Distribution of health facilities in Nigeria: Implications and options for Universal Health Coverage

Makinde, Olusesan Ayodeji; Sule, Abayomi; Ayankogbe, Olayinka O.; Boone, David

doi:10.1002/hpm.2603

Cited by 72 publications

(60 citation statements)

References 29 publications

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“…The ndings from this study, like the Liu et al study among others, revealed that PPMV shops were numerous in the two states. With fewer health facilities and health posts opening across the country [29] and fewer pharmacies opening up (especially in rural and hard to reach areas) [14], PPMVs have remained the most widespread health structure across the two (2) states; and across Northern and Southern Nigeria [18]. However, the study found a greater concentration of shops in the Northern state of Kaduna and especially in the urban areas; this is a slight deviation from the norm in many studies that PPMVs are mainly located in the rural and hard to reach areas [16,22,30].…”

Section: Discussionmentioning

confidence: 99%

“…One of the domains of access listed in the UHC includes physical access to health services; this physical accessibility is dependent on the proximity of health facilities to potential clients [31]. In a recent study where the distribution of health facilities across Nigeria was documented, primary health facilities, more than other facilities were most prominent across the country (ranging 15.5 and 18.4 per 100,000 population in Southern and Northern states respectively) [29]. The ndings from our study showed that the distribution of PPMV shops in these regions more than doubled that of the most populous health facilities; ranking 32 and 46 per 100,000 respectively in Southern state of Lagos and Northern state of Kaduna; this corroborates the ndings of Liu and colleagues that PPMVs may be more accessible than health care facilities in many places across Nigeria.…”

Section: Discussionmentioning

confidence: 99%

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Characterization and Distribution of Medicine Vendors in Nigeria: A study of Lagos and Kaduna States.

Daini

Okafor

Baruwa³

et al. 2020

Preprint

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Background In 2014, Nigeria issued the task-shifting/sharing policy for essential health services, which aimed to fill the human resource gap and improve the delivery of health services across the country. This study focuses on the characteristics, spread, and Family planning (FP) stocking practices of medicine vendors in Lagos and Kaduna, assessing the influence of health training on the provision and stocking of FP services and commodities by vendors. Methods We conducted a census of all patent and proprietary medicine vendor (PPMV) shops and followed up with a facility assessment among 10% of the mapped shops; utilizing an interviewer-administered questionnaire. Bivariate analysis was conducted using the chi-square test, and multiple logistic regression was used to estimate the adjusted odds ratio (OR) and confidence intervals (C.I) for the test of significance in the study. Results 8,318 medicine shops were censused (76.2% Urban). There were 39 shops per 100,000 population in both states on average. About half (50.9%) were manned by a medicine vendor without assistance, 25.7% claimed to provide FP services to > 2 clients per week, and 11.4% were not registered with the regulatory body or any trade association. Also, 28.2% of vendors reported formal health training; with 56.3% of these health trained vendors relatively new in the business, opening within the last five years. Vendors utilized open drug markets as the major source of supply for FP products. Health training significantly increased the stocking of FP products and inhibited the utilization of open drug markets. Conclusion PPMVs have continued to grow progressively in the last five years, becoming the most proximal health facility for potential clients for different health services (especially FP services) across both Northern and Southern Nigeria. Now comprised of a considerable mass of health trained personnel, able to deliver high-quality health services and complement existing healthcare infrastructure, if trained. However, restrictions on services within the PPMV shop and lack of access to quality health commodities and consumables have resulted in poor practices among PPMVs. There is therefore a need to identify, train, and provide innovative means of improving access to quality-assured products for this group of health workers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Characterization and Distribution of Medicine Vendors in Nigeria: A study of Lagos and Kaduna States.

Daini

Okafor

Baruwa³

et al. 2020

Preprint

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“…Our results contribute to the literature by finding consistent results through a more comprehensive analysis of the distribution of health clinics in Nigeria. To our knowledge, our paper is the first to evaluate the correlation between the quantity and the quality of existent clinics in Nigeria in a comprehensive way [31]. …”

Section: Discussionmentioning

confidence: 99%

“…In Nigeria, the health care system is made up of three levels: primary, secondary, and tertiary, depending on the level of services required by patients. The provision of primary health care (PHC) services is the responsibility of the local government, while the secondary healthcare services are under the state government, and the tertiary healthcare services under the federal government [31]. PHC clinics are the first point of contact for patients, who are then referred to the higher-level secondary and tertiary facilities depending on the level of treatment required [32].…”

Section: Introductionmentioning

confidence: 99%

The impacts of quantity and quality of health clinics on health behaviors and outcomes in Nigeria: analysis of health clinic census data

Sato

2019

BMC Health Serv Res

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Background Past studies have identified that inconvenient access to health clinics is one of the important barriers to health service utilization and health outcomes. However, establishing the link between the lack of access to health clinics and the high maternal and child morbidity and mortality in Nigeria has been a challenge due to the lack of data. This paper overcomes this problem by using the country’s health clinic census data. Methods Using the Nigerian health clinic census, we evaluate the intercorrelation between the quantity and the quality of health clinics available across the country. We also examine the correlation between the access to health clinics and health behaviors/outcomes for residents by merging the health clinic census data with data from the demographic and health survey (DHS). The health clinic census data makes it possible to capture the overall geographical allocation of health services across the country as well as their comprehensive relationship with health outcomes. Results We find a strong positive correlation between the quality of a health clinic and the quantity and quality of neighboring clinics. The high quality clinics are concentrated in areas where the density of clinics is high, and where more of the clinics around them are also of high quality. We also find that an increase in access to health clinics of high quality that are in close proximity is significantly and positively correlated with an improvement in health behaviors as well as health outcomes. Women who are more disadvantaged benefit more from the access to high quality clinics than others. Conclusions Health clinics of good quality are unevenly distributed geographically in Nigeria. The quality of health clinics should be of a level that can support the promotion of recommended health behaviors and achieve improved health outcomes throughout the country. Further studies are necessary to evaluate the optimal distribution of clinics of good quality, given that residents in less populated areas gain a higher marginal benefit from improved access to health service, despite the higher costs of supplying the service in those areas.

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“…A 2016 analysis of the Nigerian Master Health Facility List by Makinde et al . reported that primary‐level health facilities account for 88% of all facilities in Nigeria.…”

Section: Discussionmentioning

confidence: 99%

The burden of severe maternal outcomes and indicators of quality of maternal care in Nigerian hospitals: a secondary analysis comparing two large facility‐based surveys

Vogel

Fawole

Adeniran

et al. 2019

BJOG

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Objective To compare severe maternal outcomes (SMOs) from two multi-centre surveys in Nigerian hospitals, and to evaluate how the SMO burden affects quality of secondary and tertiary hospital care.Design Two facility-based surveys of women experiencing SMO (maternal near-miss or maternal deaths). Setting Sixteen secondary and five tertiary facilities in Nigeria [WHO Multi-Country Survey on Maternal and Newborn Health (WHOMCS)] and 42 public tertiary facilities in Nigeria (Nigeria Near-Miss and Maternal Death Survey). Population 371 women in WHOMCS-Nigeria and 2449 women in Nigeria Near-Miss and Maternal Death Survey who experienced SMO. Methods Secondary analysis and comparison of SMO data from two surveys, stratified by facility level. Main outcome measures Maternal mortality ratio (MMR) per 100 000 livebirths (LB), maternal near-miss (MNM) ratio per 1000 LB, SMO ratio per 1000 LB and mortality index (deaths/ SMO). Results Maternal mortality ratio and mortality indices were highest in tertiary facilities of the WHOMCS-Nigeria (706 per 100 000; 26.7%) and the Nigeria Near-Miss and Maternal Death Survey (1088 per 100 000; 40.8%), and lower in secondary facilities of the WHOMCS-Nigeria (593 per 100 000; 17.9%). The MNM ratio and SMO ratio were highest in secondary WHOMCS-Nigeria facilities (27.2 per 1000 LB; 33.1 per 1000 LB).Conclusions Tertiary-level facilities in Nigeria experience unacceptably high maternal mortality rates, but secondary-level facilities had a proportionately higher burden of severe maternal outcomes. Common conditions with a high mortality index (postpartum haemorrhage, eclampsia, and infectious morbidities) should be prioritised for action. Surveillance using SMO indicators can guide quality improvement efforts and assess changes over time.Keywords Maternal death, maternal health, maternal near-miss, quality of care, severe maternal outcome.Tweetable abstract 2820 Nigerian women with severe maternal outcomes: high mortality in tertiary level hospitals, higher burden in secondary level. Please cite this paper as: Vogel JP, Fawole B, Adeniran AS, Adegbola O, Oladapo OT. The burden of severe maternal outcomes and indicators of quality of maternal care in Nigerian hospitals: a secondary analysis comparing two large facility-based surveys. BJOG 2019; 126 (S3): 49-57. † Deceased.

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Distribution of health facilities in Nigeria: Implications and options for Universal Health Coverage

Cited by 72 publications

References 29 publications

Characterization and Distribution of Medicine Vendors in Nigeria: A study of Lagos and Kaduna States.

Characterization and Distribution of Medicine Vendors in Nigeria: A study of Lagos and Kaduna States.

The impacts of quantity and quality of health clinics on health behaviors and outcomes in Nigeria: analysis of health clinic census data

The burden of severe maternal outcomes and indicators of quality of maternal care in Nigerian hospitals: a secondary analysis comparing two large facility‐based surveys

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