alone (Doctor et al., 2011, p. 11). Whereas the mean infant mortality rate in Africa is 88.8, in North and South America it is only 25 (Abouharb & Kimball, 2007, p. 750). Doctor et al. (2011, p. 11) point out that the situation is worse in northern Nigeria than in southern Nigeria, because practices involving childbirth and fertility-related behaviors are influenced by strong cultural beliefs in the north (Doctor et al., 2011, p. 11).
One reason for the differences in the quality of healthcare between the United States and Nigeria-in addition to the obvious one of relative level of wealth-is the differences in their healthcare systems. Whereas the U.S. healthcare system is privatized and competitive, that of Nigeria is a government system. Governments are notoriously bureaucratic and subject to corruption, and their management of healthcare systems tends to be no different. Research by Lewis (2006, p. 13) cites a number of sources in her findings that evidence gathered from provider surveys and other research instruments in Nigeria and two other African countries suggests that "the level of mismanagement, vague and poorly understood performance expectations and the singular lack of accountability to anyone or any institution makes haphazard and corrupt practices difficult to identify, separate or control."
In a privatized system such as that of the United States, it is incumbent upon healthcare providers to ensure favorable outcomes for patients so that patients will choose to return for future care. This means that the availability of medications, medical equipment, and other tools and resources is maximized to the extent possible, ensuring not only better care but also more profitable care. Privatized systems are driven on profit. The U.S. healthcare system is corrupt like the Nigerian system
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