Abstract:

Efforts geared towards strengthening health systems and improving health outcomes necessitated the co-operation between developed and developing countries for long term international developmental assistance for the latter. These efforts climaxed with the signing of the United Nations millennium development goals which created a platform for the ‘injection’ of billions of dollars of donor funds, technical assistance, inter alia, into countries with great need. Accordingly, there are reflections of marked achievements towards achieving the envisaged objective(s) in recipient countries such as Nigeria. In fact, the impact of donor support for health system strengthening in Nigeria has being remarkable with funding to combat major health problems reaching unprecedented levels in recent times with improvements on certain fronts. Of such include, decrease in the prevalence of HIV/AIDS, Tuberculosis and the eradication of guinea worm, as well as capacity development and health facility infrastructural upgrades. Nevertheless, these obvious gains have not being without issues of concern hitherto. Cardinal amongst these is that not all the developmental support is reaching communities with the greatest of needs or being delivered in a manner that is proving effective. More so, are the issues of corruption, abdication of co-operate social responsibilities by the government in certain instances to donor partners, as well as the rising ‘ineptitude’ in many of the recipient communities that has fast created a climate were self-reliance is being ebbed into a place called the past. The argument therefore is that the merits and demerits of donor support for health system strengthening in Nigeria has created debates, needing further reflections thereof.

References:

1.      Aid to Africa, Policy Brief. 2010. Available Online at <http://www.un.org/africa/osaa/reports/2010_Aidbrief.pdf> Accessed 30^th April, 2013.

2.      Carter Foundation 2013. Available at <http://www.cartercenter.org/health/index.html> Accessed 2^nd May, 2013.

3.      Central Intelligence Agency (CIA) World Facts Book. 2013. Available Online at <https://www.cia.gov/library/publications/the-world-factbook/fields/2119.html> Accessed 16^th September, 2013.

4.      Conn CP, Jenkins P, Touray SO. Strengthening health management: experience of district teams in The Gambia. Health Policy and Planning. 1996; 11(1): 64–71.

5.      Delph, E. Global Vertical Programmes. The Future of Aid or a Quick Fix? Quezon City, the Philippines: EURODAD. 2008.

6.      Ejughemre U. Donor Support and the Impacts on Health System Strengthening in Sub-Saharan Africa: Assessing the Evidence through a Review of the Literature. American Journal of Public Health Research, 2013, Vol. 1, No. 7, 146-151

7.      Ejughemre U.J. Accelerated reforms in healthcare financing: the need to scale up private sector participation in Nigeria. International Journal of Health Policy and Management, 2014, 2(1), 1–7.

8.      Gottret15. P, Schieber G. Health financing revisited: a practitioner’s guide. Washington, DC: The World Bank; 2006.

9.      Hayman, R., Taylor, E.M., Crawford, F., Jeffery, P., Smith, J., Harper, I. The impact of aid on maternal and reproductive health. A systematic review to evaluate the effect of aid on the outcomes of Millennium Development Goal 5. London: 2011. EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.

10.  Health Reform Foundation in Nigeria (HEFRON). Primary Health Care in Nigeria, the effect of socio-cultural, economic, and political factors. Nigeria Health Review 2007:24.

11.  Information Nigeria. Available at <http://www.informationng.com/2011/11/donor-recipients-differ-over-n1-6b-aids-fund-for-nigeria.html> 2013, Accessed 1^st May, 2013.

12.  Jan De Maeseneer. Strengthening primary care: addressing the disparity between vertical and horizontal investment. Br J Gen Pract. 2008 January 1; 58(546): 3–4.

13.  Kim, J.Y., Gilks, C.F: Scaling up treatment – why we can't wait. New England Journal of Medicine 2005, 353:2352-2354

14.  Kim, J.Y., Gilks, C.F: Scaling up treatment – why we can't wait. New England Journal of Medicine 2005, 353:2352-2354.

15.  Kirigia M.J, Diarra-Nama A. Can countries of the WHO African Region wean themselves off donor funding for health? Bulletin of the World Health Organization 2008;86:889–895

16.  Kirigia, J.M., Emrouznejad, A., Cassoma, B., Asbu, E.Z., Barry, S.A. Performance assessment method for hospitals: the case of municipal hospitals in Angola. Journal of Medical Systems 2008.

17.  Lewis, M. “Health and Corruption in Developing and Transition Countries”. Presented at the Transparency International Annual Conference, 2003. Seoul, Korea

18.  Novignon J, Olakojo SA, Nonvignon J. The effects of public and private health care expenditure on health status in sub-Saharan Africa: new evidence from panel data analysis. Health Econ Rev 2012; 2: 22.

19.  Nigeria Must Do Away With Donor Funds To Fight HIV/AIDS. Channels Online, available at <http://www.channelstv.com/home/2013/06/13/nigeria-must-do-away-with-donor-funds-to-fight-hivaids/> Accessed 23^rd February, 2014.

20.  Okungu V. Has health aid failed to mitigate out-of-pocket expenditure in developing countries? International Health Policies News. 2011. Available at <http://e.itg.be/ihp/archives/health-aid-failed-mitigate-out-of-pocket-expenditure-developing-countries/> Accessed 5^th May, 2013.

21.  Oliveira-Cruz V, Kurowski C and Mills A. Delivery of Priority Health Services: Searching For Synergies within the Vertical versus Horizontal Debate. Journal of International Development J. Int. Dev. 2003;15, 67–86.

22.  Price JE, Leslie JA, Welsh M, Binagwaho A, 2009. Integrating HIV clinical services into primary health care in Rwanda: a measure of quantitative effects. AIDS Care 21: 608–614.

23.  Meessen B, Soucatb A, Sekabaragab C. Bull World Health Organ 2011;89:153–156.

24.  Renner, A., Kirigia, J. M., Zere, A.E., Barry, S.P., Kirigia, D.G., Kamara, C., Muthuri, HK. Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application. BMC Health Serv Res 2005;5:77.

25.  Smith DJ. AIDS NGOS and Corruption in Nigeria. Health Place. 2012; 18(3): 475–480.

26.  Schoen C, Osborn R, Squires D, Doty MM, Pierson R, Applebaum S. How health insurance design affects access to care and costs, by income, in eleven countries. Health Aff (Millwood) 2010; 29: 2323–34.

27.  The Global Funds (GFTAM) 2013. Online available at <http://portfolio.theglobalfund.org/en/Country/Index/NGA> Accessed 16th February, 2014.

28.  The Post. SURE-P Targets More Investment in Health Sector (2013). Available Online at <http://thepost-ng.com/sure-p-targets-more-investment-in-health-sector/#.UleA7VBwocc> Accessed 10^th October, 2013.

29.  The United Nations General Assembly Session 55, Meeting 3. 6^th September, 2000.

30.  United Nations Summit Agenda; The largest gathering of world leaders in history meets in New York to discuss the role of the United Nations in the 21st century.". BBC News. 7^th December, 2000. Retrieved 22^nd November, 2006.

31.  United Nations Millennium Development Goal: Combat HIV/AIDS, Malaria and Other Diseases. MDG Monitor. Retrieved 18^th October, 2012.

32.  United Nations Millennium Development Goal: Reduce Child Mortality". MDG Monitor.

33.  Vian, T. Review of corruption in the health sector: theory, methods and interventions. Health Policy and Planning, 2008;23:83-94.

34.  WHO. 1996. Integration of health care delivery. Report of a WHO study group. Technical Report Series 861, Geneva.

35.  World Bank. 2005a. Doing Business in 2005: Removing Obstacles to Growth. Washington, D.C.: World Bank

36.  World Health Organization “Declaration of Alma Ata: International Conference on Primary Health Care, Alma Ata, USSR 6-12 September, 1978”. Available at <www. who.int /hpr/NPH /docs /declaration_almaata.pdf> Accessed 26^th June 2012.

37.  World Bank Data on HIV/AIDS - adult prevalence rate (%) in Nigeria, available online from Index mundi at http://www.indexmundi.com/g/g.aspx?c=ni&v=32> Accessed 23^rd February, 2014.

38.  World Bank Data on incidence Of Tuberculosis (Per 100,000 People) in Nigeria, available online from Index mundi at <http://www.indexmundi.com/facts/nigeria/incidence-of-tuberculosis> Accessed 23^rd February, 2014.

39.  WHO certifies Nigeria Guinea Worm free. Premium Times. Online, available at <http://premiumtimesng.com/news/153401-certifies-nigeria-guinea-worm-free.html> Accessed 23^rd February, 2014.

40.  Yu D, Souteyran Y, Banda MA, Kaufman J, Perriëns JH. Investment in HIV/AIDS programs: Does it help strengthen health systems in developing countries? Globalization and Health 2008, 4:8.