Lecture Notes on -

POL 201 Political Science/ NSC 101 - Politics and Governance

(for the 200 level and 100 level Nursing Students) Federal University
of Health sciences Ila-Orangun

Course Objectives:

The main reason for introducing this course, Political Science/Politics and Governance, into the
undergraduate nursing programme is to equip students with leadership skills that are required to
influence policy towards the advocacy for quality and safe healthcare delivery. In specific terms,
it will help:

1. Nursing students to develop a more comprehensive understanding of the socio-political

factors that influence healthcare and their role as advocates and change agents within the
healthcare system.
2. Students to acquire knowledge of the difference between regulatory bodies and
professional associations
3. Students to gain insights into how they can effectively engage with political processes and
governance mechanisms to promote positive health outcomes for individuals and
communities.
4. Students to adapt to and provide for the ever-dynamic needs of their clients at every point
of contact.

INTRODUCTION

Starting any discussion on politics might seem alien to nursing students, but attempting to
understand its contribution to the healthy well-being of every citizen is often convincing. The
structural propriety of every community allows it to survive, thrive, grow, or go extinct. It is
therefore pertinent to learn a few basic definitions.

1. Political Science: Political science is the academic discipline that studies the theory and
practice of politics and government. It explores various aspects of political systems,
 institutions, behaviours, and ideologies. Political scientists analyze how power is
distributed, decisions are made, and how societies organize themselves politically.

2. Politics: Politics is the process of making decisions that apply to members of a group or
society. It involves the exercise of power, influence, and authority to achieve goals and
resolve conflicts. Politics encompasses a variety of activities, including voting, lobbying,
advocacy, and policymaking. It can occur at local, national, and international levels and
involves interactions between individuals, groups, and institutions.

3. Governance: Governance refers to the process of governing or managing the affairs of a

state, an organization, or a community. It involves establishing structures, processes, and
mechanisms for decision-making, policy implementation, and accountability. Effective
governance ensures that resources are allocated efficiently, laws are enforced, and the
needs of citizens are met. It encompasses formal institutions, such as governments and
regulatory bodies, and informal norms and practices that shape behaviour.

Structure of Politics and Governance in Nigeria

In Nigeria, the structure of politics and governance is complex and influenced by historical, social,
and cultural factors. The country operates as a federal republic with a presidential system of
government. It is characterized by a federal system with executive, legislative, and judicial
branches, a multi-party political landscape, and the influence of traditional institutions at the
grassroots level. Effective governance and political stability remains ongoing challenges, with
issues such as corruption, ethnic and religious tensions, and economic inequality shaping the
political landscape in Nigeria. This structure can be broken down into the following:

1. Federal System:

• Nigeria is divided into 36 states and the Federal Capital Territory (FCT) of Abuja. Each
state has its own government with powers to legislate on matters not listed in the exclusive
legislative list of the federal government.
 • The federal government is responsible for issues such as defense, foreign affairs, currency,
and national security. It consists of three branches: the executive, legislative, and judicial
branches.

2. Executive Branch:

• The President of Nigeria is the head of state and government and is elected to a four-year
term with a maximum of two terms.

• The president appoints ministers who oversee various government ministries and agencies.

• The executive branch also includes the Vice President, who assists the president in carrying
out their duties, and the Federal Executive Council (FEC), which is responsible for advising
the president on policy matters.

3. Legislative Branch:

• The National Assembly is Nigeria's bicameral legislative body, consisting of the Senate
and the House of Representatives. Members of the National Assembly are elected to four-
year terms.

• The Senate has 109 members, with each of the 36 states electing three senators, and the
FCT electing one senator. The House of Representatives has 360 members, with each
constituency electing one representative.

• The National Assembly is responsible for making laws, approving budgets, and overseeing
the actions of the executive branch.

4. Judicial Branch:

• The judiciary is independent of the executive and legislative branches and is responsible
for interpreting and upholding the constitution and laws of Nigeria.

• The Supreme Court is the highest court in Nigeria and has jurisdiction over constitutional
matters, disputes between states, and appeals from lower courts.

• Below the Supreme Court are the Court of Appeal, the Federal High Court, and various
state high courts, magistrate courts, and customary courts.
5. Political Parties:

• Nigeria has a multi-party system, with numerous political parties competing in elections at
the federal, state, and local levels. The two main political parties are the All Progressives
Congress (APC) and the People's Democratic Party (PDP).

• Political parties play a crucial role in Nigerian politics by nominating candidates for
elective offices, mobilizing voters, and shaping public policy through their platforms and
ideologies.

6. Traditional Institutions:

• Traditional rulers, such as kings, emirs, and chiefs, hold significant influence in Nigerian
society, particularly in rural areas.

• While they do not have formal political authority, traditional rulers often play advisory
roles and can influence decision-making at the local level.

7. Local Government:

• Nigeria has a system of local government administration, with local government areas
(LGAs) responsible for providing basic services and governance at the grassroots level.

• Local government councils are elected bodies with powers to enact bylaws, collect taxes,
and manage local affairs. However, local government autonomy has been a subject of
debate and contention in Nigerian politics.

Significance of Political Science to the Nursing Profession.

Politics, being a crucial part of man’s existence is an instrument of change (positive or negative)
that is often wielded to achieve certain gratifications. Understanding political science, politics, and
governance is, therefore, essential to us in nursing because:

1. Healthcare policies and regulations are shaped by political decisions and governance
structures.
 2. We, nurses, often interact with policymakers, government agencies, and advocacy
groups to influence health policy and improve healthcare delivery.
3. Healthcare systems operate within broader political and governance frameworks that
impact resource allocation, access to care, and quality of services.
4. Nurses need to navigate complex political environments to advocate for patients,
promote public health initiatives, and address social determinants of health.

Political Processes Relevant to Nursing

Political processes are integral to nursing practice and have a tremendous impact on healthcare
services delivery, nursing education, research, and professional development. Nurses' engagement
in political advocacy and policy-making processes is therefore essential for advancing the nursing
profession, improving patient outcomes, and achieving health equity for all individuals and
communities. The following are the common classifications of health-related political processes
that nurses must understand and know how well to navigate:

1. Health Policy Development: Political processes influence the development,

implementation, and evaluation of health policies at local, national, and international
levels. Nurses engage in policy advocacy to influence decision-makers and promote
policies that address healthcare access, quality, affordability, and equity. They work with
legislators, policymakers, and advocacy groups to shape health policy agendas and
advocate for the interests of patients and the nursing profession.

2. Legislation and Regulation: Political processes involve the enactment of laws and
regulations that govern healthcare delivery, nursing practice, licensure, and scope of
practice. Nurses participate in the legislative process by providing expert testimony,
drafting policy proposals, and lobbying for legislative reforms. They advocate for laws that
protect patient rights, improve working conditions, and advance nursing practice. Nurses
also collaborate with regulatory bodies to develop standards of practice and ensure
compliance with legal and ethical guidelines.

3. Healthcare Financing and Budgeting: Political processes determine how healthcare

services are funded, allocated, and distributed. Nurses engage in budget advocacy to secure
 resources for healthcare facilities, programs, and services. They advocate for adequate
staffing levels, funding for education and training, and investment in healthcare
infrastructure. Nurses also work to address disparities in healthcare financing and advocate
for policies that ensure equitable access to care for all individuals, regardless of
socioeconomic status or insurance coverage.

4. Healthcare Reform: Political processes drive debates and decisions on healthcare reform
initiatives aimed at improving healthcare access, affordability, and quality. Nurses play a
vital role in healthcare reform efforts by providing input on policy proposals, advocating
for evidence-based practices, and implementing reforms at the local level. They work
collaboratively with policymakers, stakeholders, and community partners to design and
implement reforms that address the evolving needs of patients and the healthcare system.

5. Public Health Advocacy: Political processes influence public health policies and
4initiatives aimed at preventing disease, promoting health, and addressing social
determinants of health. Nurses advocate for public health interventions, such as vaccination
programs, smoking cessation initiatives, and obesity prevention campaigns. We collaborate
with government agencies, non-profit organizations, and community groups to develop and
implement policies that improve population health outcomes and reduce health disparities.

6. Ethical and Social Justice Issues: Political processes intersect with ethical and social
justice issues in healthcare, such as patient autonomy, informed consent, reproductive
rights, and end-of-life care. Nurses advocate for ethical principles and human rights in
healthcare delivery and policy-making. They work to ensure that healthcare policies and
practices uphold principles of equity, justice, and respect for human dignity. Nurses also
advocate for vulnerable populations and marginalized communities to ensure that their
healthcare needs are addressed and their voices are heard in political decision-making
processes.

Impacts of Political Processes on the Nigerian Nurse:

In Nigeria, several political processes affect nursing education, practice, administration, and
research. Some of them are highlighted below:
1. Healthcare Funding and Budget Allocation: Political decisions regarding healthcare
funding and budget allocation directly impact the availability of resources for nursing
education, staffing, infrastructure, and service delivery. The Federal Government of
Nigeria allocates between 3.5% and 6.24% of her total budget to healthcare financing. This,
still, cannot completely address the challenges of health care financing in Nigeria
including inefficiency of the health system across the country, limited institutional
capacity, corruption, unstable and dwindling economy, and lack of political will. Nurses
often face challenges due to inadequate funding, leading to issues such as understaffing,
insufficient medical supplies, and limited access to continuing education opportunities.
Political advocacy is essential to ensure sufficient budget allocation for healthcare,
including nursing services.

2. Healthcare Policy Development and Implementation: Political processes influence the

development, implementation, and enforcement of healthcare policies and regulations in
Nigeria. Nurses play a crucial role in policy advocacy, providing input on issues such as
healthcare workforce development, nursing practice standards, patient safety, and quality
improvement. Nurses' involvement in policy-making processes can help address gaps in
healthcare policy and ensure that policies reflect the needs and priorities of nurses and
patients.

3. Healthcare Infrastructure and Access to Care: Political decisions impact the availability
and accessibility of healthcare infrastructure and services across Nigeria. Nurses often
work in resource-constrained settings, where inadequate infrastructure, including
healthcare facilities and equipment, affects their ability to deliver quality care. Political
advocacy is essential to address disparities in healthcare infrastructure and improve access
to essential healthcare services, particularly in rural and underserved areas.

4. Health Workforce Planning and Regulation: Political processes influence health

workforce planning, including nursing workforce development, recruitment, and retention
strategies. Nurses advocate for policies that support nursing education, licensure, and
professional development to address shortages and ensure a competent and skilled nursing
workforce. Political decisions also affect the regulation of nursing practice, including scope
of practice, licensure requirements, and professional standards.
 5. Healthcare Governance and Accountability: Political processes impact healthcare
governance and accountability mechanisms in Nigeria. Nurses advocate for transparency,
accountability, and good governance in healthcare delivery to ensure the efficient and
effective use of resources and the provision of quality care to patients. Political
accountability is essential to address issues such as corruption, mismanagement, and
inefficiency in the healthcare system.

6. Healthcare Reform and Universal Health Coverage: Political decisions regarding

healthcare reform and the implementation of universal health coverage initiatives affect
nursing practice and patient care in Nigeria. Nurses advocate for policies that promote
equitable access to healthcare services, financial protection, and health outcomes for all
Nigerians. Political support for healthcare reform efforts is crucial to address systemic
challenges and improve the overall health system performance.

Fundamentals of Healthcare Systems

Healthcare systems are complex structures that encompass various components and stakeholders,
all working together to deliver healthcare services to individuals and populations. Understanding
the fundamentals of healthcare systems is crucial for healthcare professionals to navigate their
roles effectively and contribute to improving healthcare delivery and outcomes.

The healthcare system in Nigeria is characterized by a complex interplay of factors, including

infrastructure, financing, governance, and human resources. Understanding these fundamentals is
essential for addressing challenges and improving healthcare access, quality, and outcomes in the
country.

A. Structure and Organization of Healthcare Systems

Healthcare systems are organized structures designed to provide medical care to individuals and
communities. They typically consist of healthcare facilities, providers, insurers, regulatory bodies,
and financing mechanisms. The structure and organization of healthcare systems can vary
significantly across different countries and regions, influenced by factors such as socio-economic
conditions, political systems, and cultural norms (WHO, 2000).

In most healthcare systems, care is delivered through a tiered approach, with primary care serving
as the first point of contact for patients, followed by secondary and tertiary care for more
specialized services and interventions (Shi & Singh, 2019). Understanding this structure helps
healthcare professionals coordinate care effectively and ensure patients receive appropriate
services based on their needs.

The structure and organization of healthcare systems vary widely across different countries and
regions, but they generally consist of several key components that work together to deliver
healthcare services to individuals and communities. Here's a breakdown of the typical components:

1. Healthcare Infrastructures/Facilities: Healthcare facilities are physical locations where

healthcare services are provided. These include hospitals, clinics, medical centres, nursing
homes, and rehabilitation centres. Healthcare facilities can vary in size, scope of services,
and specialization, ranging from small rural clinics to large urban hospitals with specialized
medical departments. Nigeria's healthcare infrastructure includes a mix of public and
private facilities, ranging from primary healthcare centres to tertiary hospitals. However,
there are significant disparities in infrastructure across different regions, with urban areas
typically having better-equipped facilities than rural areas (Uzochukwu et al., 2015).
Challenges such as inadequate funding, poor maintenance, and insufficient medical
equipment and supplies hinder the effectiveness of healthcare delivery (Uzochukwu et al.,
2015).

2. Healthcare Governance: Healthcare governance in Nigeria involves multiple

stakeholders, including government agencies, regulatory bodies, healthcare providers,
insurers, and civil society organizations. However, governance structures face challenges
such as corruption, inefficiency, and lack of accountability, which impact service delivery
and patient outcomes (Ogundeji et al., 2015). Strengthening governance mechanisms and
promoting transparency and accountability are essential for improving healthcare system
performance and addressing systemic challenges (Ogundeji et al., 2015).

a. Healthcare Providers / Human Resource for Health: Healthcare providers are

individuals who deliver healthcare services to patients. They include physicians
(doctors), nurses, nurse practitioners, physician assistants, pharmacists, therapists
(such as physical therapists, occupational therapists, and respiratory therapists), and
other allied health professionals. Healthcare providers may work in various
settings, including hospitals, private practices, community health centres, and home
care settings. Nigeria faces a shortage of skilled healthcare professionals, including
doctors, nurses, and midwives, particularly in rural and underserved areas (Okoro
et al., 2018). Factors contributing to the healthcare workforce crisis include brain
drain, inadequate training and education, and poor working conditions (Okoro et
al., 2018). Addressing these challenges requires investment in healthcare education,
training, and retention strategies to ensure an adequate and skilled workforce to
meet the population's healthcare needs (Okoro et al., 2018).

b. Healthcare Insurers and Payers: Healthcare insurers and payers play a crucial
role in financing healthcare services and managing healthcare expenses. They
include government-sponsored programs (such as Medicare and Medicaid in the
United States, NHIA for Nigeria), private health insurance companies, and social
health insurance schemes. Insurers and payers provide coverage for healthcare
services and reimburse healthcare providers for services rendered to patients.

c. Regulatory Bodies: Regulatory bodies are responsible for overseeing and

regulating various aspects of healthcare delivery to ensure quality, safety, and
compliance with regulations. These bodies may include government agencies,
professional licensing boards, accrediting organizations, and health ministries.
Regulatory bodies establish standards of practice, enforce regulations, and monitor
compliance to ensure that healthcare services meet quality and safety standards.
The nursing regulatory body in Nigeria is known as the Nursing and midwifery
council of Nigeria (NMCN), who regulates nursing education and practice in
Nigeria.
 3. Healthcare Financing Mechanisms: Healthcare financing mechanisms refer to the
methods used to fund healthcare services and cover healthcare expenses. These
mechanisms may include public funding through government budgets and taxation, private
health insurance premiums, out-of-pocket payments by patients, and social health
insurance schemes. The choice of financing mechanism can influence access to care,
healthcare quality, and financial protection for patients. Healthcare financing in Nigeria
relies heavily on out-of-pocket payments, with limited coverage provided by public health
insurance schemes such as the National Health Insurance Scheme (NHIS) (Onwujekwe et
al., 2016). The majority of Nigerians, especially those in low-income households, face
financial barriers to accessing healthcare services due to high out-of-pocket expenses
(Onwujekwe et al., 2016). Insufficient government funding for healthcare further
exacerbates the challenges of healthcare financing (Onwujekwe et al., 2016).

4. Health Information Systems: Health information systems play a crucial role in healthcare
delivery by facilitating the collection, storage, retrieval, and exchange of patient health
information. These systems include electronic health records (EHRs), health information
exchanges (HIEs), and other digital platforms that enable healthcare providers to access
patient data securely and efficiently.

The Structure and Organization of Healthcare System in Nigeria

The healthcare system in Nigeria is structured to provide healthcare services to its population, but
it faces numerous challenges, including inadequate infrastructure, limited resources, and
inequities in access to care. The following is an overview of the structure and organization of the
healthcare system in Nigeria:

1. Primary Healthcare Centres (PHCs): At the grassroots level, primary healthcare centres
are the foundation of Nigeria's healthcare system. They are designed to provide basic
healthcare services such as immunization, antenatal care, family planning, and treatment
for common illnesses. PHCs are intended to be the first point of contact for individuals
seeking healthcare services.
2. Secondary Healthcare Facilities: Secondary healthcare facilities include general
hospitals and specialist hospitals located at the state level. These facilities offer more
specialized services, including surgical procedures, diagnostic tests, and treatment for more
complex medical conditions. Secondary healthcare facilities serve as referral centres for
patients requiring specialized care beyond the capabilities of primary healthcare centres.

3. Tertiary Healthcare Facilities: Tertiary healthcare facilities are specialized hospitals and
medical centres located at the federal level or in major cities. These facilities provide highly
specialized services such as organ transplants, cancer treatment, cardiac surgery, and
advanced medical research. Tertiary hospitals often serve as teaching hospitals affiliated
with medical schools and training institutions.

4. Private Healthcare Sector: In addition to public healthcare facilities, Nigeria has a

significant private healthcare sector comprising hospitals, clinics, and medical practices
operated by private individuals, organizations, and religious institutions. Private healthcare
providers play a significant role in delivering healthcare services, particularly in urban
areas where they may offer more advanced and specialized care.

5. Health Insurance Scheme: The National Health Insurance Scheme (NHIS) was
established to provide financial risk protection and access to healthcare services for
Nigerians. However, the NHIS covers only a small percentage of the population, primarily
government employees and formal sector workers, leaving many Nigerians without health
insurance coverage.

6. Regulatory Bodies: Regulatory bodies oversee various aspects of healthcare delivery and
practice in Nigeria. These include the Federal Ministry of Health, the National Agency for
Food and Drug Administration and Control (NAFDAC), the Medical and Dental Council
of Nigeria (MDCN), the Nursing and Midwifery Council of Nigeria (NMCN), and other
professional regulatory bodies.

7. Challenges and Issues: Nigeria's healthcare system faces numerous challenges, including
inadequate funding, poor infrastructure, shortage of healthcare workers, unequal
distribution of healthcare resources, and widespread poverty. These challenges contribute
 to low healthcare utilization rates, high maternal and child mortality rates, and a high
burden of communicable and non-communicable diseases.

B. Key Stakeholders and Their Roles in Healthcare Governance

Healthcare governance involves the coordination and oversight of healthcare services to ensure
quality, safety, and efficiency. Key stakeholders in healthcare governance include government
agencies, regulatory bodies, healthcare providers, insurers, patients, advocacy groups, and
community organizations (Kuhlmann et al., 2018).

In the healthcare sector, several key stakeholders play essential roles in healthcare governance.
Here are some of the key stakeholders and their roles:

1. Government Agencies: Government agencies at the national, state, and local levels are
responsible for developing healthcare policies, regulations, and standards. They provide
oversight and guidance to healthcare facilities and professionals, allocate resources, and
ensure compliance with healthcare laws and regulations. Government agencies also play a
role in funding healthcare programs, implementing public health initiatives, and
monitoring healthcare quality and safety.

2. Healthcare Providers: Healthcare providers, including physicians, nurses, allied health

professionals, and other clinicians, deliver healthcare services to patients. They play a
crucial role in healthcare governance by adhering to professional standards of practice,
providing high-quality care, and advocating for patient safety and well-being. Healthcare
providers also contribute to healthcare governance through participation in quality
improvement initiatives, patient advocacy, and adherence to ethical principles.

3. Regulatory Bodies: Regulatory bodies oversee various aspects of healthcare delivery and
practice to ensure quality, safety, and compliance with regulations. These bodies may
include professional licensing boards, accreditation organizations, government agencies,
and health ministries. Regulatory bodies establish standards of practice, enforce
 regulations, and monitor compliance to safeguard patient health and maintain public trust
in the healthcare system.

4. Health Insurers and Payers: Health insurers and payers play a significant role in
healthcare governance by providing coverage for healthcare services and managing
healthcare expenses. They negotiate payment rates with healthcare providers, develop
coverage policies, and administer insurance plans. Insurers and payers also play a role in
promoting cost-effective care, preventing fraud and abuse, and improving healthcare
access and affordability for insured individuals.

5. Patients and Advocacy Groups: Patients and advocacy groups represent the interests of
healthcare consumers and advocate for patient rights, access to care, and quality healthcare
services. They play a vital role in healthcare governance by providing input on healthcare
policies, participating in decision-making processes, and holding healthcare organizations
and policymakers accountable. Patients and advocacy groups also raise awareness of
healthcare issues, promote patient education, and advocate for healthcare equity and social
justice.

6. Community Organizations: Community organizations, including non-profit

organizations, community health centres, and faith-based organizations, play a crucial role
in healthcare governance by addressing the health needs of underserved populations and
promoting community health initiatives. They collaborate with healthcare providers,
government agencies, and other stakeholders to improve access to healthcare services,
address social determinants of health, and empower communities to take co

Each stakeholder plays a unique role in shaping healthcare policies, regulations, and practices. For
example, government agencies set healthcare standards and regulations to ensure patient safety
and quality of care, while healthcare providers deliver services and advocate for patient needs.
Insurers manage healthcare finances and coverage, while patients and advocacy groups provide
input on healthcare policies and advocate for equitable access to care (Rodriguez et al., 2017).
 C. The Historical Development of Nursing within the Broader Healthcare Context

Nursing has a rich history that has evolved over centuries alongside advances in healthcare and
changes in societal norms. Understanding the historical development of nursing helps nurses
contextualize their profession within the broader healthcare landscape and appreciate the
contributions of nursing pioneers and leaders (Donahue et al., 2019).

Historical milestones in nursing, such as the establishment of nursing education programs,

professional organizations, and regulatory frameworks, have shaped the profession and influenced
nursing practice, education, and research (Kaminsky, 2018). Studying nursing history also
highlights the challenges faced by nurses in advocating for professional recognition, autonomy,
and improved working conditions, as well as the ongoing efforts to advance nursing knowledge
and practice (Kalisch & Kalisch, 2017).

Globally:

1. Early Civilizations: Nursing has ancient roots, with evidence of nursing practices dating
back to ancient civilizations such as Mesopotamia, Egypt, Greece, and Rome (Donahue et
al., 2019).

2. Medieval Europe: During the Middle Ages, nursing became associated with religious
orders, such as the Sisters of Charity and the Knights Hospitaller, who provided care to the
sick and wounded (Kalisch & Kalisch, 2017).

3. Florence Nightingale and Modern Nursing: Florence Nightingale, a British nurse and
social reformer, is considered the founder of modern nursing. Nightingale's work during
the Crimean War in the 19th century laid the foundation for modern nursing education and
professional practice (Donahue et al., 2019).

4. Professionalization of Nursing: In the late 19th and early 20th centuries, nursing began
to professionalize as nurses sought formal education and training programs (Kalisch &
Kalisch, 2017). Nursing organizations, such as the International Council of Nurses (ICN),
were formed to promote nursing as a distinct profession (Donahue et al., 2019).
 5. Advancements in Healthcare: Throughout the 20th century, nursing continued to evolve
alongside advancements in healthcare technology, research, and practice (Donahue et al.,
2019). Nurses played critical roles in healthcare delivery, patient advocacy, and public
health initiatives.

In Nigeria:

1. Traditional Healing Practices: In pre-colonial Nigeria, healthcare was primarily provided

by traditional healers, herbalists, and midwives who passed down healing knowledge
through oral traditions and apprenticeships (Iwelunmor et al., 2019).

2. Colonial Influence: With the arrival of European colonial powers in Nigeria, Western
medical practices were introduced, and colonial hospitals and clinics were established to
provide healthcare to colonial administrators and local populations (Iwelunmor et al.,
2019).

3. Post-Independence Development: Following Nigeria's independence in 1960, efforts

were made to strengthen the healthcare system and expand access to healthcare services
(Iwelunmor et al., 2019). Nursing education programs were established, and nursing
leaders emerged to advocate for the advancement of the nursing profession.

4. Professionalization of Nursing: In recent decades, nursing in Nigeria has undergone

significant professionalization, with the establishment of nursing regulatory bodies,
professional associations, and educational standards (Ogunbode et al., 2021). Nursing
leaders have worked to improve the status and recognition of the nursing profession.

5. Challenges and Opportunities: Despite progress, nursing in Nigeria continues to face

challenges such as brain drain, insufficient funding, and inadequate infrastructure
(Ogunbode et al., 2021). However, there are also opportunities for nursing to contribute to
addressing healthcare disparities, promoting public health initiatives, and advancing
healthcare delivery through innovation and collaboration.

Conclusion

Understanding the fundamentals of healthcare systems is essential for healthcare professionals to

provide quality care, advocate for patients, and contribute to ongoing efforts to improve healthcare
delivery and outcomes. By recognizing the structure and organization of healthcare systems,
understanding key stakeholders and their roles in healthcare governance, and grasping the
historical development of nursing, healthcare professionals can navigate complex healthcare
environments and work towards achieving optimal health for all individuals and communities.

References:
Donahue, M. P., Piazza, I. M., Griffin, M. Q., & Fitzpatrick, J. J. (2019). Nursing fundamentals:
Caring and clinical decision making. F.A. Davis Company.

Kalisch, B. J., & Kalisch, P. A. (2017). The evolving nursing profession. Nursing Outlook, 65(5),
661-664.

Kuhlmann, E., Batenburg, R., Groenewegen, P. P., Larsen, C., & O'Rourke, J. (2018). Health
workforce governance in Europe: where are we going?. Health Policy, 122(10), 1055-1062.

Rodriguez, H. P., Conrad, D. A., Austin, N., & Shortell, S. M. (2017). Frameworks for evaluating
health care system governance: A comparison of the United States, the United Kingdom,
and Germany. International Journal of Health Policy and Management, 6(12), 681-695.

Shi, L., & Singh, D. A. (2019). Essentials of the US healthcare system. Jones & Bartlett Learning.

World Health Organization. (2000). The World Health Report 2000: Health systems: improving
performance. World Health Organization.

Iwelunmor, J., Oyelere, H., Obiezu-Umeh, C., Shogbamimu, Y., & Ogidi, A. G. (2019). The
historical roots and development of the Nigerian health care system: A narrative review.
International Journal of Health Services, 49(4), 692-709.

Ogunbode, A. M., Fasoro, A. A., Olufunlayo, T. F., Agboola, P. O., Ojo, T. O., & Amosu, A. M.
(2021). Revisiting the history and evolution of nursing profession in Nigeria: A review.
Journal of Nursing and Midwifery Sciences, 8(2), 95-100.
Assignment:

1. You have been newly assigned as the Nursing Officer in-charge of your unit and suddenly
discovered a gross lack of essential drugs and supplies in that unit
a. What is your first line of action? 1 mark.
b. Describe how you will actualise your plans 4 marks
c. What is drug revolving fund? 2 marks
d. Discuss the relevance of drug revolving scheme to healthcare financing
mechanism. 8 marks
e. Highlight the challenges and prospects of drug revolving schemes 5 marks
2. Identify the government agencies in Nigeria that are responsible for healthcare governance
and their respective roles 10 marks
3. Compare and contrast the Nigeria political structure with those of other countries in Africa,
and attempt an intercontinental comparison. 10 marks
4. Discuss the effect of politic and governance on the wellbeing of Nigerians 10 marks

Soft copies to be submitted via [email protected] on or before 10:00 am Tuesday 16th

April 2024

While hard copies are to be submitted on or before 10:00 am Thursday 18th April, 2024

Nr. K. A. Ayinla

Lecturer in-charge