Barriers, motivators and guidelines for remanufacturing of medical equipment to improve healthcare services in Nigeria: qualitative approach

BackgroundInequalities in access to health care result in systematic health differences between social groups. Interventions to improve health do not always consider these inequalities. To examine access to reproductive health care services in Ghana and Nigeria, the patterns of use of family planning and maternal care by women in these countries are explored.MethodsWe used population-level data from the Ghana and Nigeria Demographic Health Surveys of 2014 and 2013 respectively. We applied a two-step cluster analysis followed by multinomial logistic regression analysis.ResultsThe initial two-step cluster analyses related to family planning identified three clusters of women in Ghana and Nigeria: women with high, medium and poor access to family planning services. The subsequent two-step cluster analyses related to maternal care identified five distinct clusters: higher, high, medium, low and poor access to maternal health services in Ghana and Nigeria. Multinomial logistic regression showed that compared to women with secondary/higher education, women without education have higher odds of poor access to family planning services in Nigeria (OR = 2.54, 95% CI: 1.90–3.39) and in Ghana (OR = 1.257, 95% CI: 0.77–2.03). Compared to white-collar workers, women who are not working have increased odds of poor access to maternal health services in Nigeria (OR = 1.579, 95% CI: 1.081–2.307, p ≤ 0.01). This association is not observed for Ghana. Household wealth is strongly associated with access to family planning services and maternal health care services in Nigeria. Not having insurance in Ghana is associated with low access to family planning services, while this is not the case in Nigeria. In both countries, the absence of insurance is associated with poor access to maternal health services.ConclusionsThese differences confirm the importance of a focused context-specific approach towards reproductive health services, particularly to reduce inequality in access resulting from socio-economic status. Interventions should be focused on the categorization of services and population groups into priority classes based on needs assessment. In this way, they can help expand coverage of quality services bottom up to improve access among these vulnerable groups.

High prevalence of inequality in utilizing child healthcare services has contributed in child mortality rate among under-five children globally. Though majority of these children are found in less developed economies such as Nigeria where poverty, income inequalities and diseases are widespread. This study examines the inequality in utilization of child health care services in Nigeria using the Nigeria Demographic Health Survey NDHS, 2013 data. The main objective of this study is to ascertain the demographic factors that determine child health care utilization in Nigeria. The methodology employed in this study include: Logit model, to estimate the marginal effects on the probability of utilization of child healthcare services. Also, the techniques of Field's (2003) approach to regression Base (RB) decomposition of inequality, were used to examine the difference in prevalence of child healthcare services between rural/urban dwellers and across male/female gender in Nigeria. “Utilization as dependent Variable” is proxy for modern healthcare facilities which takes the value 1or 0 otherwise. From our first objective, the empirical analysis reveals that there is a significant relationship between utilization of child healthcare service (Modern health facilities) and educational level of the mother of the child (0.0513702); similarly occupation of the parents of the child indicates a significant relationship with utilization (0.0000445), the reason is that as household move from labour-induced manual jobs to white-collar jobs they would be more likely to patronize improved child health healthcare services. This reflected the premise that children whose parents are menial workers may be more endangered than those whose parents are white-collar employed, thus the former having less health attention than the latter. In addition, it was found that the south west region (-0.0187363) of Nigeria has the least likelihood that households would not utilize modern child healthcare services while the North West (-0.1256421) is most likely not to utilize same. The recommendation that arouse is that more awareness should be made about child healthcare utilization. This would cover the gap between those who are more educated and those who are not since educational attainment is also a factor which reveals inequality in child healthcare consumption. Households should be encouraged on family planning so as to enable them have an optimal household size. Health insurance should be encouraged as a cooperative This would afford households whose forerunners are not formally employed enjoy improved healthcare services.

The adoption of user charges in the consumption of public health care services in Nigeria has been questioned on many grounds, one of which is, the willingness to pay for these services, especially given the high rate of poverty being experienced in the Nigerian economy. While out-of-pocket expenses dominate in households’ payment for health care services in Nigeria, the proportion of Nigerians living in poverty (both in the rural and urban areas) kept increasing every year as indicated by the incidence of poverty data. This unswerving increase in the poverty rate does influence the households’ ability and willingness to pay these charges in Nigeria. Accordingly, this study, using both primary and secondary data, examined the determinants of households’ willingness to pay for public health care services in Nigeria and evaluate the extent to which these factors affect households’ willingness to pay in both urban and rural areas. The findings show that the willingness to pay increased with income in all the cases considered. Distance ranks high as one of the most important price factors that influences the willingness to pay more in public sector health care services for rural dwellers while quality of care was momentous for urban respondents.

This study sought to assess the relationship between the determinants of demand for personal healthcare services delivery in Nigeria. The main objective of the study was to assess the determinants of demand for personal healthcare services delivery in Nigeria. The specific objectives were to examine the relationship between literacy; income; environmental factors, government and private expenditures on health in Nigeria. Specifically, the study is a descriptive statistics research with the use of secondary sources of data from the World Health Development Indicators (WDI) and Central Bank of Nigeria (CBN) bullettins. The study adopted Pooled Ordinary Least Square (OLS) regression model and Autoregressive Distributed Lag Model (ARDL). The analysis was based on annual time series data for the period of 1990 to 2023. The result revealed that literacy rate has a significant negative relationship with demand for personal healthcare services in Nigeria, which implies that literacy rate in Nigeria directly contributed to the decline of private demand for personal healthcare services over time. The study also observed that per capita income has a significant positive relationship with demand for personal healthcare services, which means that a rise in income levels increases demand for private health expenditure in Nigeria. Moreso, the study found that there is actually no significant relationship between environmental factor and demand for personal healthcare services in Nigeria. Finally, the study shows that government expenditure on health significantly reduces demand for personal healthcare services in Nigeria. Therefore, government health expenditure is a substitution for private health expenditure in Nigeria over time. It concludes that demand for personal healthcare services requires a deep evaluation of public health investments, economic growth policies and educational reforms. It suggested that there is the need to focus on health promotion campaigns at all levels of governance in Nigeria, and however, policies that combine literacy initiatives with health promotion campaigns can both improve demand for quality healthcare services at the private level and also ensure healthier lifestyles and preventive care.

An effective and quality health care service is one of the fundamental visions of every government to its citizenry because it is only the healthy people that can be governed and will value developmental projects. Citizens having access to quality health services translate to significant development in modern society. Therefore, the provision of adequate funds for the sector is essential. However, the Nigeria health care sector is currently confronted with colossal issues that should be surmounted to enhance effective and quality health care delivery to the citizens. This study is rooted in the evidence of appropriate works of literature in the financing of public health care services in Nigeria. From the extant works of the literature surveyed, it was revealed that public health care services in Nigeria are financed by revenue that is accrued from public tax, funding from donors, health insurance, and direct payments made by individuals. Furthermore, public health service is mostly financed by direct payments made by individuals with the government. The most perturbing issues combating public health care financing are direct payments made by individuals, poor government funding, health care policy defects in implementation, and corruption scandals. On this note, the study recommended an effective and robust government funding of public health, implementation of sound health care policies, efficient monitoring of public funds utilization, and discouraging foreign medical trips. JEL Classification Codes: A19, B10, B25, C10, C53.

The derogation of erstwhile traditional healthcare services popularized modern healthcare systems which have been adjudged by many Nigerians as profit-making ventures rather than that saving life. Only affluence can afford quality health care in Nigeria. The situation is worst for the majority of women who survive under men. Thus, exploitation and inequitable access to modern health care services stiffened health challenges for many Nigerians especially women. Thus, this study examined ways of deconstructing gender and the capitalist system of health care, a panacea for equitable access to health care services in Nigeria. Weber's social action and rational theory were used for the explanation of variables. Data was generated with the use of questionnaires, case studies, and In-depth and key informant interviews. Data were analyzed using the statistical package for the social sciences. Chi-square and cross-tabulations validated the connectivity between government policies, equitable access to health care services and the health of the masses. The validity and reliability of instruments were ascertained by pilot study (test-retest analysis). Interview and (X2=16.09; P<0.05) revealed that the irrational and non-affectionate posture of physicians under the modern health care system is more terrifying than sickness and death itself.

This paper examined the management of the Primary Health Care Services in Nigeria using both Primary and Secondary data. The Primary data were generated from social survey, interviews and participant observation while secondary data were sourced from health institutions. Data gathered were analysed using quantitative and descriptive methods. The findings of the study showed a low level of interaction and coordination among tiers of government which resulted in poor performance of PHC at the grassroot. The Primary Health Care Programme was grossly underfunded which manifested in the low performance of the PHC delivery facilities. The research identified some institutional impediments such as conflicts between Local and State Governments resulting in a strained relationship, poor collaboration and weak linkage. Community participation which is a sine qua non in the attainment of the objectives of the programme was very low. Finally, the participation of international organisations like UNICEF and USAID in PHC Programme was responsible for most of the achievement made so far. The research recommended among others that the three tiers of government must relate to one another to ensure that a harmonious relationship exists at all times through official interactions on all issues that affect the three levels of government especially the policy formulation, implementation, and evaluation, and evaluation of the Primary Health care programme.

Introductionpoor maternal health outcomes remain a major public health issue in Nigeria. These have been shown to be affected by the low level of utilization of maternal healthcare services. This study investigates the levels of gender relations (GR) among Nigerian women and how these influence their utilization of maternal healthcare services. The relations are conceptualized as feminine (FGR), masculine (MGR) and egalitarian.Methodsdata on household decision-making, antenatal care (ANC) visits, health facility delivery, and associated sociodemographic variables, were extracted from the 2018 Nigeria Demographic and Health Survey for 29,992 parous women aged 15-49 for a cross-sectional study. Associations were investigated using Chi-Square and regression analyses.Resultswomen with FGR constituted 5.7% of the population at the national level, while subnational variations ranged from 1.8% in the North-East to 12.8% in the South-South regions. The prevalence rates of the recommended minimum ANC visits (RMANC) and health facility delivery were 42.1% and 30.0% at the national level and were lowest in the northern regions. At both the unadjusted and adjusted levels, FGR was not significantly associated with RMANC and health facility delivery at the national level and in all the regions except the South-West. MGR was however significantly associated with increased odds of RMANC (OR: 2.235, CI: 2.043-2.444) and health facility delivery (OR: 2.571, CI: 2.369-2.791) at national level. Significant subnational variations in the association between gender relations and the utilization of maternal healthcare services were also recorded.Conclusionsub-national variations in GR and their varying impacts on the utilization of maternal healthcare services in Nigeria suggest that gender-related policies to improve maternal health outcomes should be location-specific, rather than general. As FGR did not affect maternal healthcare services utilization, educating men on the benefits of supporting their wives to scale-up utilization is recommended.

Reproductive and maternal health in Nigeria faces significant challenges despite efforts to improve outcomes over the years. Nigeria, Africa’s most populous country, struggles with high maternal mortality rates and disparities in access to healthcare services, particularly between urban and rural areas. Nigeria has one of the highest maternal mortality rates globally, with approximately 512 deaths per 100,000 live births as of recent estimates. This statistic underscores persistent challenges in ensuring safe childbirth and adequate maternal healthcare. This review assessed the level of utilization of reproductive and maternal health services in Nigeria. A comprehensive search was carried out using electronic sources such as PubMed, Google Scholar, and African Journal Online (AJOL). The search terms included “maternal health in Nigeria”, and “utilization of reproductive services in Nigeria”, The database search yielded a total of 55 studies. The research revealed the gradual evolution of reproductive and maternal health services from the post-colonial era to the present day. This review shows the under-utilization and disparity of reproductive and maternal healthcare services between rural and urban areas in Nigeria.

Background: Socioeconomic factors influence health outcomes and the distribution of health resources within and between countries globally. In Nigeria, there are various socio-economic factors that have been reported to be responsible for health inequities across the different geopolitical zones. Objective: To assess health inequities in relation to socio-economic factors that affect access to essential health care services in Nigeria, using family planning, maternal care, and childcare as indicators. Method: The study involved a cross-sectional secondary analysis of data from the 2018 Nigeria Demographic and Health Survey (NDHS) and a literature review of transdisciplinary approaches to addressing health inequities. Result: The overall result from the findings suggests a strong influence of geographical and socioeconomic factors in the distribution of healthcare services. Specifically, family planning services were more readily available and accessible in the Southern zones of Nigeria than in the Northern zone of Nigeria, which could be attributed to socio-cultural, religious, and access-related barriers. Results also showed that access to most maternal and child health care services was often skewed towards the southern zones, which could be due to the presence of more healthcare workers who provide these services coupled with higher access to maternal care, hence a higher uptake and utilization of maternal care services. Also, children in the northern zones had lesser odds of receiving basic and age-appropriate vaccination than those in other regions, which could be attributed to the supply-side disparities that exist between the northern and southern regions. Conclusion: This study concludes that level of educational attainment, wealth quintiles, as well as financial barriers, are the major socio-economic factors that influence access to maternal and childcare services.

Mental health has emerged as a critical facet of human well-being, necessitating focused on global attention due to an exceptional rise in the prevalence of mental disorders worldwide. Nigeria, like many other countries, faces various mental health challenges that profoundly affect the lives of its populace. This is further aggravated by a near-total lack of integration of mental health services into the country’s existing health care structures. Therefore, this study aimed to assess the current situation of mental health services across Nigeria’s health systems from family physicians’ perspectives.This descriptive cross-sectional qualitative study that used an in-depth interview guide to collect data on the current status of mental health service provision in Nigeria among family physicians located in different levels of health care in all six geopolitical regions of the country. Interviews were conducted with 23 participants and analysed using content analysis and presented using thematic categorization. Five (5) themes emerged from the participants’ description of the current status of mental healthcare situation in Nigeria: (i) Stand-alone Health Facility and Coverage for Mental Health Service Provision in Nigeria, (ii) Inadequacy of Mental Health Specialists (iii) Increasing Prevalence and Burden of Mental Health in Nigeria, (iv) Poor knowledge of mental health management, and (v) Weak Policy on Mental Health Service. There are gaps to be filled to optimize mental health service delivery in Nigeria. The study participants identified five key factors that stakeholders need to consider improving the state of mental health services in Nigeria.

ABSTRACTAs the world draws curtains on the implementation of Millennium Development Goals (MDGs), there is increasing interest in evaluating the performance of countries on the goals and assessing related challenges and opportunities to inform the upcoming Sustainable Development Goals (SDGs). This study examined changes in the timing and utilisation of maternal health care services in Nigeria and Malawi; using multivariate negative log–log and logistic regression models fitted to demographic and health survey data sets. Predicted probabilities were also computed to observe the net differences in the likelihood of both the first and the required number of antenatal care (ANC) visits for each of the three analysis years. Women in Nigeria were 7% less likely in 2008 compared to 2003, and in Malawi, 32% more likely in 2013 compared to 2000, to utilise ANC in the first trimester of pregnancy. Timing of first ANC visit was strongly influenced by wealth in Nigeria but not in Malawi. The findings in our case studies show how various contextual factors may enable or inhibit policy performance. Maternal and child health, SDGs should incorporate both wealth and degrees of urbanicity into country level implementation strategies.

Introduction: Throughout the world, the number of persons with disabilities (PWDs) is growing exponentially as a result of factors such as population increase, ageing, and medical advances that prolong life. This has increased the demand for quality health services, especially in developing countries. Aim: The aim of this research is to assess the attitudes towards PWDs of “direct” and “indirect” healthcare service providers at the University College Hospital (UCH) in Ibadan, Nigeria. Methods: The researchers analyzed the open-ended comments from 81 healthcare providers from the hospital, regarding their knowledge and attitudes towards patients with disabilities. Results: The authors classified the unsolicited comments into three main categories, thus: “institutional-level actions advocated”, “society-level changes advocated”, and “individual-level perception or attitude.” Conclusion: This project has implications for reform and development of medical services in Nigeria. It identifies specific areas of need to improve the quality of healthcare service pertaining to PWDs and their families, especially in relation to the removal of architectural barriers, the development of positive attitudes, the formulation and implementation of effective legislation, and improved pre- and in-service training of healthcare workers in line with signed domestic and international protocols.

One of the basic functions of government is to provide quality and effective health care services to its citizens as it is only when the people are healthy that any reasonable development can take place. Funding of health care sector in Nigeria is still face with enormous challenges that must be overcome if quality and effective health care service is to be made available to the people. This article reviewed relevant literatures related to public health care financing in Nigeria which were published by journals within and outside the country. An overview of the literatures showed that public health care services in Nigeria is financed through; out-of-pocket payments, tax revenue, donor funding and through health insurance. Trends have shown that the bulk of public health care is financed by households through out-of-pocket payments with government contributing just about 25% of the total health expenditure. The major challenges of health care financing includes, poor funding by government, high out of pocket payment, inadequate implementation of health care financing policy and corruption. This article concluded by recommending that there should be an increase in government funding of public health care, adequate implementation of health care policies, proper monitoring and evaluation of utilization of funds, discourage government sponsorship for treatment of personnel abroad and finally encouraging local production of drugs and other medical equipments.

BackgroundIn the context of global health priority, understanding the role of power dynamics among women as an important intervention required towards achieving optimum maternal and child health outcomes is crucial. This study examined the influence of women's decision-making autonomy on antenatal care utilisation and institutional delivery services in Nigeria.MethodsThe data for the study were derived from the 2018 Nigeria Demographic and Health Survey and comprised a weighted sample of 20,100 births in the last five years that preceded the survey among married/cohabiting childbearing women. Descriptive and analytical analyses were carried out, including frequency tables and multivariate using the binary logistic regression model.ResultsThe study revealed that despite a large number of women initiating antenatal care visits before 12 weeks of pregnancy (75.9%), far fewer numbers had at least eight antenatal care visits (24.2%) and delivered in a health facility (58.2%). It was established that the likelihood of having at least eight antenatal care visits was significantly increased among women who enjoyed decision-making autonomy on their healthcare (aOR: 1.24, CI: 1.02–1.51) and how their earnings are spent (aOR: 2.02, CI: 1.64–2.48). Surprisingly, women’s decision-making autonomy on how their earnings are spent significantly reduced the odds of initiating antenatal care visits early (aOR: 0.75, CI: 0.63–0.89). Some socio-economic and demographic factors were observed to have a positive influence on quality antenatal care utilisation and delivery in a health facility.ConclusionIn conclusion, women’s decision-making autonomy on their healthcare and how their earnings are spent was significantly found to be protective factors to having eight antenatal care visits during pregnancy. Conversely, women’s autonomy on how their earnings are spent significantly hindered their initiation of early antenatal care visits. There is a need for more pragmatic efforts through enlightenment and empowerment programmes of women to achieve universal access to quality maternal healthcare services in Nigeria.