The Nigerian health system in general is characterized to be low not only on just medical funding but also poor staff motivation and inequitable access to health as well (Obansa & Orimisan, 2013). Bases on the analysis done by Obansa and Orimisan (2013), just in Africa alone, the BI has helped ensure access to affordable and sustainable primary health services “for approximately more than 60 million people which is mainly managed and partially funded by local communities or districts in countries like Cameroon, the Gambia, Mali, Mauritania, Niger, Nigeria, and Togo”. The access of the poorest people in the community towards utilizing health care services depends on factors such as their “ability to pay for drugs and for other health services”, and their “knowledge of available measures to ensure such access and utilization either through policy provisions or through community efforts” (Omolou, Okunola, & Salami, 2012). Additionally, based on questionnaire asked about accessibility of the poor to health care services asked from respondents, “23% and 28% of consumers in the BI and non BI areas respectively were sometimes unable to pay for drugs prescribed while 16.3% and 17% of the consumers were unable to pay for other services rendered” (Omolou, Okunola, & Salami, …show more content…
Since the early 1990s, the public health sector in Nigeria has experienced serious issues resulting from both difficult economic and political conditions. The impact has been quite noticeable even before the implementation of BI in the hospital sector, mainly characterized by poorly maintained buildings, broken down equipment, and irregular supplies of essential drugs (Uzochukwu & Onwujekwe, 2004). The overall quality of health services is generally acknowledged to be poor. However, based on the longitudinal study done by Uzochukwu, Onwujekwe, and Akpala (2004) for analyzing the health care quality in Nigeria after the implication of BI has “increased from 1993 to 2001 were 53%, 126%, 218%, 152% and 287% for first curative visits, Ante-Netal care (ANC) attendance, delivery of Oral Polio Vaccines (OPV1) and measles immunization respectively”. All the increases were statistically significant, the number of health centers also increased from 14 in 1993 to 25 in 2001 (Uzochukwu, Onwujekwe, & Akpala, 2004). However, there was also a general decline in the indicators from 1999 to 2001 (Uzochukwu, Onwujekwe, & Akpala, 2004). Additionally, based on their survey distance accounted for 26.3% of reasons given by the women for the non-use of the BI health centers for delivery services (Uzochukwu, Onwujekwe, & Akpala, 2004). Also, the extremely