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尼日利亚的医疗保健融资:对实现全民健康覆盖的影响。

Health care financing in Nigeria: Implications for achieving universal health coverage.

作者信息

Uzochukwu B S C, Ughasoro M D, Etiaba E, Okwuosa C, Envuladu E, Onwujekwe O E

机构信息

Department of Community Medicine, University of Nigeria, Enugu Campus, Enugu; Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu; Department of Pharmacology and Therapeutics, Health Policy Research Group, University of Nigeria, Enugu, Nigeria.

出版信息

Niger J Clin Pract. 2015 Jul-Aug;18(4):437-44. doi: 10.4103/1119-3077.154196.

Abstract

The way a country finances its health care system is a critical determinant for reaching universal health coverage (UHC). This is so because it determines whether the health services that are available are affordable to those that need them. In Nigeria, the health sector is financed through different sources and mechanisms. The difference in the proportionate contribution from these stated sources determine the extent to which such health sector will go in achieving successful health care financing system. Unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge. This review draws on relevant literature to provide an overview and the state of health care financing in Nigeria, including policies in place to enhance healthcare financing. We searched PubMed, Medline, The Cochrane Library, Popline, Science Direct and WHO Library Database with search terms that included, but were not restricted to health care financing Nigeria, public health financing, financing health and financing policies. Further publications were identified from references cited in relevant articles and reports. We reviewed only papers published in English. No date restrictions were placed on searches. It notes that health care in Nigeria is financed through different sources including but not limited to tax revenue, out-of-pocket payments (OOPs), donor funding, and health insurance (social and community). In the face of achieving UHC, achieving successful health care financing system continues to be a challenge in Nigeria and concludes that to achieve universal coverage using health financing as the strategy, there is a dire need to review the system of financing health and ensure that resources are used more efficiently while at the same time removing financial barriers to access by shifting focus from OOPs to other hidden resources. There is also need to give presidential assent to the national health bill and its prompt implementation when signed into law.

摘要

一个国家为其医疗保健系统筹集资金的方式是实现全民健康覆盖(UHC)的关键决定因素。之所以如此,是因为它决定了现有的医疗服务对有需求的人来说是否负担得起。在尼日利亚,卫生部门通过不同的来源和机制筹集资金。这些既定来源的贡献比例差异决定了该卫生部门在实现成功的医疗保健融资系统方面能够走多远。不幸的是,在尼日利亚,实现这些来源的正确组合仍然是一项挑战。本综述借鉴相关文献,概述尼日利亚医疗保健融资的现状,包括为加强医疗保健融资而制定的政策。我们在PubMed、Medline、Cochrane图书馆、Popline、Science Direct和世卫组织图书馆数据库中进行搜索,搜索词包括但不限于尼日利亚医疗保健融资、公共卫生融资、卫生融资和融资政策。从相关文章和报告中引用的参考文献中确定了更多的出版物。我们只审查以英文发表的论文。搜索没有设置日期限制。报告指出,尼日利亚的医疗保健通过不同来源筹集资金,包括但不限于税收、自付费用(OOPs)、捐助资金和医疗保险(社会和社区)。面对实现全民健康覆盖的目标,在尼日利亚实现成功的医疗保健融资系统仍然是一项挑战,并得出结论,为了以卫生融资为战略实现全民覆盖,迫切需要审查卫生融资系统,确保更有效地利用资源,同时消除获取医疗服务的财务障碍,将重点从自付费用转移到其他隐性资源。还需要总统批准《国家卫生法案》,并在签署成为法律后迅速实施。

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