title: Reducing maternal mortality in Nigeria: the need for urgent changes in financing for maternal health in the Nigerian health system.
abstract: OBJECTIVE
  Nigeria's maternal mortality indices are among the worst in the world. Various approaches aimed at combatting the persistently high maternal mortality rates in the past have been ineffective. The objective of this article was to evaluate the fairness and equitability of financing for maternal health in the Nigerian health system.
  
  
  METHODS
  A review of the performance of the Nigerian Health system with regards to financing for maternal healthcare and comparison with other health systems utilising internationally accepted criteria was done.
  
  
  RESULTS
  Household out-of -pocket payment was found to be the largest source of health care financing in the Nigerian health system contributing as much as 65.6 % of total health expenditure. This is in sharp contrast to the performance of more effective health systems like that in South Africa where health care is free for pregnant and breast feeding mothers. The result is that South Africa reports less than a tenth of total maternal mortalities reported from Nigeria annually. The current Nigeria health financing system is not equitable and appears to encourage maternal mortalities since it does not cater for the most vulnerable.
  
  
  CONCLUSIONS
  There is an urgent need for a review of financing of maternal health in Nigeria to achieve universal access to maternal health care. An urgent overhaul of the currently under performing National Health Insurance scheme or adoption of the simpler system based on funding from taxation with universal access for health care including maternal care and services free at the point of access is suggested.
authors: Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, College of Health Sciences, Delta State University, Abraka,Delta State, Nigeria. petedidi2000@yahoo.co.uk
authors: P N
authors: PN
authors: Ebeigbe
mesh_terms: D003431:Cross-Cultural Comparison; D005193:Family Planning Services / Q000191:economics / Q000458:organization & administration; D005260:Female; D005102:Health Expenditures; D006301:Health Services Needs and Demand / Q000191:economics; D006801:Humans; D008427:Maternal Health Services / Q000191:economics / Q000379:methods; D008428:Maternal Mortality; D008429:Maternal Welfare / Q000191:economics / Q000706:statistics & numerical data; D009313:National Health Programs; D009549:Nigeria / Q000453:epidemiology; D011247:Pregnancy