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Socio-economic inequalities in the use of flu vaccination in Europe: a multilevel approach

The European-wide statistics show that the use of flu vaccination remains low and the differences between countries are significant, as are those between different population groups within each country. Consid...

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Health economic evaluation of an electronic mindfulness-based intervention (eMBI) to improve maternal mental health during pregnancy – a randomized controlled trial (RCT)

Anxiety and depression are the most prevalent psychiatric diseases in the peripartum period. They can lead to relevant health consequences for mother and child as well as increased health care resource utiliza...

Efficiency evaluation of 28 health systems by MCDA and DEA

Policymakers, who are constantly discussing growing health expenditures, should know whether the health system is efficient. We can provide them with such information through international health system effici...

The effect of basic public health service equalization on settlement intention of migrant workers in China: the mediating effect model based on subjective feelings

During the 14th Five-Year Plan, China aims to transform rural migrants into urban citizens and ensure equal access to public services to enhance new urbanization. Understanding migrant workers' settlement inte...

A framework for ex-ante evaluation of the potential effects of risk equalization and risk sharing in health insurance markets with regulated competition

Many health insurance markets are organized by principles of regulated competition. Regulators of these markets typically apply risk equalization (aka risk adjustment) and risk sharing to mitigate risk selecti...

Cost of illness of breast cancer in low- and middle-income countries: a systematic review

This systematic review explores the cost of illness (COI) studies on breast cancer in low- to middle-income countries (LMICs). Studies in Cochrane, Proquest Thesis, PubMed and Scopus were considered. The repor...

A decade of liver transplantation in Mongolia: Economic insights and cost analysis

Mongolia introduced liver transplantation 10 years ago, becoming the 46th country globally to successfully perform this procedure. However, the cost of liver transplantation treatment remains expensive in Mong...

Has China’s hierarchical medical system improved doctor-patient relationships?

Developing harmonious doctor-patient relationships is a powerful way to promote the construction of a new pattern of medical reform in developing countries. We aim to analyze the effects of China’s hierarchica...

Insured-non-insured disparity of catastrophic health expenditure in Northwest Ethiopia: a multivariate decomposition analysis

Financial risk protection is one indicator of universal health coverage (UHC). All people should be protected from financial risks such as catastrophic health expenditures (CHE) to ensure equitable health serv...

Economic analysis of digital motor rehabilitation technologies: a systematic review

Rehabilitation technologies offer promising opportunities for interventions for patients with motor disabilities. However, their use in routine care remains limited due to their high cost and persistent doubts...

Social costs associated with fibromyalgia in Spain

Fibromyalgia is a chronic rheumatic disease of unknown aetiology, highly disabling and mainly affecting women. The aim of our work is to estimate, on a national scale, the economic impact of this disease on th...

Untangling the corruption maze: exploring the complexity of corruption in the health sector

Healthcare corruption poses a significant threat to individuals, institutions, sectors, and states. Combating corruption is paramount for protecting patients, maintaining the healthcare system's integrity, and...

Correction: A microcosting approach for planning and implementing community‑based mental health prevention programs: what does it cost?

The original article was published in Health Economics Review 2024 14 :35

Cost-effectiveness of immune checkpoint inhibitors as a first-line therapy for advanced hepatocellular carcinoma: a systematic review

Since 2017, immune checkpoint inhibitors (ICIs) have been available for the treatment of advanced hepatocellular carcinoma (HCC) or unresectable HCC, but their adoption into national medical insurance programs...

Cost-benefit analysis of haemodialysis in patients with end-stage kidney disease in Abuja, Nigeria

Significant gaps in scholarship on the cost-benefit analysis of haemodialysis exist in low-middle-income countries, including Nigeria. The study, therefore, assessed the cost-benefit of haemodialysis compared ...

Exploring unmet healthcare needs and associated inequalities among middle-aged and older adults in Eastern China during the progression toward universal health coverage

Given the rapid population aging in China, achieving universal health coverage (UHC) presents a primary challenge in addressing unmet healthcare needs and associated inequalities among middle-aged and older ad...

Retrospective analysis of hospitalization costs using two payment systems: the diagnosis related groups (DRG) and the Queralt system, a newly developed case-mix tool for hospitalized patients

Hospital services are typically reimbursed using case-mix tools that group patients according to diagnoses and procedures. We recently developed a case-mix tool (i.e., the Queralt system) aimed at supporting c...

Estimating the budget impact of a Tuberculosis strategic purchasing pilot study in Medan, Indonesia (2018–2019)

Indonesia has the world’s second-highest tuberculosis (TB) burden, with 969,000 annual TB infections. In 2017, Indonesia faced significant challenges in TB care, with 18% of cases missed, 29% of diagnosed case...

The effects of Medicaid expansion on the racial/ethnic composition within nursing home residents

The Affordable Care Act (ACA), enacted in 2010, aimed to improve healthcare coverage for American citizens. This study investigates the impact of Medicaid expansion (ME) under the ACA on the racial and ethnic ...

Comparative policy analysis of national rare disease funding policies in Australia, Singapore, South Korea, the United Kingdom and the United States: a scoping review

Rare diseases pose immense challenges for healthcare systems due to their low prevalence, associated disabilities, and attendant treatment costs. Advancements in gene therapy, such as treatments for Spinal Mus...

Correction: The economic costs of orthopaedic services: a health system cost analysis of tertiary hospitals in a low-income country

The original article was published in Health Economics Review 2024 14 :13

Utilization of maternal health facilities and rural women’s well-being: towards the attainment of sustainable development goals

The sustenance of any household is tied to the well-being of the mother's health before, during, and after pregnancy. Maternal health care has continued a downward slope, increasing maternal mortality in rural...

Does hospital competition improve the quality of outpatient care? - empirical evidence from a quasi-experiment in a Chinese city

Although countries worldwide have launched a series of pro-competition reforms, the literature on the impacts of hospital competition has produced a complex and contradictory picture. This study examined wheth...

Cost-effectiveness of brentuximab vedotin compared with conventional chemotherapy for relapsed or refractory classic Hodgkin lymphoma in China

Relapsed or refractory classic Hodgkin lymphoma (RRcHL) associates with poor prognosis and heavy disease burden to patients. This study evaluated the cost-effectiveness of brentuximab vedotin (BV) in compariso...

Cost-effectiveness of endovascular treatment for acute ischemic stroke in China: evidence from Shandong Peninsula

Recently, the endovascular treatment (EVT) of acute ischemic stroke has made significant progress in many aspects. Intravenous thrombolysis (IVT) is usually recommended before endovascular treatment in clinica...

The healthcare costs of increased body mass index–evidence from The Trøndelag Health Study

Earlier studies have estimated the impact of increased body mass index (BMI) on healthcare costs. Various methods have been used to avoid potential biases and inconsistencies. Each of these methods measure dif...

A microcosting approach for planning and implementing community-based mental health prevention programs: what does it cost?

Estimating program costs when planning community-based mental health programs can be burdensome. Our aim was to retrospectively document the cost for the first year of planning and implementing Healthy Minds H...

The Correction to this article has been published in Health Economics Review 2024 14 :49

Systematic review of the economic evaluation model of assisted reproductive technology

With the increasing demand for fertility services, it is urgent to select the most cost-effective assisted reproductive technology (ART) treatment plan and include it in medical insurance. Economic evaluation ...

Predicting healthcare expenditure based on Adjusted Morbidity Groups to implement a needs-based capitation financing system

Due to population aging, healthcare expenditure is projected to increase substantially in developed countries like Spain. However, prior research indicates that health status, not merely age, is a key driver o...

Budget impact analysis of continuous glucose monitoring in individuals with type 2 diabetes on insulin treatment in England

In 2022, updated guidance from NICE expanded the options for self-monitoring of blood glucose for patients with type 2 diabetes (T2DM), to include continuous glucose monitoring (CGM). In this budget impact ana...

Does the introduction of an infliximab biosimilar always result in savings for hospitals? A descriptive study using real-world data

Biosimilars are biologic drugs that have the potential to increase the efficiency of healthcare spending and curb drug-related cost increases. However, their introduction into hospital formularies through init...

Factors influencing medical expenditures in patients with unresolved facial palsy and pharmacoeconomic analysis of upper eyelid lid loading with gold and platinum weights compared to tarsorrhaphy

There are no standards in diagnostic and therapeutic approaches to eye care in incomplete eyelid closure due to unresolved facial palsy (FP). Loading of the upper eyelid (UELL) with gold weights (GWs) or plati...

A Hierarchical Bayesian approach to small area estimation of health insurance coverage in Ethiopian administrative zones for better policies and programs

Sample surveys are extensively used to provide reliable direct estimates for large areas or domains with enough sample sizes at national and regional levels. However, zones are unplanned domains by the Demogra...

Heterogeneous effects of hospital competition on inpatient quality: an analysis of five common diseases in China

Many countries has introduced pro-competition policies in the delivery of healthcare to improve medical quality, including China. With the increasing intensity of competition in China's healthcare market, ther...

Examining confidential wholesale margin estimates in European countries for the price negotiation of patented drugs in Germany: a statistical model

Based on the legal framework laid down in section 130b (9) of Book V of the German Social Code, various criteria are relevant for the negotiated price for new patented drugs in Germany. European reference pric...

The long-term cost-effectiveness of once-weekly semaglutide versus sitagliptin for the treatment of type 2 diabetes in China

To estimate the long-term cost-effectiveness of once-weekly semaglutide versus sitagliptin as an add-on therapy for type 2 diabetes patients inadequately controlled on metformin in China, to better inform heal...

UHC in Morocco: a bottom-up estimation of public hospitals' financing size based on a costing database

Morocco is engaged in a health system reform aimed at generalizing health insurance across the whole population by 2025. This study aims to build a national database of costs at all levels of public hospitals ...

Preferences in adolescents and young people’s sexual and reproductive health services in Nigeria: a discrete choice experiment

Barriers to utilization of sexual and reproductive health (SRH) services by adolescents and young people (AYP) have persisted despite evidence that youth-friendly services have a positive effect on contracepti...

Insurance barriers and inequalities in health care access: evidence from dual practice

We investigate access disparities in pharmaceutical care among German patients with type 2 diabetes, focusing on differences between public and private health insurance schemes. The primary objectives include ...

Impact of reimbursement systems on patient care – a systematic review of systematic reviews

There is not yet sufficient scientific evidence to answer the question of the extent to which different reimbursement systems influence patient care and treatment quality. Due to the asymmetry of information b...

The economic effect of financial compensation in China’s healthcare system: comprehensive insights regarding supply and demand factors

We aim to analyse the effects of government subsidies on residents’ health and healthcare expenditure from the perspectives of supply and demand.

Correction: Universal health coverage in the context of population ageing: catastrophic health expenditure and unmet need for healthcare

The original article was published in Health Economics Review 2024 14 :8

Correction: Inequalities in unmet health care needs under universal health insurance coverage in China

The original article was published in Health Economics Review 2024 14 :2

Catastrophic health expenditures: a disproportionate risk in uninsured ethnic minorities with diabetes

Chargemaster prices are the list prices that providers and health systems assign to each of their medical services in the US. These charges are often several factors of magnitude higher than those extended to ...

End-of-life expenditure on health care for the older population: a scoping review

The existing evidence shows that the pattern of health expenditure differs considerably between people at the end-of-life and people in other periods of their lives. The awareness of these differences, combine...

Timing of preventive behavior in the case of a new and evolving health risk: the case of COVID-19 vaccination

Time preferences for preventive behavior under novel risks and uncertain contexts may differ from timing preferences related to familiar risks. Therefore, it is crucial to examine drivers of preventative healt...

Correction: A comparative study of bibliometric analysis on old adults’ cognitive impairment based on web of science and CNKI via CiteSpace

The original article was published in Health Economics Review 2023 13 :56

Public health spending in Sub-Saharan Africa: exploring transmission mechanisms using the latent growth curve mediation model

In response to the imperatives of universal health coverage, structural factors that may hinder the effectiveness of increased spending in sub-Saharan Africa (SSA) need attention. This study assessed the media...

The economic costs of orthopaedic services: a health system cost analysis of tertiary hospitals in a low-income country

Traumatic injuries are rising globally, disproportionately affecting low- and middle-income countries, constituting 88% of the burden of surgically treatable conditions. While contributing to the highest burde...

The Correction to this article has been published in Health Economics Review 2024 14 :41

Cost-utility and cost-effectiveness analysis of disease-modifying drugs of relapsing–remitting multiple sclerosis: a systematic review

Multiple sclerosis (MS) is a chronic, autoimmune, and inflammatory disease. The economic burden of MS is substantial, and the high cost of Disease-modifying drugs (DMDs) prices are the main drivers of healthca...

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Effect of economic and security challenges on the Nigerian health sector

Folashade t alloh.

1 Faculty of Health and Social Sciences, Bournemouth University, UK

Pramod R Regmi

2 Visiting Research Fellow, Chitwan Medical College, Tribhuvan University, Nepal; Datta Meghe Institute of Medical Sciences, India

Dear Editor,

The call on the federal Government of Nigeria to declare a state of emergency in the Nigerian health sector by its federal law makers has come at a time when the health sector of the country is unfortunately in a dysfunctional state. This has been furthered by the fact that the Nigerian economy has suffered setbacks in recent times, particularly with the official announcement of having entered an economic recession by Finance Minister for the federal government in July 2016, after annual inflation increased to 17.1%, the highest in the last decade 1 . This came following the steep fall in the price of crude oil from $115 in 2014 to the current $35 per barrel 2 . Crude oil accounts for 75% of Nigeria's economy, so the fall in oil prices, therefore, has a significant impact on all sectors of the country. In addition to the drop in oil prices, Nigeria is fighting insurgency by Boko Haram, one of the most deadly terror groups in the world. There are also Niger-Delta militants that are bombing oil pipelines in the South-South region of Nigeria in an agitation against the government disrupting the production of crude oil in the area.

In the plethora of issues facing Nigeria as a nation, the health of the citizens became a low priority for the government, especially those in crisis-ridden area. For example, the United Nation Children's Fund (UNICEF) in July 2016 announced the withdrawal of its humanitarian workers to Borno State insurgency victims, due to the threat to the life of health workers in the area. Following the humanitarian workers withdrawal, UNICEF has warned that more than 2 million crisis victims are in dire need of humanitarian aid with more than 1.2 million internally displaced people 3 . This has resulted in more than an estimated 244,000 children having severe malnutrition, with 49,000 at risk of dying if humanitarian aid is not provided in areas mostly affected by the insurgency. The level of acute malnutrition recorded between July and August 2016 was well above the 15% threshold and classified as critical with some cases higher than 50% representing about half of children affected.

Already in some Northern states more than 72% of health centres in Yobe and 60% in Borno have been destroyed due to the insurgency. These challenges have resulted in poor health outcomes for these states' citizens. For example, the African health observatory report by World Health Organisation (WHO), stated that Nigeria experienced the fourth highest maternal deaths among African countries. This led to over 820/100,000 deaths per live births and 109/100 000 children under five deaths per live births translating to 58, 000 women and 750, 000 children dying in 2015 4 .

Nigerian life expectancy which is put at 53 for males and 56 years for females is among the lowest in the world. Similarly, in 2015, less than half (49%) of children in the country were able to receive immunisation of DPT/Penta dose which was far below the 90% target in the Millennium development goal 4 to reduce child mortality. More than half of children in need of immunisation were not reached in 2015 for vaccination against measles and rubella which raises health concerns. WHO 5 has reported three cases of polio in crisis-ridden areas of Borno state: this was after the country reported two years of no polio cases. However, the re-emergence of the two cases might be as a result of the inaccessibility of health workers to reach children in crisis areas.

After the Abuja benchmark declaration in 2001 to spend at least 15% of countries' yearly budget on the health sector, Nigeria has yet to meet the target in any given year. The impact of poor health sector funding is amplified during this worst recession in over a decade in Nigeria. In addition, the federal ministry of health reported reduction in budgetary allocation to the health sector as a gradual decrease from N264.46bn (approx. $839 millions) equivalent to 6.0% of the national budget in 2014 to N257.38bn (approx. $816 millions) equivalent to 4.23% annual budget in 2016 6 . This has resulted as an effect of economic recession, causing the GDP to drop by -2.06% in 2016 as reported by National bureau of statistics 1 . With the lack of funding in Nigeria, the health sector remains incapable of dealing with the health challenges facing the country. These range from poor healthcare framework and co-ordination, fragmented services, scarcity of medicines and medical supplies, old and decaying infrastructure, lack of healthcare access to all, to poor quality of healthcare service delivery and increasing health inequality gaps between rich and poor citizens. In addition, allegations of corruption surrounding many of the country's lawmakers in different scandals over the years have had an effect on the health sector. The need to push health into the forefront of national issues cannot be over emphasised.

The need for the Nigerian federal government to implement the Abuja 2001 declaration benchmark commitment, by setting aside 15% of its yearly budget to revive primary health care in each ward of the federation-as this is the first contact for most poor citizens of the country-is particularly apparent. There is an urgent need for framework and policy regarding sustainable immunisation financing, and also the need for a universal health insurance scheme. In order for the need-based resource mobilisation, development partners' contribution should be clearly identified and represented in the budget to enable transparency and accountability.

The fight against insurgency and economic challenges should not take way attention due to the health sector, as an effective functioning healthcare system is essential for national health security. A way forward will be to look for alternative funding sources outside budgetary allocations and international grants.

Health Expenditure, Health Outcomes and Economic Growth in Nigeria

10 Pages Posted: 12 Nov 2019

Joshua Ogunjimi

University of Ibadan - Department of Economics

Date Written: November 1, 2019

This study examined the relationship among health expenditure, health outcomes and economic growth in Nigeria for the period between 1981 and 2017. This study adopted the Toda-Yamamoto causality framework to examine these relationships. The Augmented Dickey Fuller unit root test was used to check for maximum order of integration of the variables used in the study and the result was one while the Autoregressive Distributed Lag (ARDL) Bounds test approach to cointegration was used to investigate if a long-run relationship exists among the macroeconomic variables used in the study and the result was in the affirmative. The results of the Toda-Yamamoto causality tests showed a unidirectional causality running from health expenditure to infant mortality while there is no causality between real GDP and infant mortality; a unidirectional causal relationship running from health expenditure and real GDP to life expectancy and maternal mortality; and a unidirectional causal relationship running from real GDP to health expenditure. This study therefore recommended that the Nigerian government should make concerted efforts geared towards increasing the health expenditure at least to meet up with the WHO’s recommendation that all countries should allocate at least 13 per cent of their annual budget to the health sector for effective funding as this would bring desired health outcomes and employ the use of modern technology and the services of professional health personnel should be sought to combat the high incidence of maternal and infant mortality in the health sector in Nigeria.

Keywords: Health expenditure, Life expectancy, Infant mortality, Maternal mortality, Toda - Yamamoto causality test, Nigeria

Suggested Citation: Suggested Citation

Joshua Ogunjimi (Contact Author)

University of ibadan - department of economics ( email ).

Department of Economics Ibadan, OK Oyo State 900001 Nigeria

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The state of health economic evaluation research in Nigeria: a systematic review

Affiliation.

• 1 College of Pharmacy, The University of Texas at Austin, Austin, Texas, USA. [email protected]
• PMID: 20550221
• DOI: 10.2165/11536170-000000000-00000

This study assessed the state of health economic evaluation (including pharmacoeconomic) research in Nigeria. A literature search was conducted to identify health economic articles pertaining to Nigeria. Two reviewers independently scored each article in the final sample using a data collection form designed for the study. A total of 44 studies investigating a wide variety of diseases were included in the review. These articles were published in 34 different journals, mostly based outside of Nigeria, between 1988 and 2009. On average, each article was written by four authors. Most first authors had medical/clinical affiliations and resided in Nigeria at the time of publication of the study. Based on a 1 to 10 scale, with 10 indicating the highest quality, the mean quality score for all studies was 7.29 (SD 1.21) and 59% of the articles were of fair quality (score 5-7); 5% were of even lower quality. The quality of articles was statistically significantly (p < or = 0.05) related to the country of residence of the primary author (non-Nigeria = higher), country of the journal (non-Nigeria = higher), primary objective of the study (economic analysis = higher) and type of economic analysis conducted (economic evaluations higher than cost studies). The conduct of health economic (including pharmacoeconomic) research in Nigeria was limited and about two-thirds of published articles were of sub-optimal quality. More and better quality health economic research in Nigeria is warranted.

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African Journal of Health Economics

AFRICAN JOURNAL OF HEALTH ECONOMICS

 AIM AND SCOPE OF THE JOURNAL

African Journal of Health Economics is an International Journal aimed at promoting and sustaining the knowledge, development and application of health economics in health policy and systems in Africa. The areas of interest to the journal include economic analysis of health and healthcare, development of methodologies for health economics and policy analysis that are sensitive enough to significantly reflect differences observed in the African context, health care provision, health care financing, equity and efficiency in service provision and delivery, public health policy and governance, determinants of health and their policy implications, valuation of health, a wide range of health related materials with policy implications, development and evaluation of health systems, programmes and related interventions being carried out in the Africa. It is particularly keen to publish findings and reviews which though originating from the African region, are of general interest to a global readership. Articles originating from other parts of the worlds but which are relevant to policy debates in health systems in Africa are also welcome.     

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AJHE receives manuscripts of the following forms: original research articles, review papers, methods articles, perspective, and letters to the editor. Manuscripts which have a public health focus must sufficiently address health economics and/or health policy implications of the findings of the article to be considered for publication. Those focussing on health policy analysis must provide relevant bodies of theory on which the reviews are based. Where none exists, sufficient justification for not presenting such must be provided.

Authors should note that AJHE addresses a range of international readership including policy makers at national and international levels, programme managers, academics, public health practitioners and other readers interested in application of health economics and policies especially in African countries. It also provides information about such areas of interest to the broader international community that are involved in financial and technical assistance to various countries in Africa. It is therefore expected that submissions must have a high overall quality acceptable in an international journal. The editors reserve the right to reject manuscripts that do not meet such standards.

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The AJHE operates a peer review system and currently receives articles which must be submitted through the editorial office email. The process of review is as follows:

• Following submission, the corresponding author receives an email notification of the receipt of his article and the article is assigned a number.
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• Authors are notified of the decision of reviewers. These may involve an acceptance of the article with or without minor or major revisions, or rejection of the article. Once such decisions are made, the corresponding author will receive the appropriate notification.
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Journal articles

• Culyer AJ, Wagstaff A. Equity and equality in health and health care. Journal of Health Economics. 1993;12(1):431-57.
• De Allegri M, Kouyate B, Becher H, Gbangou A, Pokhrel S, Sanon M, et al. Understanding enrolment in community health insurance in sub-Saharan Africa: a population-based case-control study in rural Burkina Faso. Bull World Health Organ. 2006 Nov;84(11):852-8.

Entire Book

• Billoski TV. Introduction to Paleontology. 6th ed. New York: Institutional Press; 1992.

Book section/chapter

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The State of Health Economic Evaluation Research in Nigeria

A Systematic Review

• Review Article
• Published: 23 September 2012
• Volume 28 , pages 539–553, ( 2010 )

Cite this article

• Paul Gavaza 1 ,
• Karen L. Rascati 1 ,
• Abiola O. Oladapo 1 &
• Star Khoza 1  

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28 Citations

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This study assessed the state of health economic evaluation (including pharmacoeconomic) research in Nigeria. A literature search was conducted to identify health economic articles pertaining to Nigeria. Two reviewers independently scored each article in the final sample using a data collection form designed for the study.

A total of 44 studies investigating a wide variety of diseases were included in the review. These articles were published in 34 different journals, mostly based outside of Nigeria, between 1988 and 2009. On average, each article was written by four authors. Most first authors had medical/clinical affiliations and resided in Nigeria at the time of publication of the study. Based on a 1 to 10 scale, with 10 indicating the highest quality, the mean quality score for all studies was 7.29 (SD 1.21) and 59% of the articles were of fair quality (score 5–7); 5% were of even lower quality. The quality of articles was statistically significantly (p 0.05) related to the country of residence of the primary author (non-Nigeria = higher), country of the journal (non-Nigeria = higher), primary objective of the study (economic analysis = higher) and type of economic analysis conducted (economic evaluations higher than cost studies).

The conduct of health economic (including pharmacoeconomic) research in Nigeria was limited and about two-thirds of published articles were of suboptimal quality. More and better quality health economic research in Nigeria is warranted.

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Acknowledgements

The authors acknowledge help received from The University of Texas at Austin Library in accessing the articles used in the study. Some of the articles were accessed through the university’s interlibrary loan facility.

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest relevant to the content of this review.

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Gavaza, P., Rascati, K.L., Oladapo, A.O. et al. The State of Health Economic Evaluation Research in Nigeria. Pharmacoeconomics 28 , 539–553 (2010). https://doi.org/10.2165/11536170-000000000-00000

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Published : 23 September 2012

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DOI : https://doi.org/10.2165/11536170-000000000-00000

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Health Topics (Nigeria)

The Nigeria country health profiles provide an overview of the situation and trends of priority health problems and the health systems profile, including a description of institutional frameworks, trends in the national response, key issues and challenges. They promote evidence-based health policymaking through a comprehensive and rigorous analysis of the dynamics of the health situation and health system in the country.

Human resources for health

The Federal Ministry of Health has a Human Resources for Health Unit whose functions include the planning, production and management of health manpower at the national level. As part of its planning function, the Unit has produced a Draft National HRH Policy in collaboration with the WHO and is about to develop an implementation plan for the policy.

Nigeria has a number of colleges of medicine, pharmacy, and nursing/midwifery involved in the basic and postgraduate/high level training and re-training of doctors, pharmacists, and nurses/midwives respectively. School of Radiography handles the training of radiographers while Schools of Health Technology train professionals such as Community Health Officers, Community Health Extension Workers, Laboratory Technicians, Pharmacy Technicians, Health Records Officers, and Health Records Assistants.

FMOH collaborates with some local universities concerning the in-service training of health manpower in the some areas.

One of the problems affecting the health sector is the lopsided distribution of health professionals in favour of urban centres. Also, some categories of health manpower are in short supply. There is an uncomfortable mix of under-utilization and over-utilization of the skills of health professionals depending on the geographic location and professional category/sub-category involved.

WHO provide guidance and support for effective analysis, planning and management of health workforce in Nigeria. Further to the development of HRH plan at Federal level, some states will be supported to develop HRH Plans to help focus on HRH at services delivery points, as part of strengthening the health system.

Essential medicines

In Nigeria the majority of patients pay for medicines out of pocket, and unfortunately the cost of medicines is high and consequently unaffordable to most Nigerians. Drug distribution, unauthorized retailing, and poor quality and counterfeit medicines are some of the challenges that complicate the work of the drug regulatory agency NAFDAC who has been working tirelessly to ensure that availability of good quality, efficacious and safe medicines.

A National Drug Policy has been approved and a strategic plan has been developed. WHO plays a key role in galvanizing the support of partners, mobilizing resources and supporting research, as well as taking a lead in implementing some of the provisions of the policy.

Traditional medicines are well accepted in the country. Efforts are being made to properly integrate traditional medicine into the Nigerian health system and WHO is providing technical assistance in furtherance of the African Regional Strategy for promoting the role of Traditional Medicines in the health system.

Health financing and social protection

WHO devotes its efforts in this area to building capacity to obtain health expenditure information and utilize relevant health financing and economic evidence to formulate plans and policies and guide intervention for improving systems of health financing and social protection. WHO also provides technical assistance in determining the financial implications of scaling up priority health interventions in Nigeria.

Nigeria, is just at the point of tapping the full benefits of NHA such as the provision of tool for evidencebased decision-making in health policy, health financing, and health interventions and WHO is building capacity among staff members from the Ministry of Health and related government departments like Bureau of Statistics at State and Federal levels.

Health information, evidence and research policy

WHO is focusing on supporting the development of a strengthened National Health Information System that provides timely and quality information for decision-making. Support will be provided for developing functional Data base of basic indicators taking into Account Health MDGs.

A Services Availability Mapping exercise is being implemented in some states as part of efforts to develop the NHMIS. Development of and support in the use of standardized classification systems, including International Classification of Diseases (ICD), International Classification of Functioning (ICF) and other classifications will be promoted at the state level. National Health Research Policy and Plan and State Level Plans will be supported. In particular, support will be provided for analyses and strengthening of health research systems and health research policies by setting up National and State level coordination mechanism for Health Research, and supporting National Scientific Health Systems Research Dissemination meetings.

Essential national health research will provide information and input into decision making as to choice of cost effective and efficient health interventions. Focus will be on stimulating research into such areas as reducing risk factors and burden of diseases, improving health systems and promoting health as a component of development.

Nigeria’s Expanded Programme on Immunization (EPI) was first initiated in 1979 and the Federal Government of Nigeria through the Federal Ministry of Health continues to place high priority on immunization. In 1999, a new drive to sustainably re-vitalize the immunization system commenced in synergy with the accelerated strategy on polio eradication. Consequently, the Federal Government established the National Programme on Immunization (NPI) whose key focus was to provide support to the implementation of state and LGA immunization programmes.

WHO provided technical support to national authorities at federal, state, local government and ward level to strengthen the implementation of the Reaching Every Ward (REW) strategy and the Government of Nigeria signed a memorandum of understanding with WHO to conduct training on the strategy for health workers at national, state, local government and ward levels.

The support provided by WHO, along with other partners, to the efforts of national authorities in routine immunization contributed to improved access to and coverage of routine immunization services.

The number of fixed immunization service delivery points and outreach immunization sites continues to increase steadily.

Supported by immunization partners Nigeria has made great strides in the last two years, in particular in its polio eradication efforts. This gives hope that the year 2010 could see the interruption of transmission.

One of the major activities of WHO in Nigeria is to support the generation, collation, processing, and dissemination of strategic information on determinants, deterrents and other factors affecting the epidemic and the responses to it. Support is provided for the conduct of sentinel sero-prevalence surveillance among women attending ANC in public facilities. The Behavioral Sentinel surveillance (BSS) and National AIDS and Reproductive Health Survey (NARHS) were also supported.

WHO has also provided technical assistance to review the national VCT guidelines. This was undertaken under the coordination of the Ministry of Health in collaboration with other partners.

WHO has also assisted in conducting a training of ART Site Coordinators, Record Officers and Pharmacists to update them with the tools and procedures for patient tracking which contributes to improved capacity at ART service delivery points.

The UN Theme Group on HIV is the coordinating mechanism for the UN agencies activities in support of the national response. WHO Representative has been the chair of the UNTG since 2004.

The country office has also provided technical support in the elaboration of proposals for various rounds of funding from Global Fund to Fight AIDS Tuberculosis and Malaria and continues to provide such assistance.

Early in 2005 the President of Nigeria gave a directive to reach 250,000 with ARV treatment by June 2006. WHO participated in the elaboration of a framework for achieving the Presidential directive. Four states, namely Oyo, Ekiti, Plateau and Benue were supported by WHO to develop their multi-sectoral action plans for HIV/AIDS.

A future thrust for the WCO will be to continue forging partnership with other UN Organizations through the UN Theme Group on HIV. WHO will also continue to play its role in the Country Implementation Support Team (CIST) which in turn will be one of the committees of the Expanded Theme Group for HIV/AIDS in Nigeria.

Tuberculosis is still a major public health problem in Nigeria, with the country ranking 5th among the 22 high TB burden countries which collectively bear 80% of the global burden of TB. The number of TB cases notified in the country increased from 31,264 in 2002 to 90,307 in 2008; more than 450,000 TB cases have been successfully treated free of charge in the past 5 years in Nigeria. The TB burden in Nigeria is further compounded by the ongoing HIV/AIDS epidemic and the emergence of multi-drug resistant tuberculosis (MDR-TB).

The National Tuberculosis and Leprosy Control Programme was launched 1991. The programme operates at all three tiers of government, with each level having a well trained officer in charge of coordination in all the 774 Local Government Areas in the 36 states of the country and FCT.

The WHO/IUATLD global DOTS strategy for effective TB services was adopted since 1993 as an integral part of PHC.

With the support from partners DOTS has been extended to cover all the states of the Federation and the Federal Capital territory. Partners include WHO, CIDA, USAID, GLRA, NLR, IUATLD and DFB. More Local Government Areas (LGA) are now implementing the DOTS Strategy while there is an increase in the number of laboratory microscopic centers to improve access to diagnosis. The Nigeria Stop TB Partnership was launched in April 2009 to support Government efforts in advocacy and mobilisation of additional resources from the private sector and multilateral organizations for the control of TB in Nigeria and thus improve the chances of reaching the Stop TB and MDG targets for TB control by 2015.

WHO continues to support the government in achieving its goals. The goal of the National TB programme is to reduce, significantly, the burden of TB by 2015 in line with the Millennium Development Goals (MDGs) and the STOP TB Partnership targets which are to detect at least 70% of the estimated infectious (smear-positive) cases and to achieve a cure rate of at least 85% of the detected smear-positive cases so as to reduce TB prevalence and death rates by 50% relative to 1990 level by 2015 and to eliminate TB as a public health problem (

WHO is supporting the Government in carrying out prevalence surveys including a survey of Multi Drug Resistant TB.

Malaria is the most significant public health problem in Nigeria. The economic cost of malaria, arising from cost of treatment, loss of productivity and earning due to days lost from illness, may be as high as 1.3% of economic growth per annum. The disease is a major cause of maternal mortality and poor child development.

Traditionally, the malaria problem has been seen as a challenge for the health sector alone with little or no involvement by other sectors or the general community.

A rational review of treatment policy based on use of ACTs has been approved by national authorities. The multi-sectoral transition committee to guide implementation process, towards promoting access to effective treatment, has been inaugurated and functioning. The RBM partnership is waxing stronger by the day. Scaled up implementation of proven malarial control interventions are being intensified with resources made available by government and stakeholders with the support of RBM partners. WHO is a major player in the partnership, supporting the Secretariat as well partners’ programmes.

WHO’s strategic approach includes continued support for national authorities especially the health ministries in essential public-health functions related to malaria control; promotion of synergies with related health programmes especially those for immunizations, child and maternal health, pharmaceuticals and environmental health; promotion of the participation of communities and civil society; engagement of the private sector in the delivery of prevention and treatment; identification of best practices and financing mechanisms for extending interventions; preparation of tools and support measures for district level management;

WHO intends to continue to improve its capacity at country and state levels in collaboration with HIV/AIDS and Tuberculosis programmes and in cooperation with the Federal Ministry of health has just deployed officers to each zone of the federation to support the scaling up of Malaria interventions.

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Does Income Affect Health? Evidence from a Randomized Controlled Trial of a Guaranteed Income

This paper provides new evidence on the causal relationship between income and health by studying a randomized experiment in which 1,000 low-income adults in the United States received $1,000 per month for three years, with 2,000 control participants receiving $50 over that same period. The cash transfer resulted in large but short-lived improvements in stress and food security, greater use of hospital and emergency department care, and increased medical spending of about $20 per month in the treatment relative to the control group. Our results also suggest that the use of other office-based care—particularly dental care—may have increased as a result of the transfer. However, we find no effect of the transfer across several measures of physical health as captured by multiple well-validated survey measures and biomarkers derived from blood draws. We can rule out even very small improvements in physical health and the effect that would be implied by the cross-sectional correlation between income and health lies well outside our confidence intervals. We also find that the transfer did not improve mental health after the first year and by year 2 we can again reject very small improvements. We also find precise null effects on self-reported access to health care, physical activity, sleep, and several other measures related to preventive care and health behaviors. Our results imply that more targeted interventions may be more effective at reducing health inequality between high- and low-income individuals, at least for the population and time frame that we study.

Many people were instrumental in the success of this project. The program we study and the associated research were supported by generous private funding sources, and we thank the non-profit organizations that implemented the program. We are grateful to Jake Cosgrove, Leo Dai, Joshua Lin, Anthony McCanny, Ethan Sansom, Kevin Didi, Sophia Scaglioni, Oliver Scott Pankratz, Angela Wang-Lin, Jill Adona, Oscar Alonso, Rashad Dixon, Marc-Andrea Fiorina, Ricardo Robles, Jack Bunge, Isaac Ahuvia, and Francisco Brady, all of whom provided excellent research assistance. Alex Nawar, Sam Manning, Elizabeth Proehl, Tess Cotter, Karina Dotson, and Aristia Kinis were invaluable contributors through their work at OpenResearch. Carmelo Barbaro, Janelle Blackwood, Katie Buitrago, Melinda Croes, Crystal Godina, Kelly Hallberg, Kirsten Jacobson, Timi Koyejo, Misuzu Schexnider, and the staff of the Inclusive Economy Lab at the University of Chicago more broadly have provided key support throughout all stages of the project. Kirsten Herrick provided help with the nutrition diary data collection effort of this project. We are grateful for the feedback we received throughout the project from numerous researchers and from our advisory board, as well as useful feedback from seminar and conference participants. This study was approved by Advarra Institutional Review Board (IRB).We received funding for this paper from NIH grant 1R01HD108716-01A1. Any views expressed are those of the authors and not those of the U.S. Census Bureau. The Census Bureau has reviewed this data product to ensure appropriate access, use, and disclosure avoidance protection of the confidential source data used to produce this product. This research was performed at a Federal Statistical Research Data Center under FSRDC Project Number 3011. (CBDRB-FY24-P3011-R11537). The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.

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Research, Innovation Critical To Addressing Nigeria’s Health Challenges – FG

Minister of State for Health and Social Welfare, Dr. Tunji Alausa, has said that health research is critical to addressing Nigeria’s Unique heath challenges.

The minister stated this on Wednesday at the National Strategic Meeting on Health Research Development and Innovation, in Abuja.

The meeting brought together a distinguished assembly of experts, policymakers, researchers, and stakeholders dedicated to advancing the nation’s health through research and innovation.

Dr. Alausa said “Nigeria, with its diverse population and unique health challenges, stands at a critical juncture in its journey towards achieving optimal health outcomes for all its citizens. In this quest, the role of health research and innovation cannot be overstated.”

He highlighted the significance of the meeting as an opportunity to reflect on progress, identify gaps, and chart a strategic path forward.

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He extended his gratitude to the National Health Research Committee, National Health Research Ethics Committees, research agencies such as NIMR, NIPRID, NICRAT, the NCDC, and partners like the World Health Organisation. He also acknowledged the participation of prominent figures such as Professor Ogunsola, VC of the University of Lagos.

“Your dedication and hard work are the backbone of our national health research agenda. Together, we have the potential to create a vibrant and sustainable research environment that drives innovation, enhances health outcomes, and ultimately ensures a healthier and more prosperous Nigeria,” Dr. Alausa stated.

He urged participants to think boldly and creatively, embrace collaboration, and translate research findings into impactful policies and practices. He expressed confidence that the strategic meeting’s outcomes would significantly advance the national health research agenda and contribute to the nation’s health and social welfare goals.

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Large language models don’t behave like people, even though we may expect them to

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One thing that makes large language models (LLMs) so powerful is the diversity of tasks to which they can be applied. The same machine-learning model that can help a graduate student draft an email could also aid a clinician in diagnosing cancer.

However, the wide applicability of these models also makes them challenging to evaluate in a systematic way. It would be impossible to create a benchmark dataset to test a model on every type of question it can be asked.

In a new paper , MIT researchers took a different approach. They argue that, because humans decide when to deploy large language models, evaluating a model requires an understanding of how people form beliefs about its capabilities.

For example, the graduate student must decide whether the model could be helpful in drafting a particular email, and the clinician must determine which cases would be best to consult the model on.

Building off this idea, the researchers created a framework to evaluate an LLM based on its alignment with a human’s beliefs about how it will perform on a certain task.

They introduce a human generalization function — a model of how people update their beliefs about an LLM’s capabilities after interacting with it. Then, they evaluate how aligned LLMs are with this human generalization function.

Their results indicate that when models are misaligned with the human generalization function, a user could be overconfident or underconfident about where to deploy it, which might cause the model to fail unexpectedly. Furthermore, due to this misalignment, more capable models tend to perform worse than smaller models in high-stakes situations.

“These tools are exciting because they are general-purpose, but because they are general-purpose, they will be collaborating with people, so we have to take the human in the loop into account,” says study co-author Ashesh Rambachan, assistant professor of economics and a principal investigator in the Laboratory for Information and Decision Systems (LIDS).

Rambachan is joined on the paper by lead author Keyon Vafa, a postdoc at Harvard University; and Sendhil Mullainathan, an MIT professor in the departments of Electrical Engineering and Computer Science and of Economics, and a member of LIDS. The research will be presented at the International Conference on Machine Learning.

Human generalization

As we interact with other people, we form beliefs about what we think they do and do not know. For instance, if your friend is finicky about correcting people’s grammar, you might generalize and think they would also excel at sentence construction, even though you’ve never asked them questions about sentence construction.

“Language models often seem so human. We wanted to illustrate that this force of human generalization is also present in how people form beliefs about language models,” Rambachan says.

As a starting point, the researchers formally defined the human generalization function, which involves asking questions, observing how a person or LLM responds, and then making inferences about how that person or model would respond to related questions.

If someone sees that an LLM can correctly answer questions about matrix inversion, they might also assume it can ace questions about simple arithmetic. A model that is misaligned with this function — one that doesn’t perform well on questions a human expects it to answer correctly — could fail when deployed.

With that formal definition in hand, the researchers designed a survey to measure how people generalize when they interact with LLMs and other people.

They showed survey participants questions that a person or LLM got right or wrong and then asked if they thought that person or LLM would answer a related question correctly. Through the survey, they generated a dataset of nearly 19,000 examples of how humans generalize about LLM performance across 79 diverse tasks.

Measuring misalignment

They found that participants did quite well when asked whether a human who got one question right would answer a related question right, but they were much worse at generalizing about the performance of LLMs.

“Human generalization gets applied to language models, but that breaks down because these language models don’t actually show patterns of expertise like people would,” Rambachan says.

People were also more likely to update their beliefs about an LLM when it answered questions incorrectly than when it got questions right. They also tended to believe that LLM performance on simple questions would have little bearing on its performance on more complex questions.

In situations where people put more weight on incorrect responses, simpler models outperformed very large models like GPT-4.

“Language models that get better can almost trick people into thinking they will perform well on related questions when, in actuality, they don’t,” he says.

One possible explanation for why humans are worse at generalizing for LLMs could come from their novelty — people have far less experience interacting with LLMs than with other people.

“Moving forward, it is possible that we may get better just by virtue of interacting with language models more,” he says.

To this end, the researchers want to conduct additional studies of how people’s beliefs about LLMs evolve over time as they interact with a model. They also want to explore how human generalization could be incorporated into the development of LLMs.

“When we are training these algorithms in the first place, or trying to update them with human feedback, we need to account for the human generalization function in how we think about measuring performance,” he says.

In the meanwhile, the researchers hope their dataset could be used a benchmark to compare how LLMs perform related to the human generalization function, which could help improve the performance of models deployed in real-world situations.

“To me, the contribution of the paper is twofold. The first is practical: The paper uncovers a critical issue with deploying LLMs for general consumer use. If people don’t have the right understanding of when LLMs will be accurate and when they will fail, then they will be more likely to see mistakes and perhaps be discouraged from further use. This highlights the issue of aligning the models with people's understanding of generalization,” says Alex Imas, professor of behavioral science and economics at the University of Chicago’s Booth School of Business, who was not involved with this work. “The second contribution is more fundamental: The lack of generalization to expected problems and domains helps in getting a better picture of what the models are doing when they get a problem ‘correct.’ It provides a test of whether LLMs ‘understand’ the problem they are solving.”

This research was funded, in part, by the Harvard Data Science Initiative and the Center for Applied AI at the University of Chicago Booth School of Business.

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Euromonitor International wins 13 titles at FocusEconomics 2024 Awards

• Euromonitor receives 60 awards for forecasting across six categories
• Prestigious awards recognise accurate forecasting in country-level macroeconomic categories  

London, UK – Euromonitor International’s Economies and Consumers Team has been named the top forecaster in 13 categories at the prestigious FocusEconomics 2024 Analyst Forecast Awards .  

Euromonitor’s Economies and Consumers Team has won two top prizes as a forecaster in the Financial Sector category and 11 country-specific top prizes in the Real Sector category, rounding up a highly successful evening for the market researchers.  

The annual awards recognise the most accurate economic forecasters for six key macroeconomic indicators for more than 100 countries – GDP, Fiscal Balance, Inflation, Interest Rate, Exchange Rate and Current Account .  

Lan Ha, Head of Economies Research   at Euromonitor International , said: “ I am delighted with our Economies and Consumers Team’s continued success at these highly regarded awards. We stand firmly among top industry leaders, demonstrating real expertise in the field of economic forecasting. Our team’s dedicated and robust analytical skills have culminated in numerous awards acro ss categories and countries.”  

The categories where Euromonitor International’s Economies and Consumers Team was ranked as the number one forecaster are:  

• Financial Sector: Bangladesh, Inflation
• Financial Sector: Denmark, Inflation
• Real Sector: Bosnia, Current Account
• Real Sector: Bosnia, Overall
• Real Sector: Ecuador, Overall
• Real Sector: France, Current Account
• Real Sector: Hong Kong, Current Account
• Real Sector: Lithuania, Current Account
• Real Sector: Macedonia, Current Account
• Real Sector: Netherlands, Current Account
• Real Sector: Nigeria, GDP
• Real Sector: Norway, Current Account
• Real Sector: Singapore, Current Account  

On top of the 13 first-place prizes, Euromonitor International was also ranked runner-up in 30 financial categories, including the prestigious Financial Sector USA inflation category, and took third place in a further 17 categories. Overall, Euromonitor collected 60 top three finishes at the awards.  

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