THE NIGERIAN HEALTH SYSTEM Flashcards by Iseoluwa Ojo

Population = approx. ___________
(140431790) _____ Census
• Projected - 211,400,708

•State – ____ States and FCT

. 140 million

2006 Census

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____ geopolitical zones- list them

NW,NC,NE,SW,SE,SS

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• LGA - _______ Local Governments Areas
• LGAs divided into _______
• _______ Wards

• _____ Wards in Lagos State (mega city)

774 ; wards

8,812

376

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_______ are the smallest geopolitical units

Wards

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• Each ward population = __________
• Target = at least one standard PHC/ward

30-50 thousands

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Responsibilities of the 3 tiers of Government
• Federal Government: (_________) healthcare
• State Government: (_________) healthcare
• Local Government Authorities – LGA:
(__________) health care

tertiary

secondary

primary

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Provision of Health Care in Nigeria
By the three tiers of government
• The primary health care system is managed by the _______ ______ with support from the _______ and _______
government.
First level (Patients are often referred to
the secondary - tertiary health care levels).
•

774 LGAs

States and Federal

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Provision of Health Care in Nigeria
By the three tiers of government

Secondary health care system (_________ hospital-first level of speciality) is managed by the ____________ at the State level

General

Minstry of Health

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Provision of Health Care in Nigeria
By the three tiers of government

Tertiary health care is provided by the _________ hospitals/_________ hospitals is managed by the federal
governent (In some cases, state governments, voluntary or non-governmental organizations, private
practtitioners)

teaching

specialist

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Health Care Reforms Launched in Nigeria (1)
• ________ development plan
• _____________ Scheme
• _____________
• __________ Reform
• _____________________ Scheme

• Ten-year development plan
• Basic Health Care Scheme
• Primary Health Care
• Health Sector Reform
• Nigerian Health Insurance Scheme

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Private Health Sector

• In addition to the public health sector, Nigeria has a viable private health sector that provides various health services ranging from ________ care to
_________ care services.
• These include private not for profit sector notably Non Governmental Organizations (including _________ organizations), individuals, and the for-
profit sector, which is dominated by ________ hospitals, clinics and registered _______ shops.
• There is substantial community contribution to health care in the country especially at ___________
care level.

primary ; tertiary

religious ; private

drug ; primary

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Health Care Reforms Launched in Nigeria (2)
• Year _______ - first attempt to establish Ward Health or Ward Development Committees (WHCs/WDCs).
• LGAs supervised and controlled funding to wards.

______ -National/State Health Reform Laws introduced
- State PHC Boards & Local Government Health
Authorities, (LGHAs) established
- WHCs/WDCs established or reconstituted. All
backed by the enabling law.
- Health Facility Management Teams inaugurated or
re-constituted

2000

2006

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Challenges of Health System in Nigeria
• Indicators of health in Nigeria
• Health Institutions (as at 2011)
• 33,303 general hospital,
• 20278 primary health centres,
• 59 teaching hospital and federal medical centres
• Health access- ( low or high?)
• Health Service Provision
• Private Vendors-____%
• Government- ____\%

Low

70;30

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Challenges of Health System in Nigeria
• NHIS – _____%
• Employed by informal sector -52-60%
• Sub-standard drugs – _____%
• Over ____% of the population live below poverty line
• Poor ________ system between various tiers of health care
• Poor monitoring and evaluation
• Poor _______________ system

40%
70%
50%
referral
disease tracking

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Challenges of Primary Health Care Implementation
Challenges of the first 3 national attempts:
• Inadequate __________
• Poor ______________
• Low ___________________
• Inadequate __________

infrastructure
community participation
political commitment
funding

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Challenges of Primary Health Care Implementation in Lagos State before 2007
• Poor ______________ by LGAs
❑No ______ organ to co-ordinate PHC
implementation by LGs and LCDAs.
• Low Level _____________
❑No functional PHC _________ Structures.
• Dilapidated ___________:
❑198 poorly maintained Primary Health
Centres

Coordination ; state

Community Participation

Management ; Infrastructure

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Challenges of Primary Health Care
Implementation in Lagos State before 2007
• Inadequate ___________
❑No __________.
• Inadequate __________.

Personnel

Pharmacist.

staff capacity.

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FUNCTIONS OF PHC BOARD/AGENCY
• Coordinate _________ , _________, _________ and Evaluation of PHC Services
• ___________ Commissioner for Health and Executive Chairmen of Local Governments and Local Council Development Areas on matters regarding PHC Services.
• Improve / establish Policies in respect of Primary Health Care implementation
matters (e.g. two-way referral, management of primips, payment for service, health
insurance)

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Planning, Budgeting, Monitoring

Advise

Challenges of Primary Health Care
Implementation in Lagos State before 2007
•Poor ————-

•____________ of Essential Drugs
and other commodities.
•Poor Data Management.

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Staff Attitude

Irregular supply

FUNCTIONS OF PHC BOARD/AGENCY (2)

• Coordinate ____________ in collaboration with partners
• Organize programmes on ______ involvement in health care
• Ensure Manpower Planning, Development and Training (
additional training of _________ in the College of Health Technology
and linking with nearest PHC for accreditation and supervision in
collaboration with the Traditional Medicine Board
• Monitor activities of Local Government Health Authorities.
• Recruit and promote PHC staff on GL.07 and above. NB:
previously handled by the Local Government Service
Commission.

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WHC trainings

male

TBAs

The need to ensure _______ in the delivery of health care services and
improve access, informed the development of the ______________________________ (WMHCP) in line with the ward health system
currently being implemented at the primary health care level in Nigeria.

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equity

Ward Minimum Health Care Package (WMHCP)

The WMHCP targets the grass root for the delivery of a minimum set of
primary health care interventions needed to meet the basic health
requirements of a majority of Nigerians, resulting in substantial reduction in morbidity and mortality and contributing significantly to
achieving “Health for All”.

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Yeahhhh

Description of a Ward
• The ward is the smallest political structure, consisting of a
geographical area with a population range of ________ to ________
people.
• There are on average, ________ wards per LGA, each represented by an
elected councillor.

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10,000

30,000

ten (10)

The main rationale for selecting a ward as an operational area for
delivering a minimum health care package was to mobilize _______________ to health service delivery as a requisite for social development.

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political commitment

Description of a Ward (2) Structurally, each ward has a Ward Development Committee composed of the following: • A Ward/Clan ________ as Patron • An elected ________ • ________, • ________ of village/community development committees, • ________ of school, • Senior agricultural extension worker, • ________ ________ officer, • Representatives of ________ groups (which includes VHW/TBA, NGO/International Organizations, Religious Groups, Women and Youth groups, chairmen of patent medicine and store dealers, traditional healers), • Heads of facilities in the area).

Head ; Chairman Secretary ; Chairmen Headmaster of Community Development occupational

Overall Goal of delivering the Ward Minimum Health Care Package Goal • To contribute to __________ __________ __________. Purpose: • Reduce __________ and __________; in the Nigerian communities.

national socio-economic development. morbidity ; mortality

Minimum Health Care Package The Minimum Health Care Package include the following health interventions: • ______________________________(____________________) • Child ________ • ________ and ________ Care • ________ • ________ Disease Prevention • Health ________ and Community ________

Control of Communicable Diseases (Malaria, STI/HIV/AIDS, TB) survival Maternal ; New born Nutrition ; Non Communicable Education ; Mobilization

In order to implement this set of minimum health care packages, communities will be mobilized using appropriate _____/_____ strategies. Functional health infrastructure, human resources/manpower and financial resources would also be provided to support health service delivery at the ward level. Therefore, the following services are required: • Provision of ____________ • ________________ for Health • Health __________ Development

IEC/BCC strategies. Essential Drugs Human Resources Infrastructure

Minimum Health Package for malaria control: • Availability of _______________ (ITNs) for all pregnant women and children under five (5) years of age; and insecticide for re-treatment, or long lasting ITNs. • Provision and use of _________________________________ for treatment of uncomplicated malaria. • Institutionalizing effective case management of malaria in the community and all health facilities. • Provision of _____________________ for Intermittent Preventive Treatment in pregnant women.

Insecticide Treated Nets (ITNs) Artemisinin based Combination Therapy (ACT) Sulphadoxine-Pyrimethamine

Minimum Health Package for Tuberculosis • Provision of basic laboratory infrastructure and equipment in all ward health centres for ______________________ of tuberculosis. {microscope, slides and slide covers, stains, swaps, sterile sputum receptacles, disposable gloves} • Ensure the availability of drugs and infrastructure for _____________________________ (DOTS) {Rifampicin, INH, Pyrazinamide, Streptomycin, Ethambutol etc for all identified cases}

case identification Direct Observation Treatment Short Course (DOTS)

Minimum Health Package for STI/HIV/AIDS • Availability of ______________________ (VCT) services; {i.e trained Counsellors, conducive infrastructure and Rapid Test kits for HIV} in all Wards. Counselling would include _____________ options. • Provision of ________ and establishment of logistic mechanisms for their distribution. • Treatment of ________ infections {trained staff, appropriate drugs; {refer: National essential drugs list} • Routine implementation of _______ and _______ activities

Voluntary Counselling and Testing (VCT) safe infant feeding condoms ; Opportunistic IEC and BCC

CHILD SURVIVAL: Situation Analysis • In Nigeria, children under five years of age constitute a significant ____% of the total population. • The infant mortality rate is _____ per 1000 live births. There is also a wide regional variation in the distribution of infant and neonatal mortality. • Based on the magnitude of these problems, several child survival programmes on control of diarrhoea diseases and acute respiratory infections, growth monitoring, breast feeding, immunisations etc have been instituted and are currently being implemented in the country.

20% 57.7

Common childhood diseases like ________, Acute Respiratory Infections (particularly ___________ ), _________,____________ and _______________________ (VPDs) especially _______ are the leading causes of mortality and morbidity in Nigeria.

Malaria; pneumonia Diarrhoea ; Malnutrition Vaccine Preventable Diseases; measles

Minimum Health Package for Child Survival include: • To have at least ______% of Health workers trained on IMCI in each Ward: the training is to pay particular attention to _________ and the need for prompt _______. • To have at least _____ trained and functional Community Resources Persons (CORPs) per Ward. • Each LGA to have adequate _________ equipment {Deep freezers, cold boxes, vaccine carriers, ice-packs, constant electricity supply, alternative source of power supply}.

60% ; new born care referral ; 30 cold chain

Minimum Health Package for Child Survival include: • All facilities to have _________ and _________ • Each LGA to have at least a designated motor vehicle or boat as appropriate; and each ward to have designated motorcycle as appropriate for distribution of Vaccines. • Every under-five child to be provided with a ________ card. • Essential drugs including ______ (low osmolar) sachets, Zinc tablets and appropriate antibiotics to be available at all health facilities

vaccine carriers ; ice packs child health; ORT

COMPONENT 3: MATERNAL AND NEWBORN CARE Situation Analysis • The maternal mortality rate in Nigeria is estimated to be _____ per 100,000 live births (with regional variations), representing approximately ___% of all deaths in women of childbearing age. • This has been attributed to inadequate number of _________________ , low _______ and poor ________ of services, poor ________ of care, ___________ access to emergency obstetric care, weak community support, lack of ______ involvement, and low status of women, _______ and low _________ levels. • Lack of _________ commitment, inadequate funding of the health sector leading to deterioration of health infrastructures and services, have also been noted as key factors contributing to high maternal mortality in Nigeria.

814 ; 25% skilled health providers morale ; utilization ; quality uneven ; male poverty ; literacy political

Minimum Health Package for Maternal and Newborn Care The following minimum package for Safe Motherhood is the establishment of One (1) _________________________ (BEOC) in each Ward. • Adequately staffed including ______ midwives or Nurse/midwife (double qualified) for 24 hours coverage. Basic staff skill would include ability to provide focused antenatal care, perform ‘_________ of _________ and placenta products; provide _________________ care and effective ____________ care. • Provided with the all basic obstetric ___________ • Provided with adequate stock of _____________________Garment • Provided with basic obstetric drugs; including oxytocin, misoprostol, sedatives and antibiotics. • Provided with __________ Facilities for referral.

Basic Essential Obstetric Care Centres (BEOC) four (4) manual removal of placenta neonatal ; post natal equipment ; Non-Pneumatic Anti-Shock transportation

COMPONENT 4: NUTRITION Situation Analysis • The nutritional status of the vulnerable groups, notably women and children in Nigeria is poor. • The nutritional problems include protein energy malnutrition as well as the deficiencies of ________ , ________ and ________. • In addition, nutritional deficiencies have been found to contribute to high rates of morbidity and mortality in Nigeria, especially amongst infants and young children. • However, the feeding practices contribute to the prevalence of malnutrition.

iron, iodine and vitamin A.

Minimum Health Package for Nutrition • Health and Nutritional Educational materials • Provision of equipment for _________________________ in all wards. {Kitchen and Food demonstration space in designated health facilities, appropriate cooking implements, Appropriate refrigerating apparatus, Food demonstration charts, Plates, spoons etc, Trained health staff.} • Establishment of Community-based _________________ in all communities by trained volunteers, with appropriate equipment {Mosley scale, Tape rule, Child health Cards} and health facility based growth monitoring. • Implementation of food Security programme at household and community levels.

food demonstration growth monitoring

The following NCDs are noted to be increasing in prevalence in Nigeria; __________ , __________ disease, __________ disease, __________ , __________ related diseases, __________ , ________ health and _________ Health conditions, __________ related diseases (e.g. asbestosis and silicosis), malnutrition and _________________.

hypertension ; coronary heart sickle cell ; Diabetes Mellitus smoking ; cancers oral ; mental occupational ; bronchial asthma.

Minimum Health Package for Non-Communicable Diseases: The following minimum package on NCDs at the primary care level: • Capacity building of health workers for prevention and control of NCDs in all facilities. • Availability of IEC materials on NCDs displayed in all facilities. • Provision of basic equipments for _________ and ______________ of NCDs i.e. Sphygmomanometer, Weighing Scale, Hyetometer, Urine Test Kits etc. (Refer section on equipment)

screening early diagnosis

_______________________ (IEC) and __________________ (BCC)

Information Education and Communication (IEC) and Behavioral Change Communication (BCC)

Minimum Package For Health Education And Community Mobilization Based on the above targets the following minimum package for health education and community mobilization is proposed: • At least _______ Health workers and ______ members of the VDC/WDC per ward are trained as Health Educators. • Every facility to have relevant __________________ conspicuously displayed with _____________________ language and graphics. • A logistic vehicle or motor cycle with _____________________ to be available at LGA level for the purpose of health education

two (2) ; two (2) I.E.C materials cultural acceptable public address system

THE NIGERIAN HEALTH SYSTEM Flashcards

(43 cards)