ORGANIZATIONAL STRUCTURE

AT VARIOUS LEVELS OF CARE

DR K.R. ADEWOYE
INTRODUCTION

 It is important for health planners and

managers to have a proper understanding of
the political arrangements in the country.
 As these have implications on planning,

implementation & evaluation.

 Which invariably influence the organization

and management of the health system

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Introduction/ Justification Cont’d
 Health planners must also be aware of the
existence of multiple political jurisdiction,
and multiple levels of government.
 They must be ready at all times to access

their implications on the nation's health care

system.
 In this lecture, students will be exposed to

the various levels of healthcare & their

organizational structure.

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Levels of Government

◦ Federal;- FMoH, NACA, NPHCDA,

◦ State;- SMoH, SACA, SPHCDA

◦ Local Government- LACA

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HEALTH CARE DELIVERY SERVICES

 In Nigeria the health care delivery system has a

three-tier structure that is coordinated and
supported by the three levels of government in
Nigeria.
◦ The Local Government has responsibility for the
Primary Health Care (PHC)

◦ The State Government has responsibility for the

secondary health care and in addition, provides
technical support to the Local Government as well as
supervisory role

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Role of State Government
◦ The State government is also involved in
manpower development for Local Government
health facilities through its training institutions
and in terms of capacity building of Local
Government health workers.
◦ The State government runs public general
hospitals, specialist hospitals and supervise
activities of private hospitals which are mainly
involved in curative health care.
◦ The State government in addition is involved in
health policy formulation and regulatory
function.

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 The Federal Government undertakes:

◦ To provide policy guidance and strategic

support to States in their effort at establishing
health system that are based on PHC and are
accessible to their people.

◦ To coordinate State efforts in order to ensure

coherent, nationwide health system.

◦ In collaboration with the State government, to

undertake the overall responsibility for
monitoring and evaluation of the
implementation of the Health- for – all
Strategy.

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 The Federal Government has
responsibility for:

Tertiary health care delivery in addition to

several other function which include;
 Funding, supervisory, regulatory, as well as
manpower development roles in PHC.

 Regulation of health practice

 Manpower development for all levels of health care

delivery

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Federal Government Responsibilities
 Disease control and prevention
 Collaboration with International
Agencies for health care provision and
regulation
 Technical support to all levels of health
care delivery.
 International health services
 Policy formulation, standardization and
regulation

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 Tier of Level of Health Health
Governme Health Care
Service Mgt Service
nt System Provision S
u
p
Fed Teaching p
Tertiary o
Federal MOH Hospital r
t
,
s
State Owned u
secondar States p
State Hospitals e
y MOH r
v
Health i
LGA Health facilities s
i
LGA Primary Teams owned by o
LGA’s n
Health a
Ward Health
Centers and n
Dev. d
Clinics
Committees r
e
f
Community Health CHEWS and e
r
Committees Volunteers r
a
l
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Communities and Households
Organogram of FMOH
HMH

HMSH
PS

DFD DPH DHPR DPM DFA DPRS DHS

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Secondary health care
In form of General Hospitals
 Responsibility of State government

 Requires higher level of manpower – Doctors, Nurses,

Pharmacist, Laboratory technologists/technicians

 Requires higher level of equipment and infrastructure –

Wards for admission of patients, laboratory, blood
bank, operation theatre, radiological services, etc

 Takes referrals from primary level

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Secondary health care
 Provides out-patient and in-patient care.

 Include general medical, Surgical, Paediatrics,

Obstetrics and Gynaecology and community
health services.

 To be available at district, divisional and zonal

levels.

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Organogram of SMOH
HCH

PS Hosp Mgt Board

DPS DPH DPRS DFA DHS

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PRIMARY HEALTH CARE

Components of primary health care (PHC) include

the following:
◦ Education concerning prevailing health problems
and the methods of preventing and controlling
them.
◦ Promotion of food supply and proper nutrition
◦ Adequate supply of safe water and basic sanitation
◦ Maternal and child health care, including family
planning
◦ Immunization against the major infectious diseases
◦ Prevention and control of locally endemic and
epidemic diseases
◦ Provision of essential drugs
◦ Appropriate treatment of common diseases and
injuries
◦ Mental health
◦ Oral health
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Organogram of LGA Health Dept
Supervisory Councilor for Health

PHC Coordinator

Asst PHC Asst PHC Asst PHC Asst PHC Asst PHC
Coord Coord Coord Coord Coord
Immunization Health Educ MCH/FP Essential Drugs M&E

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