determinant of Healthcare demand in Nigeria

literature review

The determinant of healthcare demand in Nigeria, a case study of OYO state, Nigeria.  Download the full research work in a doc editable format. The human capital is able to accomplish those desired objectives outlined by the society only on the fundamental premise that the people are in good health. Health is a basic fundamental right of all citizens and health promotion forms an intrinsic part of health care because a healthy society reflects the well-being of a nation.

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

All over the world, debates abound on the roles that socio-economic status of people play in influencing their level of health care demand, health seeking behaviour, information about and/or utilization of health care facilities to aid their general health condition. This dialectic is particularly worrisome especially in sub-Saharan Africa where almost 70% of the population are of low social economic status, reside in rural community and are confined into the informal of the economy (Noko, 2016).

According to National Open University (2007), the decision to utilize health services involves several stages which include; visibility and recognition of symptoms, the extent to which the symptoms are perceived as dangerous, the amount of tolerance for the symptoms, and basic needs that lead to denial. Several factors including cultural, social, gender, economic and geographic are predisposing factors in the utilization of health services. The need for utilizing health services is borne out of the assumption that only special institutions charged with the responsibility of providing healthcare can provide relevant therapeutic services to people who have health problems.

The human capital is able to accomplish those desired objectives outlined by the society only on the fundamental premise that the people are in good health. Health is a basic fundamental right of all citizens and health promotion forms an intrinsic part of health care because a healthy society reflects the well-being of a nation.

By Definition, Health is a state of complete physical, social and mental well-being and not merely an absence of a disease or infirmity (WHO, 2000). Embedded in good health is not least disease, as this is more in keeping with poor health. In recent years, the definition of    health has been modified to include the ability to lead a socially and economically productive life.  The goal of the national Health policy is to bring about a comprehensive health care system, based on primary health as clearly stated by the Federal Ministry of health is protective, preventive, restorative and rehabilitative to every citizen of the country within the available resources so that individuals and communities are assured of productivity, social well-being and enjoyment of living. In most rural areas in Africa, one in three women lives more than five kilometers from the nearest health facility (World Bank, 1994b). The scarcity of vehicle, especially in remote areas and poor road condition can make it extremely difficult for women to reach even relatively nearby facilities. Walking is the basic mode of transportation even for women in labour (Williams et al, 1985; World Bank, 1994b; Noko, 2016).

The role of income in health is buttressed by the fact that poverty is generally associated with poor health (Abel-Smith and Leiserson, 1978). Health status is a direct product of economic power, Propper, (2000). Andy and Cassels (2004) emphasize that ill health can cause poverty via loss of income, catastrophic health expenditures and orphan hood. A number of socio-demographic characteristics of the individual affect the underlying tendency to seek health care (Addai, 2000; Celik and Hotchkiss, 2000; Adekunle et al, 1990; Gertler et al, 1988). Poor health conditions can have a debilitating impact on the economy in terms of lower investment flows and reduced tourist traffic. Over two billion people do not have adequate health care to meet their basic needs (Poppov Reasearch Network 2009).

Adekunle (2015) noted that poor infrastructure coupled with non-payment of civil servant salary promptly is among the major deterrent’s to effective health care demand in Oyo state. He argued that most household in Oyo state do not visit hospital regularly because of the price charged by the hospitals including general hospitals. Given the role of health in the productivity of a work force the health care sector has been generally regarded as a major key to the development of the nation. But despite the laudable contributions of the health sector to economic development, the Nigerian health sector has witnessed various turbulence that has negatively revised the progress recorded at various times.

Nearly 15 percent of Nigerian children do not survive to their fifth birthday. Two leading causes of child mortality are malaria (30 percent) and diarrhea (20 percent). Malnutrition contributes to 52 percent of death of children under five.

A household survey conducted by the government in 2003-2004 showed that 54.4 percent of the population is poor, with a higher poverty rate in rural area of 63.3 percent (HERFON, 2006). The incidence of poverty in Nigeria is widespread and increasing with some of the worst poverty linked health indicators in Africa. There has been a sharp increase in poverty from 1992 to 1996, with an estimated third of the population living below $1 per day and nearly two thirds below

$2 per day (FMoH, 2005).

Some of the factors that affect the overall performance of the health system include; inadequate health facilities/structure, poor human resources and management, poor remuneration and motivation, lack of fair and sustainable health care financing, unequal economic and political relations, the neo-liberal economic policies of the Nigerian state, corruption, illiteracy, very low government spending on health, high out-of-pocket expenditure in health and absence of integrated system for  disease prevention, surveillance and treatment, inadequate mechanisms for families to access health care, shortage of essential drugs and supplies and inadequate supervision of health care providers are among some of the persistent problems of the health system in Nigeria.

1.2 Statement of the problem

The lack of adequate health care services and the inability of individuals within a given society to acquire modem health care services at affordable rates have led to the deterioration of the health status of individuals, in Nigeria, it is common to see health institutions with no drugs and with dilapidated structures, the dwindling income and purchasing power of individuals, coupled with the high cost of drugs and of treatment, combined to keep health care services out of the reach of many, the effects are high infant and mortality, increase in the death rate, reduction of life expectancy and of the productive capacity of the people, absenteeism at work, low output, low income, and poverty, for instance, an infant mortality rate of 81 per 1000 live births was recorded in 2001, while the maternal mortality rate was 1000 per 100,000 live births in the same year, an under-fïve mortality rate of about 133 per 100,000 live births and life expectancy at birth of about 52 years were also registered (ADB, 2003).

A number of research has been carried to determine the determinant of health care services in Nigria. However, it not clear as to what determines health care services in Oyo state since few works carried in Oyo state does not have a consensus findings (Tonuchi, 2016; Adekunle, 2015). The lack of clear evidence on the determinants of health care demand is deepened further when one studies the outcome of a baseline survey done by UN HABIT (2005) in Ibadan, under the poverty eradicating project. Some casual observations show that over 60 percent of the respondents did not visit government health facilities although these facilities were nearer to them than alternative facilities. They instead visited alternative health facilities. Additionally, the alternative health facilities visited were more expensive than the government facilities in terms of money costs (Mwabu et al., 1993, Sahn et al., 2003). It is the lack of concrete evidence as to what determines the health care service demand in Oyo state that this work aim to address.

1.3 Research Questions

Given the aforementioned problem prevalent in health care demand, hence this research work tries to answer the following specific research questions:

  1. To what extent does cultural and demographic factors impacted on health care demand in Oyo state?
  2. To what extent does Economic factors impacted on health care demand in Oyo state?
  3. To what extent does social and service delivery factors impacted on health care demand in Oyo state?

1.4 Objectives of the Study

The main objective of the study is to investigate the determinant of health care service demand in Oyo state. The specific objectives of study are to:

(i) Empirically investigate the impact of cultural and demographic factors on health care demand in Oyo state

(ii) Examine the impact of economic factors on health care demand in Oyo state.

(iii) Empirically evaluate the impact of social and service delivery factors on health care demand in Oyo state.

1.5 Significance of the Study

The study will be of benefit to Government and hence will help public fund managers in making adequate financial planning, forecast as well as mending the needed areas in public expenditure on health care services. Also it will encourage government in finding lasting solution to the problem of income inequality and rising poverty across the country.

Individuals and groups will also benefit from this study as it will provide the avenue for better understanding of the needs for proper health care and how to access one without much stress. It will help the organization to invest wisely and help them to respond more to the societal needs.

This research work will be of great intellectual value to students of economics and other discipline who would want to make further research on health care demand in Oyo state and Nigeria at large.

Lastly, it will add to already existing body of knowledge on this topic as it will provides a new window for further research.

1.6 Scope and Limitation of the Study

The study seeks to analyze Nigeria’s taxation and its impact on her economic growth. The study will investigate demographic factors, economic factors, and service delivery system as it concern the demand pattern of Oyo household.

Materials for the study were not adequate and consistent thereby resulting to extra effort by the researcher to validate the data.

Inaccessibility of Data: Difficulty in accessing data for the study was yet another limitation. This had its own toll on the research work because it limited the data that was used for the study. Most of the respondent were not always willing to respond to research question thus the researcher has to put in extra effort to get them convince that it is for academic purpose only.

Financial Constraint: Lack of adequate funds on the part of the researcher constituted another problem. The researcher employ three research assistant who help in guiding the respondents in the process of data gatherings.

However, amidst all these enumerated constraint faced by the researcher, effort was adequately made by the researcher to ensure the reliability of the result by subjecting the research to many advance econometric test to fish out any possible spuriousity of result among others.

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