ECO. 266 (ONLINE QUIZ/ASSIGNMENT–ORGANIZATION AND FINANCING OF THE HEALTH CARE SYSTEM IN NIGERIA–18-9-2025))

ECO. 266 (ONLINE QUIZ/ASSIGNMENT–ORGANIZATION AND FINANCING OF THE HEALTH CARE SYSTEM IN NIGERIA–18-9-2025)

The Organization of the Healthcare System in Nigeria and How Healthcare Can Be Financed in Nigeria” tailored for 200-level Economics students at the University of Nigeria.

Multiple Choice Questions (50)

1. Which of the following is the primary responsibility of the Nigerian Ministry of Health?
   A) Regulate the economy
   B) Oversee healthcare policies and programs
   C) Manage education systems
   D) Control the banking sector
2. The Nigerian healthcare system is primarily funded through:
   A) Private donations only
   B) Government budgets, private sector, and out-of-pocket payments
   C) International aid only
   D) Corporate taxes
3. Which of the following is NOT a component of Nigeria’s healthcare delivery system?
   A) Primary healthcare
   B) Secondary healthcare
   C) Quaternary healthcare
   D) Tertiary healthcare
4. The National Health Insurance Scheme (NHIS) in Nigeria was established primarily to:
   A) Provide free healthcare to all citizens
   B) Reduce out-of-pocket expenses and improve healthcare financing
   C) Privatize healthcare services
   D) Regulate pharmaceutical prices
5. Which level of healthcare in Nigeria deals mainly with preventive and basic curative services?
   A) Tertiary
   B) Secondary
   C) Primary
   D) Quaternary
6. The Nigerian healthcare system is characterized by:
   A) Uniform access for all citizens
   B) Significant disparities in access and quality
   C) Exclusive reliance on traditional medicine
   D) Complete privatization
7. Which of the following is a challenge faced by Nigeria’s healthcare system?
   A) Excess of healthcare workers
   B) Overfunding of healthcare programs
   C) Inadequate infrastructure and funding
   D) No reliance on international aid
8. The role of private healthcare providers in Nigeria is to:
   A) Complement government services and increase access
   B) Replace all public healthcare services
   C) Only serve expatriates
   D) Regulate health policies
9. Out-of-pocket payments in Nigeria’s healthcare financing refer to:
   A) Payments made by the government on behalf of patients
   B) Direct payments made by individuals at the point of service
   C) Insurance reimbursements
   D) International aid transfers
10. The primary goal of healthcare financing is to:
    A) Maximize profits for healthcare providers
    B) Ensure sustainable funding and equitable access
    C) Eliminate traditional medicine
    D) Reduce government involvement
11. Which of the following is an example of a public source of healthcare funding?
    A) User fees
    B) Tax revenues
    C) Private insurance premiums
    D) Charitable donations
12. The concept of ‘catastrophic health expenditure’ refers to:
    A) Healthcare costs exceeding a household’s ability to pay, leading to impoverishment
    B) Health insurance covering all costs
    C) Government-funded health programs
    D) Free healthcare services
13. The Nigerian government’s commitment to Universal Health Coverage (UHC) aims to:
    A) Provide free healthcare to everyone
    B) Ensure all individuals have access to quality health services without financial hardship
    C) Privatize all healthcare services
    D) Reduce health workforce
14. Which of the following is a form of prepayment for healthcare?
    A) Out-of-pocket payment
    B) Health insurance premiums
    C) Direct cash payments
    D) Donations
15. The main challenge of health insurance schemes in Nigeria is:
    A) Overenrollment
    B) Low enrollment and limited coverage
    C) Excessive government funding
    D) Lack of healthcare facilities
16. The concept of ‘social health insurance’ involves:
    A) Coverage funded through employer and government contributions
    B) Only private sector involvement
    C) Out-of-pocket payments only
    D) Healthcare paid for directly by patients
17. Which Nigerian agency is primarily responsible for regulating pharmaceuticals and ensuring drug safety?
    A) NAFDAC (National Agency for Food and Drug Administration and Control)
    B) NPHCDA (National Primary Health Care Development Agency)
    C) NHIS (National Health Insurance Scheme)
    D) NCDC (Nigerian Centre for Disease Control)
18. The ‘public-private partnership’ (PPP) in healthcare refers to:
    A) Collaboration between government and private entities to deliver health services
    B) Privatization of all public hospitals
    C) Government taking over private clinics
    D) Donation of private hospitals to the government
19. Which of the following best describes the ‘hierarchical’ organization of Nigeria’s healthcare system?
    A) Tertiary hospitals at the top, primary health centers at the base
    B) Primary hospitals at the top, tertiary at the base
    C) All levels are equally accessible
    D) Only private hospitals exist
20. In Nigeria, traditional and faith-based healthcare providers are:
    A) Illegal and unregulated
    B) Widely used, especially in rural areas, and often integrated into the health system
    C) The only formal healthcare providers
    D) Completely replaced by modern medicine
21. The Nigerian government established the Basic Health Care Provision Fund (BHCPF) to:
    A) Provide free tertiary care
    B) Improve access to primary healthcare services, especially in underserved areas
    C) Promote traditional medicine
    D) Reduce health worker salaries
22. One of the main financing challenges for Nigeria’s healthcare system is:
    A) Excess of funds
    B) Dependence on volatile oil revenues
    C) Overregulation
    D) Surplus of healthcare workers
23. The Sustainable Development Goal (SDG) 3 aims to:
    A) Achieve universal health coverage and access to quality essential health services
    B) Eradicate all diseases
    C) Make healthcare exclusively private
    D) Focus only on maternal health
24. The ‘out-of-pocket’ expenditure as a share of total health expenditure in Nigeria is:
    A) Very low, less than 10%
    B) Substantial, often exceeding 70% of total health expenditure
    C) Only relevant in urban areas
    D) Not applicable in Nigeria
25. What is a major advantage of health insurance in Nigeria?
    A) Reduces financial barriers to access
    B) Eliminates healthcare costs
    C) Fully replaces government funding
    D) Only available to the wealthy
26. Which of the following best describes Nigeria’s health workforce coverage?
    A) Adequate and evenly distributed across the country
    B) Shortage of healthcare workers, especially in rural areas
    C) Excess of specialists but shortage of general practitioners
    D) Fully trained healthcare workers available nationwide
27. The Nigerian National Health Act (2014) aims to:
    A) Establish a legal framework for health financing and service delivery
    B) Privatize all hospitals
    C) Reduce government involvement in health
    D) Promote traditional medicine exclusively
28. Health financing strategies that involve pooling resources aim to:
    A) Spread financial risks across many individuals
    B) Directly pay healthcare providers from government funds
    C) Increase out-of-pocket payments
    D) Limit access to healthcare
29. Which of the following is an example of a contributory health financing scheme?
    A) Community-based health insurance
    B) Out-of-pocket payments
    C) Donor funding
    D) Tax exemption
30. The main aim of Nigeria’s National Strategic Health Development Plan (2018-2022) is to:
    A) Achieve Universal Health Coverage by improving health system components
    B) Focus solely on infectious disease control
    C) Reduce healthcare workforce
    D) Eliminate traditional medicine
31. A major barrier to healthcare access in Nigeria is:
    A) Overpopulation of healthcare workers
    B) High costs and poor infrastructure
    C) Overfunding of health programs
    D) Excessive healthcare facilities
32. The role of community health workers in Nigeria is to:
    A) Provide basic health education and services at the community level
    B) Replace doctors in hospitals
    C) Regulate pharmaceuticals
    D) Manage hospital administration
33. The Nigerian government’s approach to health financing includes:
    A) Increasing reliance on donor funding only
    B) Combining government budgets, insurance, and out-of-pocket payments
    C) Eliminating private sector involvement
    D) Providing free healthcare universally without funding
34. The ‘risk pooling’ mechanism in healthcare financing helps to:
    A) Reduce financial risk for individuals by sharing costs across a large population
    B) Increase individual payments
    C) Limit access to insurance
    D) Focus only on catastrophic illnesses
35. The Nigerian healthcare system is mainly financed through:
    A) Oil revenues, taxes, and donor support
    B) Private investments only
    C) International loans only
    D) Charitable organizations exclusively
36. The concept of ‘capitation’ in healthcare financing refers to:
    A) Payment of a fixed amount per patient per period to providers
    B) Payment based on number of services provided
    C) Out-of-pocket payments only
    D) Government grants for hospitals
37. Which of the following is a goal of Nigeria’s National Health Policy?
    A) Achieve equitable access to quality health services
    B) Privatize all healthcare services
    C) Reduce the number of healthcare workers
    D) Focus solely on infectious diseases
38. The Nigerian healthcare system’s reliance on which funding source makes it vulnerable to economic fluctuations?
    A) Oil revenue and government budget allocations
    B) Private insurance premiums
    C) Philanthropic donations only
    D) International tourism
39. What is the role of the Nigeria Centre for Disease Control (NCDC)?
    A) To monitor, detect, and respond to infectious disease outbreaks
    B) To regulate private health insurance
    C) To manage hospital infrastructure
    D) To provide primary healthcare services
40. The challenge of ‘urban-rural disparity’ in Nigeria’s healthcare system refers to:
    A) Better healthcare access in urban areas than in rural areas
    B) Equal access across all regions
    C) Higher healthcare costs in rural areas
    D) Overconcentration of healthcare providers in rural areas
41. One of the strategies to improve healthcare financing in Nigeria is:
    A) Implementing health taxes and community-based insurance schemes
    B) Eliminating government funding
    C) Reducing the number of health facilities
    D) Relying solely on traditional medicine
42. The concept of ‘equity in healthcare’ implies:
    A) Fair distribution of health services regardless of income or location
    B) Healthcare only for the wealthy
    C) Equal access irrespective of health needs
    D) Healthcare based only on insurance coverage
43. The main purpose of health sector reforms in Nigeria has been to:
    A) Improve efficiency, equity, and sustainability of the health system
    B) Privatize all hospitals
    C) Reduce health expenditure
    D) Limit access to specialized care
44. In Nigeria, health insurance coverage is:
    A) Widespread and universal
    B) Limited, with low enrollment rates
    C) Not recognized legally
    D) Mandatory for all citizens
45. The primary challenge of implementing Universal Health Coverage in Nigeria is:
    A) Insufficient funding and infrastructural deficits
    B) Overabundance of healthcare workers
    C) Excessive health insurance coverage
    D) Lack of diseases
46. The Nigerian government’s health financing reforms aim to:
    A) Increase financial protection and expand access to essential services
    B) Replace all public health services with private providers
    C) Reduce healthcare workforce
    D) Focus only on urban health
47. The role of international donors in Nigeria’s healthcare system is to:
    A) Provide financial and technical support for health programs
    B) Manage all health services
    C) Replace government funding
    D) Only fund traditional medicine
48. What is one reason for low healthcare utilization in Nigeria?
    A) High costs and limited access in rural areas
    B) Overpopulation of hospitals
    C) Overfunding of health services
    D) Excess healthcare workers
49. The concept of ‘health system strengthening’ involves:
    A) Improving the components of the health system to achieve better health outcomes
    B) Building more hospitals only
    C) Reducing health workforce
    D) Privatizing the entire health sector
50. The ‘triple burden of disease’ in Nigeria includes:
    A) Infectious diseases, non-communicable diseases, and injuries
    B) Malnutrition, literacy, and unemployment
    C) Maternal health, child health, and elderly care
    D) Traditional medicine, herbal remedies, and faith healing

Essay Questions (10)

1. Discuss the structure of Nigeria’s healthcare system, focusing on the roles and functions of primary, secondary, and tertiary healthcare levels.
2. Analyze the main challenges faced by Nigeria’s healthcare financing system and propose potential solutions to improve sustainability and equity.
3. Evaluate the impact of the National Health Insurance Scheme (NHIS) on healthcare access and financial protection in Nigeria. What are its limitations?
4. Explain the concept of Universal Health Coverage (UHC). How feasible is the goal of achieving UHC in Nigeria considering current healthcare financing mechanisms?
5. Assess the role of government policies and reforms in transforming Nigeria’s healthcare system in recent years.
6. Discuss the importance of public-private partnerships in Nigeria’s healthcare delivery and financing. Provide examples of successful and unsuccessful partnerships.
7. Examine the disparities in healthcare access between urban and rural areas in Nigeria. What strategies can be implemented to bridge this gap?
8. Describe how Nigeria’s reliance on oil revenue affects healthcare funding and discuss alternative financing strategies.
9. Analyze the role of traditional and faith-based healthcare providers within Nigeria’s health system. What are the opportunities and challenges associated with integrating these providers?
10. Critically evaluate the prospects of health system strengthening in Nigeria. What key factors must be addressed to ensure sustainable improvements?