Impact of government policies on health in Africa: Analysis of the Nigerian experience

The crisis in the health sector in Nigeria has become pronounced over the past two decades. The problems facing the sector include a decline in the funds allocated to the health sector, a marked deterioration in the training of health manpower and quality of health services. Other problems, particularly the biased manner in which health resources are spent, the areas of professional training that are emphasized, and the concentration of health institutions and professionals in the southern part of Nigeria, all reveal the nature of the crisis. In this respect, some of the themes that are explored throughout this analysis, include bias, regional inequality, and deterioration. Therefore, this study is significant because it shows how political decisions impact upon health. The data from two teaching hospitals, information about the quality of resources devoted to the health sector, and the training of health manpower, all point to the fact that government policies impinge upon the viability of the health sector. Some of the specific policies that have been detrimental to health are structural adjustment initiatives, inadequate funding of health, location of most training facilities in the south, and the preference for tertiary medicine. However, some of the problems facing the health sector stem from lack of administrative capacity, which manifests itself in the mismanagement of available resources and the schism between hospital administrators and health personnel. In sum, while government policies are mostly to blame for the health problems in Nigeria, the managerial deficiencies at the hospital level have also contributed to the malaise in the health sector.