Background: Health care delivery has remained crippled in most third world countries. In Nigeria, various attempts by subsequent governments to improve on it has at best been on paper.Method: Analysis of hospital data for the period spanning 7 years before the onset of the revolving fund and eleven years after its onset was done. Method of application was also documented.Result: Service delivery was improved. Morbidity was reduced. Workers moral were better. However, improved services brought in more patients, resulting in increase mortality. Conclusion: An improved revolving fund scheme practiced by many establishments may improve the general status of our institutions. Acknowledgement: To staffs of Records Department, Accounts department and nurses in the various wards of the hospital. To Prof. A.O.U. Okpani for his immense contribution. Introduction Adequate health-care delivery has remained a mirage for most of the developing countries. Despite funding from government, external financing, insurance, individuals, corporate donations, community financing and user charges, our health-care delivery has remained comatose with resultant high morbidity and mortality 1 . Inadequate manpower development and poor infrastructures, absence of basic facilities and utilities have not made things better. With the general poverty status of our people and poor leadership, the future of the health industry seems hopeless. The Nigerian health budget for 2008 was N138.17billion 2 .In Nigeria, the national assembly has consistently made budgetary allocation to the tune of at least 4.5% of federal government recurrent expenditure to the health sector 3, 4 . In 2004, statistics from organization for economic co-operation and development (OECD) showed that the total public health expenditure in Nigeria amounted to only 1.2% gross domestic product (GDP). This is grossly inadequate for the health burden of a nation such as Nigeria 3, 4 .In many African countries, the public spending on health care is well below the levels needed to achieve the millennium development goals over the next decade 5,6 In developed countries health care is better financed. Spain’s health budget for 2008 was greater than 1billion euros. Japans health success implementation is rooted in its adequate financing .Here, local governments assumed the main responsibility for financing health promotion 8-11 . Japans fiscal year 2008/2009 starting in April had 21.78trillion yen budgeted for medical services and pensions 9-10 . Health package for their citizens are obviously better and advanced.The introduction of a hospital revolving fund scheme in the University of Port Harcourt Teaching Hospital about ten years ago (1997) where the various departments collect user fees and recycle it back into the system has improved health-care delivery. Materials and method Records of hospital activities between 1990 and 2007 were retrieved from records department, various wards and the administrative unit of the hospital. These records were analysed. Revolving fund schemeThe pilot scheme was started by the department of obstetrics and gynaecology. Take-off seed money of N250, 000.00 (US dollars 1,623.00) was loaned to the department by the University of Port Harcourt Teaching hospital management. This money was used to purchase the immediate consumables and materials needed for the take off of the project. It has since been paid back. This is to make the department relatively autonomous. A project committee was set up, made up of a project manager (Head of Department of obstetrics and gynaecology), a project accountant, project secretary, three other consultants in the department, the department’s chief resident or resident doctors’ representative, the chief medical director’s representative, the director of clinical services and training, the chairman, medical advisory committee, the chief nursing officer obstetrics and gynaecology, the head of pharmacology department or his representative.T
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