Health System in Nigeria: From Underperformance to Measured Optimism

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2016-09-14 DOI:10.1080/23288604.2016.1224023

O. Adeyi

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引用次数: 16

Abstract

Why Has the System not Achieved Effective Coverage for all Nigerians, Especially the Poor? Prospects References Fifty-five years after independence, indicators of Nigeria’s health outcomes and coverage of basic health services show underperformance, both in absolute terms and relative to other countries at similar levels of economic development. Yet, though the decline in infant and child mortality could be swifter, the trend of these indicators overall is in the right direction. Furthermore, the country’s recent successes against Guinea worm disease, poliomyelitis, and Ebola Virus Disease show areas of high performance despite systemic weaknesses. There are marked variations across geopolitical zones and states; some of these, such as indicators of maternal and child health service coverage and outcomes, correlate strongly with educational status and wealth. Significant positive associations between education and the use of maternal health services in Nigeria are well documented, and so are the historical crossregional variations in education policies and school enrollment. The past five decades have seen numerous health policies and development plans in Nigeria, culminating in the National Health Act of 2014. The Act provides for a range of responsibilities, instruments, and institutions, covering but not limited to responsibility for health, eligibility for health services, and establishment of a national health system; financing; health establishments and technologies; rights and obligations of patients and health care personnel; national health research and information system; human resources for health; control of blood, blood products, tissue, and gametes in humans; and regulations and miscellaneous provisions. It is, potentially, a very consequential Act. To understand what needs to be different for this Act to succeed where prior national policies mostly underachieved, it is worth examining the context and some key drivers of Nigeria’s health.

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尼日利亚的卫生系统:从表现不佳到适度乐观

为什么该系统没有有效地覆盖所有尼日利亚人，特别是穷人?独立55年后，尼日利亚的卫生成果和基本卫生服务覆盖率指标无论从绝对值还是相对于经济发展水平相似的其他国家而言，都表现不佳。然而，尽管婴儿和儿童死亡率的下降可能更快，但这些指标的总体趋势是正确的。此外，该国最近在防治麦地那龙线虫病、脊髓灰质炎和埃博拉病毒病方面取得的成功表明，尽管存在系统性弱点，但在一些领域取得了优异成绩。地缘政治区域和国家之间存在显著差异;其中一些指标，如妇幼保健服务覆盖面和成果指标，与教育状况和财富密切相关。在尼日利亚，教育与孕产妇保健服务的使用之间存在显著的积极联系，历史上教育政策和入学率的跨区域差异也是有据可查的。过去50年，尼日利亚制定了许多卫生政策和发展计划，最终于2014年通过了《国家卫生法》。该法规定了一系列责任、文书和机构，包括但不限于卫生责任、卫生服务资格和建立国家卫生系统;融资;卫生机构和技术;患者和医护人员的权利和义务;国家卫生研究和信息系统;卫生人力资源;人类血液、血液制品、组织和配子的控制;以及规章和杂项规定。这可能是一个非常重要的法案。要了解在以往国家政策大多未能取得成功的情况下，该法案要取得成功需要哪些不同之处，有必要研究尼日利亚卫生的背景和一些关键驱动因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.