day.
• Only 39% of the population can access needed healthcare services without financial hardship.
• OOP payments are the main source of funding for health services.
• Nigerian government has a limited role in healthcare provision.

Concepts

• Healthcare financing: Mobilization of funds for healthcare services.
• Health financing: Process of resource allocation and financial incentives to ensure access to public and personal healthcare services.
• Health: General condition of a person, encompassing physical, mental, and social well-being.
• WHO defines health as a state of complete well-being, not just the absence of disease.
• Health is a relative state where individuals can function well physically, mentally, socially, and spiritually.
• Health care services: Preventative, treatment, and management of illness as well as mental and physical well-being preservation.
• Government role: Government establishes licensing requirements for healthcare providers and promotes insurance to reduce costs.

Government Health Care Financing

• Providing funds for maintaining public health.
• Aims to ensure affordability, accessibility, and equitable access to medical services.
• Provides financial risk protection.
• Government health care finance represents a small percentage of the total GDP, approximately 4.5% in 2020.

Sources of Health Care Financing

• Tax-based public sector health financing - derived from government tax revenue.
• User fee charges (OOP) - private health expenditures.
• Aids and grants: donations from charitable organizations and individuals.
• Voluntary prepayments: private health insurance schemes funded before receiving care.
• Revolving funds: allow users to pay for curative services while preventive services are subsidized.
• Direct government/private financing: public and private employers utilize government and private hospitals respectively.
• Community self-help: community voluntary contributions used to build healthcare facilities.

Types of Healthcare Production Costs

• Implicit costs - reflect the opportunity costs of using a medical firm’s resources.
• Explicit costs - include wages, utilities, and medical supplies.

Characteristics of Health Care Financing in Nigeria

• Low government investment.
• Extensive OOP payments.
• Limited insurance coverage.
• Low donor funding.

Challenges/Constraints

• Economics: high treatment costs, low health budget, poverty.
• Societal factors: illiteracy, corruption, indiscipline, poor behavior, selfishness.
• Cultural beliefs: reliance on non-orthodox healthcare, harmful cultural practices.
• Equipment: lack of modern equipment.
• Inadequate and unskilled personnel.
• Low state of development.
• Corruption.
• Environmental degradation.
• Limited access to healthcare facilities.
• Low motivation and remuneration.
• Poor healthcare financing.
• Distance from healthcare facilities.
• Faith in traditional birth attendants (TBAs).
• Quality of healthcare services.
• Poor provider human relations.
• Poor maintenance of health facilities.
• Lack of essential drugs and equipment.
• Poor waste disposal practices.
• Low status of women.
• Low community participation.
• Low staff motivation.
• Poor information sharing.
• Rapid population growth.
• Low per capita income/poverty.
• Food insecurity.
• Poor living conditions.
• Bad leadership.
• Emigration.
• Unemployment.

References

• Population health reports.
• World Health reports.
• Social and Preventive Medicine Texts.
• Journal of Epidemiology and Community Health.
• Bulletin of the WHO and related Agencies.
• Online materials.