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Decentralized delivery of primary health services in Nigeria: survey evidence from the states of Lagos and Kogi (English)

This report presents findings from a survey of 252 primary health facilities and 30 local governments carried out in the states of Kogi and Lagos in Nigeria in the latter part of 2002. Nigeria is one of the few countries in the developing world to systematically decentralize the delivery of basic health and education services to locally elected governments. Its health policy has also been guided by the Bamako Initiative to encourage and sustain community participation in primary health care services. The survey data provide systematic evidence on how these institutions of decentralization are functioning at the level local-governments and community based organizations-to deliver primary health service. The evidence shows that locally elected governments indeed do assume responsibility for services provided in primary health care facilities. However, the service delivery environments between the two states are strikingly different. In largely urban Lagos, public delivery by local governments is influenced by the availability of private facilities and proximity to referral centers in the state. In largely rural Kogi, primary health services are predominantly provided in public facilities, but with extensive community participation in the maintenance of service delivery.


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    Gauri,Varun, Das Gupta,Monica, Khemani,Stuti

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    Departmental Working Paper

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    Decentralized delivery of primary health services in Nigeria: survey evidence from the states of Lagos and Kogi

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Gauri,Varun Das Gupta,Monica Khemani,Stuti

Decentralized delivery of primary health services in Nigeria: survey evidence from the states of Lagos and Kogi (English). Africa Region Human Development working paper series Washington, D.C. : World Bank Group.