Allocation Of Funds Across Expenditure Heads In The Nigerian Public Teaching Hospitals

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Allocation Of Funds Across Expenditure Heads In The Nigerian Public Teaching Hospitals


Abstract


This study focused on the Allocation Of Funds Across Expenditure Heads In The Nigerian Public Teaching Hospitals, Lagos university teaching hospitals (LUTH) as case study. The study is was specifically focused on identifying expenditure heads in public teaching hospitals in Nigeria; examining whether funds are adequately distributed across expenditure heads in Nigerian public teaching hospitals; placing emphasis on the importance of adequate allocation of funds across the different expenditure heads in Nigerian public teaching hospitals and evaluating the use to which funds are appropriated for in the Nigerian public teaching hospitals..

The study adopted the survey research design and randomly enrolled participants in the study. A total of 100 responses were validated from the enrolled participants where all respondent are staff of Lagos university teaching hospitals (LUTH).


Chapter One


Introduction

1.1 Background to the Background

Health care services are one of the cardinal services any government must provide for its citizenry. In both the developed and developing countries, a large proportion of the nation’s wealth is channeled to health. For instance, the world health reports (2005) gave Nigerian government expenditure on health as a percentage of her gross domestic products (GDP) for the year 2001 to be 5.3 percent, year 2002 to be 5.0 percent and year 2003 to be 4.7. This is to buttress the fact that the Nigerian government health care service expenditure are very significant in relation the the gross domestic product. But surprisingly our health care delivery have been next to zero, this as many say have led to medical tourism.

No organization functions well without adequate funding and our hospitals aren’t left out. Every public hospital which receives funds against approved annual work plans shall maintain separate bank accounts and separate books of accounts in respect of funds received for its programs. The mission of every public hospital in Nigeria is to serve the health care needs of people in its communities 24 hours a day, seven days a week. The task of its medical objective depends to a greater extent on the application of basic hospital financial rules, guidelines and accounting policies.

Public teaching hospitals in Nigeria are medical centers that provide clinical education and training to future and current health professionals. Teaching hospitals are often affiliated with medical schools and work closely with medical students throughout their period of matriculation, and especially during their clerkship (internship) years.
Adequate redistribution of funds in public hospitals is mostly handled by the government and this goes through a lot of procedures and processes.

In ensuring effective allocation of funds across departments for the smooth running of hospitals, the budget for each department mush have to be reviewed to ensure equity and transparency in the allocation of recourses. This budget examination would also help in monitoring these funds when they are eventually deployed.

In many countries, the Ministry of Health pays directly for some resources used in public hospitals (e.g stationery, vehicle maintenance, salaries). However, sometimes, the ministry cannot determine the specific spending levels by hospital. In this case, one will need to estimate the allocated amounts in line items oneself, preferably, in consultation with officials at the hospital and the ministry.


1.2 Statement of the Problem

The inadequate allocation of funds across departments of government or public hospitals has led to a whole lot of problems with our public health sector. Cases of fraud and over expenditure in our public hospitals has been a cause for concern, the general poor performance of public hospitals has led to medical tourism which has resulted in our country loosing substantial amount of money that would have improved our economy. Equally, cases of under-funding of our hospitals have been common especially in our government/public hospitals.


1.3 Objective of the Study

The main objective of this study is to examine the Allocation Of Funds Across Expenditure Heads In The Nigerian Public Teaching Hospitals. The following are the specific objectives of this study;

  1. To identify expenditure heads in public teaching hospitals in Nigeria.
  2. To examine whether funds are adequately distributed across expenditure heads in Nigerian public teaching hospitals.
  3. To place emphasis on the importance of adequate allocation of funds across the different expenditure heads in Nigerian public teaching hospitals.
  4. To evaluate the use to which funds are appropriated for in the Nigerian public teaching hospitals.

1.4 Research Question

  1. What are the expenditure heads in public teaching hospitals in Nigeria?
  2. Are funds adequately distributed across expenditure heads in Nigerian public teaching hospitals?
  3. How important is adequate allocation of funds across the different expenditure heads in Nigerian public teaching hospitals?
  4. Are funds distributed used for the purpose to which they are allocated in Nigerian public teaching hospital?

1.5 Hypothesis of the Study

The following hypothesis was formulated and tested for the study

H0: Funds are not adequately distributed across expenditure heads in Nigerian public teaching hospitals.

H1: Funds are effectively distributed across expenditure heads in Nigerian public teaching hospitals.


1.6 Significance of the Study

This study contributes to knowledge and could serve as a bench mark or guide for other work or study. It avails public teaching hospitals with information about proper allocation of funds to the expenditure heads in public hospitals to enhance performance thereby reducing medical tourism.


1.7 Scope of the Study

The study is on allocation of funds across expenditure heads in Nigerian public teaching hospitals using the Lagos university teaching hospitals (LUTH) as a case study.


1.8 Limitation of the Study

The study was limited by a number of factors but the most prominent are;

Financial constraint

The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.


1.9 Definition of Terms

Teaching Hospital:

A teaching hospital is a hospital or medical center that provides clinical education and training to future and current health professionals. Teaching hospitals are often affiliated with medical schools and work closely with medical students throughout their period of matriculation, and especially during their clerkship (internship) years.

Fund Allocation:

Sum of money set aside and earmarked for a specified purpose

Allocation:

The action or process of allocating or sharing out something.

Expenditure:

Payment of cash equivalent for good or services or a charge against available funds in settlement of an obligation as evidenced by an invoice, receipt, voucher or other such document.


1.10 Organizations of the Study

The chapter one consist of the introductory part of the study which includes the study background, the statement of the research problem, the study objective and scope of the study.

The second chapter is a critical review of other literatures relevant to the study and its objectives including the theoretical framework for the study. While the third chapter is methods of data collection, sampling and data analysis used in conducting the study. The fourth chapter centres around the research findings including an analysis of how it relates to previous findings. The fifth chapter consists of the summary of findings, conclusion and recommendations base on the study objectives.


Chapter Five


Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings on the Allocation Of Funds Across Expenditure Heads In The Nigerian Public Teaching Hospitals, Lagos university teaching hospitals (LUTH) as case study. The chapter consists of summary of the study, conclusions, and recommendations.


5.2 Summary of the Study

In this study, our focus was on the Allocation Of Funds Across Expenditure Heads In The Nigerian Public Teaching Hospitals, Lagos university teaching hospitals (LUTH) as case study. The study is was specifically focused on identifying expenditure heads in public teaching hospitals in Nigeria; examining whether funds are adequately distributed across expenditure heads in Nigerian public teaching hospitals; placing emphasis on the importance of adequate allocation of funds across the different expenditure heads in Nigerian public teaching hospitals and evaluating the use to which funds are appropriated for in the Nigerian public teaching hospitals..

The study adopted the survey research design and randomly enrolled participants in the study. A total of 100 responses were validated from the enrolled participants where all respondent are staff of Lagos university teaching hospitals (LUTH).


5.3 Conclusions

With respect to the analysis and the findings of this study, the following conclusions emerged;

Strengthening and improving healthcare systems is one of the primary responsibilities of government. No matter what the choice is, the choice of health care financing should be able to mobilize resources for health and improve access to quality care at the same time. Due to weak institutional capacities, lack of expertise as well as a high level of poverty in the country, Nigeria need to adopt a combination of mechanisms in order to achieve effective health care financing system.


5.4 Recommendation

Based on the findings the researcher recommends that;

In order for Nigeria to move towards sustainable health spending that will lead to a sustainable health outcome, there is a need for investments in the improvement of healthcare. If this is achieved, more and more people will escape from poverty and this can only be achieved through well-targeted government spending and subsidy to the sector. Roles of the government in the sector must be redefined and sharpened. Financial provisions shall be made for poor and vulnerable groups in the form of direct payments, subsidies, paying for insurance contributions or any other methods. Similarly, there is the need for expansion of social health insurance through the National Health Insurance Scheme (NHIS) to cover the informal sector as a means of increasing resources for health thereby ensuring universal access to care and providing financial protection to the poor and vulnerable. In other words, there is the need for a pragmatic and sustainable risk pooling mechanism; introduction of means to remove physical and financial barriers to access of healthcare services for the poor accompanied by financial protection policy; as well as the usage of socio-economic characteristics of households to provide evidence for policy focus. Other strategies that could help the country include increased Public-Private Partnership (PPP) – looking at government partnership with private health care providers, traditional health providers and non-governmental health care providers. The government can also embark on contracting out health services in public health institutions to these groups and increased investment in rural health facilities. Finally, strengthening the regulatory and supervisory role ofa private organization will lead to more efficient use and reallocation of available resources.


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