Health sector reforms: implications for reproductive health in Nigeria

Abstract

Health sector reforms emerged as a major focus in the 1990s covering a wide range of structural and institutional changes. The components of a fundamental health sector reform includes: decentralization of power and resources; improving function of national health ministries; improving the performance of civil service (and managers); broadening health financing mechanism; introducing managed competition; guaranteeing access, redressing equity and pro-poor orientation; as well as broadening ownership and impact. Nigeria’s overall health system performance was ranked 187th among the 191 Member States by the WHO in 2000. The issue of financing and user fees has implications for reproductive health services uptake.
Where maternal services are rendered free there was an increase in service uptake where the quality of the services that are being provided are guaranteed. Local authorities or communities should be allowed to set their priorities based on their peculiar needs and problems of their locality, but such should not go against the main objective of the health reform. The approach of “basket funding” should be continued to ensure quality monitoring and evaluation of the health system in general and assuring the quality of health related data.

Key words: Health sector reforms, Reproductive health, Health financing mechanism, Nigeria