SEMINAR PAPER

ON
HEALTH ADMINISTRATION IN NIGERIA

SUBMITTED TO THE FACULTY OF NURSING

ACHIEVERS UNIVERSITY, OWÓ, ONDO STATE.

BY
ADEBAYO TAIWO REBECCA
AUO20AN3156
COURSE CODE : NSC412
COURSE TITLE : SEMINAR IN NURSING

LECTURER IN CHARGE : PROF. S. K. OLUBIYI, MRS M. I.

OMOTORIOGUN

APRIL, 2024
TABLE OF CONTENT
1.0 Introduction

2.0 Objectives

3.0 Main Content

3.1 Definition of terms

3.2 Importance of Health administration in Nigeria

3.3 Challenges in Health administration in Nigeria

3. 4 Strategies for effective Health administration

3.5 Impact of policies in Health administration in Nigeria.

3.6 Principles of financial management in health administration

3.7 Roles of Information technology in Health administration

4.0 Implication of health administration in Nigeria to nursing practice,

policy

5.0 Conclusion

6.0 Recommendation

References
 ABSTRACT
Health administration in Nigeria is a field of study that deals with the
management of hospitals, health institutions and organizations . The Nigerian
healthcare system faces challenges such as underfunding, corruption, poor
remuneration, brain drain, inadequate infrastructure, poor leadership, insufficient
human resources and poor health insurance coverage.

This topic explores the vital role of effective management and leadership in
healthcare organizations. It delves into various aspects of health administration,
including strategic planning, financial management, quality improvement, and
healthcare policy. Participants will gain insights into the challenges and trends in
the field of health administration and learn strategies to optimize operational
efficiency, enhance patient outcomes, and ensure the delivery of high-quality
healthcare services. This topic equips healthcare professionals with the
knowledge and skills necessary to navigate the complex healthcare landscape and
effectively lead healthcare teams.(Sharon B. Buchbinder, Nancy H. Shanks 2017).

Health administration focuses on effective management strategies, healthcare

policy implications, and the evolving landscape of healthcare delivery. We will
delve into challenges and opportunities in the field, aiming to provide insights for
professionals and stakeholders navigating the dynamic realm of health
administration.

1.0 INTRODUCTION
Healthcare in Nigeria is supported by government, the private sector religious
organizations and non-governmental organizations. The health care system in
Nigeria is organized under a three-tiers system, the federal, state and the primary
healthcare centres under local government. The healthcare system in Nigeria is
divided into three categories namely primary, secondary and tertiary health.
(Ogbenna, Okafor, Ejim, Samuel, Grace, Chiadichiem,2016).

Health administration is a crucial aspect of the healthcare industry, focuses on the

effective management and organization of healthcare systems. It encompasses
tasks such as planning, coordinating, and overseeing the delivery of healthcare
services, as well as addressing financial, legal, and regulatory aspects. Health
administrators play a key role in ensuring that healthcare organizations operate
smoothly, provide high-quality care, and adapt to evolving industry challenges.
Healthcare administration is an exciting, dynamic field that merges elements from
a broad range of professional disciplines , such as business development, risk
management, accounting, human relations, regulatory compliance.

2.0 OBJECTIVES
At the end of this study, learners should be able to :

I. Identify the importance of Health administration in Nigeria

ii. Identify the challenges in Health administration in Nigeria

iii. Discuss strategies for effective Health administration

iv. Discuss the impact of policies in Health administration in Nigeria.

vi. Identify the principles of financial management in health administration

vi. Identify the roles of Information technology in Health administration

3.0 MAIN CONTENT

3.1 OVERVIEW

Definition of Terms

HEALTH

The World Health Organization (WHO) defines health as a state of complete

physical, mental and social well-being and not merely the absence of disease or
infirmity .

WHO's definition of health is not limited to physical health but also includes
mental and social well-being, and is not just the absence of disease but also a
state of well-being and quality of life

ADMINISTRATION

Administration refers to the management and organization of resources, policies,

and procedures to achieve specific goals and objectives. It involves the
coordination and supervision of activities, personnel, and resources to ensure
efficient and effective operation of an organization, system, or process.

HEALTH ADMINISTRATION

it encompasses planning, organizing, directing, and controlling healthcare

services, programs, and facilities to deliver quality patient care and promote
public health.

Administration can also refer to the bureaucracy or management structure of an

organization, government, or institution, responsible for making and enforcing
rules, policies, and decisions.
3.2 Importance of Health administration in Nigeria

Administration, according to the Cambridge Dictionary, means “the

arrangements tasks needed control operations plan and to the of a or
organization ”. Based on this definition, it can be emphatically said that the
proper administration in the Nigerian health sector is very crucial to the sector's
smooth-running. Specifically, proper administration has helped the Nigerian
health sector in so many ways, some of which include: management of
human resources; management of financial resources; management of client
care/patients care experience; management of health informatics; and
overseeing compliance with medical and legal regulations /policies (Doyle,
2019).

A . Management of human resources: Every health organization wants to

work with people that are adequately skilled, enthused, and productive; the
concept of human resource management cut across recruitment/hiring,
evaluation, promoting, retiring and firing of personnel. This shows that human
resource management in the health sector is a very challenging task. For
instance, the process of personnel recruitment, alone, is not a process of
gamble or chance, as it requires deep scrutiny and thorough evaluation of
applicants (American Society of Clinical Oncology, 2008). Hiring an efficient,
motivated and competent team of 393 employees in the health sector is
very challenging, more especially, because hiring wrong personnel can spell a big
doom due to the peculiarity of the sector – a sector that deals directly with
human lives. Furthermore, in some situations, some under-performing or non-
performing needs to fired or retired, as the case may be. All these processes
(i.e. the recruitment/hiring, evaluation, promoting, retiring and firing of
personnel) involve a lot of expertise, and those professionals responsible for
these daunting tasks in the Nigerian health sector are healthcare
administrators ( Omeleke & Taleat, 2017).
B. Management of financial resources: It is a popular saying that "money is
power". Just as a fuel powers an automobile engine, so also financial resources
empower an organization. The health sector is one of the most, if not the
most, crucial sectors of a nation. As a result, a lot of financial resources are
budgeted for the smooth running of this sector. To achieve the set goal of a
sector, more especially the health sector, the financial spending of such sector
must be very prudent. The judicious management of financial resources is not
a child's play, neither is it an easy task. However, with the input of professional
and qualified health administrators, the Nigerian health sector had beenable to
tackle the persistent challenges of financial resource management embatiling
the country (Omeleke & Taleat, 2017).

C. Management of client care/patient care experience: Scientific research has

shown that poor care coordination is associated with negative health outcomes
(Carayon, Hundt, Hoonakker, Kianfar, Alyousef, Salek, Cartmill, Walker,
Tomcavage, 2015). Client/patient care coordination is a very broad concept
which cut across various areas, ranging from health information to building
healthy relationships with clients/patients . Proper coordination of health service
delivery goes a long way in determining the quality of services rendered by a
health organization. The management of client care/patient care experience
requires a lot of expertise.

D. Management of health informatics: Health informatics, according to the

United States National Library of Medicine, is “the interdisciplinary study of the
design, development, adoption and application of IT-based innovations in
health care services delivery, management and planning”. Health informatics is a
very broad aspect under health administration and it has played a very central
role in the improvement of healthcare service quality in Nigeria (Ojo & Popoola,
2015).

E. Overseeing compliance with medical and legal regulations/policies:

Virtually all organizational practices, be it health-related or not related to
health, are guided by laid down regulations or policies. The monitoring of
personnel compliance with intra- and inter-organizational regulations/policies is
one of the crucial roles played by health administrators (Doyle, 2019). Any
violation of organizational policy can put the offending organization at the risk
of potential jeopardy. However, with the help of professional health
administrative principles, such violations can be prevented and curbed
through proper monitoring of organizational activities. In Nigeria, healthcare
administrators are saddled with this huge responsibility and through their
skills, they have salvaged many health organizations from organizational
policy/regulation violations.

3.3 The challenges in Health administration in Nigeria

There are many challenges facing health care in Nigeria. Some of these challenges
are peculiar to a certain hierarchy of the healthcare system while others are not
specific to any health care system. That is it affects both the primary, secondary
and tertiary health care.

Challenges Peculiar to Primary Health Care in Nigeria

Lack of capacity at the local government level has contributed to the collapse and
comatose state of primary health care in Nigeria (Uche & Uche, 2019; Oyibocha et
al, 2014). The primary health care centres are located in rural areas; this is as
most of the Nigerian populace lives in rural areas. Due to insecurity and lack of
the social amenities of life in the villages and rural communities, healthcare
workers and other support staff will not want to live or stay at their place of work.
There is increase insecurity and kidnapping of doctors, this will discourage them
from residing in the community. Also, government diverts and focuses more on
the tertiary health care facilities as the tertiary health centres are located in the
state capitals and urban areas. The educated and the rich live in the urban areas
therefore they receive a large bulk of the budgetary allocation to health to
improve their infrastructure. Despite the challenges facing primary health care in
Nigeria, primary health care is still important for the achievement of quality
health care for the Nigerian populace (Aigbirenolen et al 2014).
Challenges That Affect the Primary, Secondary and Tertiary Health Facilities

A. Power tussle: Every worker and staff in the health sector is

important as their services complement each other both the clinical and non-
clinical staff that are more or else support staff with the physician who is the
medical doctor as the head of the team. There have been several conflicts in the
health sector between various categories of staff. For instance, there have been
conflicts between doctors and other staff. Power tussle in the health sector has
led to the formation of cliques and cartels; this has affected the healthcare
services rendered to the public.

B. Resource Allocation: Allocation of resources is very important in

the health sector. This involves the allocation of resources which may be in form
of medical supplies and finance not excluding human resources. Some
departments of the hospital tend to care for very sick patients and the entry
points into the hospital. These sections require more attention both in material
and human resources. They need to be equipped to standard and also regular
training and retraining of the staff. Sometimes, this is not done and the staff is
expected to make do with what is available as they do not have control over the
resource allocation to each section of the hospital. Most Nigerian hospitals are
filled with obsolete equipment and machines. Even when new medical equipment
and machines are purchased, the staff is not trained on how to use them hence
the equipment remains underused and sometimes get bad due to lack of usage.

C. Conflict: Various forms of conflict have occurred in the healthcare

sector in Nigeria. This has affected health administration in Nigeria. This conflict
has been between various categories of healthcare workers including the hospital
support staff who are the non-clinical staff. In hospitals, Interprofessional conflicts
are very common especially among doctors, nurses and pharmacists. This rivalry
affects healthcare delivery and it is the clients and patients that seek healthcare
that suffer.
D. Corruption: In Nigeria, corruption seems to feature everywhere, including the
health sector. This has also affected health administration in health care financing
and the allocation of resources. Also in the posting healthcare workers and the
location of health facilities. For instance in Nigeria people have their beliefs.
Sometimes a community is not confronted before choosing the site of a primary
healthcare facility. If the facility is built in an area marked by the people to use it
as an evil forest they will never visit the health facility even if they are very sick.
The implementaƟon of well-intended government policies for health care has
been adversely affected by politics (Abe E, Omo-Aghoja LO, Onowhakpor, 2013).

E. Migration: In recent times there have been an increased number

of healthcare workers migrating to the developed countries and middle due to

brain drain in search of greener pastures, this has led to brain drain nationwide
(Uche 2014).

3.4 Strategies for Effective health administration in Nigeria

There are two main strategies for effective health administration. Each of these
strategies addresses critical aspects of healthcare management, contributing to
improved outcomes and overall organizational success, and they include:

1. Data-driven decision making

2. Patient-centered care approaches

DATA-DRIVEN DECISION MAKING:

Data-driven decision-making in health administration refers to the practice of
using data and analytics to guide and inform decisions related to the management
and delivery of healthcare services. This approach involves systematically
collecting, analyzing, and interpreting relevant data to support informed choices
that can optimize various aspects of healthcare administration.

Data-driven decision making entails:

1.Support Clinical Decisions

Healthcare administrators use data-driven insights to support clinical

decision-making. This includes adopting electronic health records (EHRs) and
utilizing data analytics to improve patient diagnosis and treatment plans.

2.Resource Allocation:

Data-driven decision-making assists in allocating resources effectively.

Administrators can analyze data on patient demographics, treatment outcomes,
and demand patterns to optimize staffing levels, equipment utilization, and
facility planning.

3.Quality Improvement:

Health administrators leverage data to identify areas for improvement in

healthcare delivery. By analyzing performance metrics, patient outcomes, and
satisfaction surveys, they can implement targeted strategies to enhance overall
quality of care.

4. Patient Satisfaction and Engagement:

Data-driven approaches help in understanding patient preferences and improving

patient satisfaction. By analyzing patient feedback, administrators can tailor
services to meet patient needs and enhance overall engagement. (Bryson, J. M.
2018).
PATIENT-CENTERED CARE APPROACHES

Patient-centered care approaches in health administration prioritize the needs,

preferences, and experiences of patients throughout the healthcare system
(Hambrick, D. C., & Fredrickson, J. W. 2019).

This approach recognizes the importance of involving patients in decision-making,

respecting their values, and delivering care that is tailored to individual needs.
Patient-centered care approaches entails:

1.Communication and Shared Decision-Making:

Health administrators foster a culture of effective communication between

healthcare providers and patients. Shared decision-making models are
encouraged, ensuring that patients are actively involved in decisions about their
care.

2.Empathy and Respect: Administrators promote an organizational culture that

emphasizes empathy and respect for patients. This includes training healthcare
staff to understand and respond to the unique needs and perspectives of each
patient.

3.Care Coordination:

Health administration focuses on coordinating care across different healthcare

providers and specialties. This ensures a seamless and integrated experience for
the patient, reducing fragmentation in healthcare delivery.

4.Patient Education:

Administrators support initiatives for patient education, providing resources and

information to empower patients to actively participate in their own healthcare
management.

5.Access to Information: Patient-centered care involves ensuring that patients

have access to their health information. Health administrators facilitate the
implementation of systems that allow patients to review and understand their
medical records

3.5 Impact of policies in Health administration in Nigeria

Policies significantly impact health administration in several ways:

1.Regulatory Compliance: Health policies establish regulations that healthcare

organizations must adhere to, influencing how administrators manage operations
to ensure compliance.

2.Financial Management:

Healthcare policies, including reimbursement and funding mechanisms, shape the

financial landscape, impacting budgeting, resource allocation, and financial
sustainability.

3.Quality of Care:

Policies set standards for healthcare delivery, affecting how administrators

prioritize and implement quality improvement initiatives to enhance patient care.

4.Access to Healthcare:

Health policies influence the availability and accessibility of healthcare services,

impacting administrators’ decisions on facility locations and resource distribution.

5.Emergency Preparedness:

Health policies often include guidelines for emergency preparedness and

response, impacting how administrators plan for and manage crises. (Erasmus, E.,
& Gilson, L. 2018)

3.6 Principles of financial management in Health administration

In healthcare organizations, managing risk and money in a manner that facilitates
achieving the financial objectives of an organization is the primary responsibility
of financial management. A healthcare institution can deliver effective healthcare
to all its patients with solid and well-organized financial management policies. The
primary responsibility of financial management in health administration is to
manage resources and risks to advance the organization's financial objectives
(Tommy Watts, Ann Kearney, 2023).

At a high level, healthcare financial management involves analysis, planning,

decision-making, management and risk mitigation.( David Luther, 2023). Some of
the specific tasks that the financial management function is responsible for in a
healthcare organization include the following:

1. Evaluation and Planning :

One of the most fundamental aspects of financial management involves

evaluating the financial condition and effectiveness of the healthcare
organization’s operations. Equally essential is the work financial managers do to
plan for the company’s financial future.

2. Budgeting and Forecasting :

Budgeting and forecasting work hand in hand in healthcare financial

management. A healthcare organization’s budget outlines how much money the
company will earn and spend over a specific period. A financial forecast zeroes in
on analyzing the probable future, helping to determine how funds should be
allocated so the healthcare organization hits its budgeted target. Expected shifts
in demand — flu season, for example — as well as unexpected changes, like a
pandemic, should also be taken into account.

3. Generating Income :
Those charged with financial management in healthcare organizations play the
pivotal role of identifying ways to increase income while maintaining focus on the
organization’s core mission of patient care. This work might involve negotiating
with insurance companies for higher reimbursement rates, modeling price
increases when supply costs go up, exploring the use of telemedicine to boost
income or benchmarking prices against market averages, for example.

4. Compliance :

The healthcare industry is subject to distinct federal and state regulations;

financial managers must keep up with these changing requirements.

5. Investment Decisions :

To remain relevant, healthcare organizations must continue to invest in

improvements, which could include funding research and development initiatives,
purchasing new equipment or implementing new types of care and patient
experience improvements.

3.7 Roles of Information Technology in Health administration

Technology plays a role in almost every part of a medical visit, from making an
appointment in a patient portal to recording vitals in an electronic health record
to identifying population trends with an analytics platform. HIT oversees a range
of technologies for tasks, including care coordination, information sharing, patient
monitoring and decision-making.(Trinity Cytrus 2022)

Some of their roles are as follows :

1. Digital Records: IT helps keep patient information organized electronically,

making it easy for healthcare providers to access and manage data.
2. Smooth Communication:IT tools like messaging systems and telehealth
platforms enhance communication among healthcare professionals, ensuring
better coordination.

3. Efficient Tasks: IT automates administrative tasks like scheduling appointments

and handling billing, making healthcare operations more efficient.

4. Regulatory Compliance: IT ensures that healthcare organizations follow rules

and standards, keeping patient data secure and meeting legal requirements.

5.Smart Decision-Making: IT provides tools for data analysis, helping

administrators make informed decisions and improve healthcare strategies.

and reporting data, contributing to disease surveillance and policy development.

4.0 Implications of health administration in Nigeria to nursing practice

The impact of health administration on nursing practices in Nigeria includes:

1. Improved patient care : Effective health administration ensures adequate

resources, leading to better patient care and outcomes.

2. Nursing workforce management: Health administration affects nurse staffing,

training, and development, influencing the quality of care provided.

3. Resource allocation: Health administration decisions impact the availability of

resources, such as equipment, supplies, and facilities, affecting nursing practice.
4. Policy implementation : Health administration influences the development and
implementation of policies affecting nursing practice, such as infection control
and medication management.

5. Quality improvement initiatives: Health administration drives quality

improvement initiatives, such as accreditation and quality assurance, impacting
nursing practices.

6. Leadership and management: Health administration affects the leadership and

management of nursing services, influencing the autonomy and decision-making
authority of nurses.

7. Continuing professional development: Health administration can support or

hinder opportunities for nurses' continuing education and professional growth.

8. Job satisfaction and retention : Effective health administration can improve

nurses' job satisfaction and retention, reducing turnover and brain drain.

By recognizing the impact of health administration on nursing practices, nurses

can engage with health administrators to advocate for policies and practices that
support quality patient care and support. (Federal Ministry of Health, Nigeria
2020).

5.0 Conclusion

The maintenance of a vibrant Nigerian healthcare sector is very crucial to the

growth and sustainability of national development in Nigeria. Health
administration is important for the management of human, financial and material
resources including the control of health informatics. Compliance with medical
ethics is also a product of good health administration. The sector still has a large
room for improvement in its area of administration through training and good
governance.
6.0 Recommendation

1. State health insurance

Policy makers and political actors need to devise health care reforms to address
the lack of social and financial protection for the poor and vulnerable populations.
Part of this reform is the expansion of the NHIS. States should be mandated to
provide health insurance coverage to all residents. Making health insurance
optional for states over the years has affected the ability of the NHIS to increase
the level of coverage for the people.

2.Financing and coverage

Political actors, policy makers and all stakeholders in the health sector should
establish a government funded social and financial risk protection scheme
through a general tax financing system for the poor and vulnerable, and invest in
basic infrastructure for health care in rural areas for quality health care service
delivery. UHC schemes are important in addressing the problem of poor coverage,
limited access to health care, and poor quality of health care services.( Bolaji
Aregbesola, 2019)

3. Good governance: Good governance encompasses transparency,

accountability, integrity, proper management, and proper leadership. Through
good governance, crucial problems like bribery, nepotism, forgery, and other
corrupt practices can be brought to the barest minimum, if not completely
eradicated (Omeleke & Taleat, 2017). Based on our experience, the current
downturn in the Nigeria healthcare sector is mainly due to poor governance. If
Nigeria can get it right, more especially in the area of good governance, these
crucial problems will be largely solved, the Nigerian healthcare sector will
improve and have a better standing.
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