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

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.

Detalhes

  • Autor

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

  • Data do documento

    2003/09/24

  • TIpo de documento

    Documento de trabalho departamental

  • No. do relatório

    32815

  • Nº do volume

    1

  • Total Volume(s)

    1

  • País

    Nigéria,

  • Região

    África,

  • Data de divulgação

    2010/07/01

  • Disclosure Status

    Disclosed

  • Nome do documento

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

  • Palavras-chave

    primary health care;health post;supervision of state;primary health care services;community participation;primary health care facilities;primary health service;health facility;quality of public spending;civil service pay scale;health care service delivery;public health care;public service delivery;Health Service Delivery;service delivery agency;primary health facility;public health facility;health facility level;health care needs;source of financing;federal government;data on expenditures;nature of health;civil service cadre;health survey;vaccine preventable disease;service delivery process;decentralized service delivery;public service provider;exploitation of mineral;infant mortality rate;public health management;nurses and midwives;agricultural work;home health care;health education worker;local government revenue;lack of resource;intergovernmental fiscal relation;place of origin;local tax base;public expenditure analysis;public water source;extent of decentralization;water and electricity;source of facility;world oil price;hours of service;staff salary;public resource;Public Facilities;governance environment;survey instrument;community base;facility survey;Health Workers;budget allocation;education service;active participation;Health policies;Education Services;public primary;health needs;budget resource;routine immunization;intended destination;referral centers;democratic government;public budget;health outcome;home visit;care facility;local capacity;management structure;purposive sampling;monthly salary;state revenue;average age;malaria treatment;basic amenity;Essential Drugs;public revenue;medical supply;provider incentives;evidence-based policy;public accountability;study design;determining outcome;household survey;policy formulation;local representatives;logistical difficulties;supplemental income;supply side;health indicator;remote location;primary data;official language;good governance;health expenditure;state policy;Public Services;decentralization policy;medical school;financing pattern;oil revenue;Political Economy;outpatient service;survey data;public provider;average distance;analytical methodology;democracy dividend;empirical evidence;sanitary inspection;public clinic;survey methodology;notifiable disease;private provider;essential supplies;public provision;malarial drug;decentralized system;preventive health;basic equipment;fee policy;valuable knowledge;local citizen;public transfer;causal impact;increased spending;building construction;Postnatal Care;improved service;clinical training;field data;health equipment;environmental facility;health officer;local condition;external shock;government study;local accountability;significant correlation;health clinic;health clinics;fiscal crisis;professional training;piped water;incentive problem;fiscal transfer;paramount issue;essential services;monthly wage;good performance;disciplinary action;health activities;patients present;alternative interpretation;government budgetary;field staff;international donor;supervisory responsibility;decentralized level;improved health;household demand;financing arrangement;constitutional provision;professional qualification;salary structure;informal payment;fringe benefit;rural setting;public official;common benefit;Vocational Education;

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