Inequalities in health care in Ondo State, Nigeria

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Abstract
The Third Development Plan (1975—80) for Nigeria focused on the inequality in the distribution of medical facilities and health manpower in the country. The Plan, therefore, accelerated health manpower production and aimed to reduce the imbalance in the distribution of facilities. The Fourth Plan (1980—85) categorically stated the necessity to ensure a more equitable distribution of health facilities and manpower for every part of the Federation. The present paper assesses how the national objectives have been met by reviewing health services in Ondo State. Ondo became a separate state in February 1976 following the creation of the 19 state structure of Nigeria. The state is divided into 17 administrative units or local government areas (LGAs). In 1979 when the civilian government took over, the number of health facilities was increased — hospitals from 18 to 26, maternity centers 127 to 164 and dispensaries from 153 to 173. By 1985 there were also 30 comprehensive health centers as against two in 1979. However, the results of the location quotient analysis indicate increasing disparities in the distribution of both hospitals and the lower health facilities. Consequently, some LGAs have an excess share of the health facilities relative to their population. Spatial inequality in the distribution of health facilities is also reflected in the provision of hospital beds, nurses and doctors, despite the substantial increase in man power resources in the state during the study period. Despite the desire by the state government to ensure a more equitable distribution of health resources, glaring disparities are still evident. The deterioration in government facilities has resulted in a mass exodus of health professionals due to low salaries and poor working conditions. There has been, at the same time, a marked growth in the private sector and a decline in government attempts to strengthen primary health care.

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