The impact of family and budget structure on health treatment in Nigeria.

Health-treatment decisions, in much of the world, are affected by the family's ability to meet the cost. In West Africa the situation is more complex because husbands and wives typically have separate budgets. This article reports an exploration of the impact on treatment of divided family budgets in Nigeria where health services now charge for prescribed drugs. It was found that most child treatment is paid for by one person only, usually a parent, and that the treatment chosen is decided by the person meeting the cost. Mothers are most likely to pay for minor illnesses but the father's role becomes more important as the cost rises. Because the type, and even fact, of treatment depends on the ability to pay, and because the family is not a unity in these decisions, the health system may have to devise charging procedures that make both parents responsible, possibly with community involvement in securing payment.