Health care financing and services utilization in cross river state, nigeria

Abstract

The average annual budgetary allocation for health in Nigeria is about the lowest in Africa at 5.7% as the total health expenditure is only 0.7% of GDP against the WHO recommended 4%-5%. The out-of-pocket spending by Nigerians is more than 60% of total health expenditure instead of WHO recommended 30-40%, while the national coverage of the National Health Insurance is below 5% which poses a serious problem to health care service utilization. In Nigeria, the ever rising socioeconomic costs of healthcare and the limited or complete lack of supportive public financing is a major challenge to the attainment of the sustainable development goals (SDGs) recently adopted to reduce poverty and improve the wellbeing of all citizens of the world. This paper examined health care financing in Cross River State and determined the extent to which it poses problems to services utilization. The paper reviewed literature relevant to the study while the Marxist conflict theory of healthcare utilization was employed. The design for the paper was Expost facto which relied on secondary data from Cross River State Ministry of Health. The study reviewed various sources of health care financing in Cross River State and the impact of these sources on health care system strengthening or quality health care provision. From the study or discourse and review of health expenditure and its related challenges, it was found out that, out-of -pocket expenditure or user-fee charges, community-based financing, private donor agencies financing and tax-based public health financing sources in the state have not significantly impacted on good services provision to individuals. From these findings, it was recommended among others that government should encourage the establishment of village/ward development committees whose responsibilities should include taking initiative to assist government in building health post (in communities where such do not exist), Government should maintain existing health facilities and provide proper logistics during health campaigns and monitoring of health workers activities at the health facilities.