Despite shortcomings in those areas in many developing countries, the public health system itself bears responsibility for providing adequate health services to the population. Unfortunately, public health systems in many developing countries fail to function effectively, due both to inadequate resources and poor policy and management choices. Health Care Facilities Poor planning, or planning influenced by factors other than medical need, contributes to health care systems inadequately designed to respond to patients' needs. The location of facilities often is chosen based on where politicians live, or where physicians prefer to practice, rather than where the neediest patients live.
Facilities tend to be concentrated in cities, far from rural populations.
According to World Bank data, the number of health facilities in 30 Nigerian states ranges from one per 200 people in Lagos State to one per 129,000 in Benue State. Three-fourths of the country's health facilities are located in urban areas, which contain only 30 percent of the population. One region in Guinea-Bissau has more than five times the number of hospital beds per person found in another, more populated region. This distribution of facilities poses a significant barrier to access to health care for much of the developing world. Additional studies indicate that better location of maternal and child health facilities in rural Nigeria would have increased coverage by 20 percent.