Money matters mater – but it is not all about Money: Addressing challenges private sector hospitals face in providing newborn care

Abstract

Background:
Nigeria is unlikely to reach the Sustainable Development Goal (SDG) 3.2 target of 12/1000 live births by 2030 as the Neonatal Mortality rate (NMR) which fell from 70/1000 live births in 1967 to 34/1000 in 2022 rose to 41/1000 in 2023-2024. Increasing the involvement of private-sector medical facilities in newborn care could improve access of newborns to skilled care, reduce the burden on government hospitals, and provide data. This study investigated the challenges private hospitals face in providing newborn care and discussed possible solutions.

Methods
Convenience sampling of staff of registered private hospitals in two cities (Kaduna, Zaria), using a questionnaire. Common neonatal conditions seen were sepsis, jaundice, asphyxia, and prematurity. Financial issues were a major challenge and consisted of the cost of providing care (consumables, equipment, electricity, payment of visiting medical staff), parent/caregiver's difficulty in paying, and
delayed payments by Health Insurance Schemes. Non-financial challenges included managing the poor condition of newborns at
presentation, problems with referrals and parents/caregivers, and insufficient knowledge of staff about newborn care. Suggested Solutions include on-time payments by health Insurers, training (Clinical and business) and increasing the number of insured persons.
Conclusion:
It is recommended that governments encourage private medical practitioners to provide or improve newborn care by ensuring timely settlement of bills, increasing insurance coverage and training, building referral networks, and assisting in obtaining loans. The Nigeria Society of Neonatal Medicine should advocate for private practitioners, assist in training, supervise policy implementation, encourage investment in public-private neonatal units, and expand its membership.