Access to quality health care is seen as one of the social problems facing many
countries. Meanw... more Access to quality health care is seen as one of the social problems facing many
countries. Meanwhile, in the last three decades in Africa, Community-Based
Health Insurance (CBHI) has been promoted as an effective health financing
option for providing access to care for individuals in the informal sector and
toward attaining universal health coverage. However, these goals are often
truncated by certain challenges. Drawing from the experience of rural Nigeria,
this study aims to answer the question: what are the challenges that face CBHI
programs in Africa? Premised on the health policy triangle, this work analyzed
the challenges in relation to the roles played by the various partners in the
implementation of the program. The study found that each of these actors were partly responsible for the challenges that befell the program prior to the eventual
collapse. Public healthcare facilities in the rural areas are inadequate in terms of
number and spatial distribution to improve access to care. The health maintenance
organization was not able to meet the enrolment target and the healthcare providers
gave preference to those that were ready to pay out-of-pocket over
enrollees in the program. Government should endeavor to enforce substantial
financial and administrative commitment to healthcare provisioning in order to
attain universal healthcare coverage.
Bibliography: leaves 268-317The challenge of accessing affordable healthcare services in the deve... more Bibliography: leaves 268-317The challenge of accessing affordable healthcare services in the developing countries prompted the promotion of community-based health insurance (CBHI) as an effective alternative. CBHI has been implemented in many countries of the South over the last three decades for the purpose of improving access and attaining universal health coverage. However, the sudden stoppage of a CBHI programme in rural Nigeria raised a lot of concerns about the suitability of the health financing scheme. Thus, this thesis examines the stoppage of the CBHI programme in rural Kwara, Nigeria. Premised on the health policy triangle as a conceptual framework, mixed methods approach was adopted for data collection. This involved 12 focus group discussions, 22 in-depth interviews, 32 key informant interviews and 1,583 questionaires. The study participants were community members, community leaders, healthcare providers, policymakers, international partner, health maintenance organisat...
Social accountability is an important strategy towards ensuring that political leaders and actors... more Social accountability is an important strategy towards ensuring that political leaders and actors implement the right policies in the interest of the entire society. In 2007, a community-based health insurance programme was implemented in selected rural communities in Kwara State, Nigeria, through collaboration between the Dutch Health Insurance Fund, PharmAccess Foundation, the Kwara State Government, and Hygeia Nigeria Limited to provide access to basic healthcare for the people. After operating for 9 years, the programme stopped in 2016. This paper describes how social and political accountability shaped the introduction, functioning, and stoppage of the CBHI programme. The study adopted a qualitative approach for data collection, particularly in-depth (n = 22) and key informant interviews (n = 32). Findings indicate that the community-based health insurance programme was proposed by the foreign agency and that the state government was instrumental in the stoppage of the programm...
Access to quality health care is seen as one of the social problems facing many
countries. Meanw... more Access to quality health care is seen as one of the social problems facing many
countries. Meanwhile, in the last three decades in Africa, Community-Based
Health Insurance (CBHI) has been promoted as an effective health financing
option for providing access to care for individuals in the informal sector and
toward attaining universal health coverage. However, these goals are often
truncated by certain challenges. Drawing from the experience of rural Nigeria,
this study aims to answer the question: what are the challenges that face CBHI
programs in Africa? Premised on the health policy triangle, this work analyzed
the challenges in relation to the roles played by the various partners in the
implementation of the program. The study found that each of these actors were partly responsible for the challenges that befell the program prior to the eventual
collapse. Public healthcare facilities in the rural areas are inadequate in terms of
number and spatial distribution to improve access to care. The health maintenance
organization was not able to meet the enrolment target and the healthcare providers
gave preference to those that were ready to pay out-of-pocket over
enrollees in the program. Government should endeavor to enforce substantial
financial and administrative commitment to healthcare provisioning in order to
attain universal healthcare coverage.
Bibliography: leaves 268-317The challenge of accessing affordable healthcare services in the deve... more Bibliography: leaves 268-317The challenge of accessing affordable healthcare services in the developing countries prompted the promotion of community-based health insurance (CBHI) as an effective alternative. CBHI has been implemented in many countries of the South over the last three decades for the purpose of improving access and attaining universal health coverage. However, the sudden stoppage of a CBHI programme in rural Nigeria raised a lot of concerns about the suitability of the health financing scheme. Thus, this thesis examines the stoppage of the CBHI programme in rural Kwara, Nigeria. Premised on the health policy triangle as a conceptual framework, mixed methods approach was adopted for data collection. This involved 12 focus group discussions, 22 in-depth interviews, 32 key informant interviews and 1,583 questionaires. The study participants were community members, community leaders, healthcare providers, policymakers, international partner, health maintenance organisat...
Social accountability is an important strategy towards ensuring that political leaders and actors... more Social accountability is an important strategy towards ensuring that political leaders and actors implement the right policies in the interest of the entire society. In 2007, a community-based health insurance programme was implemented in selected rural communities in Kwara State, Nigeria, through collaboration between the Dutch Health Insurance Fund, PharmAccess Foundation, the Kwara State Government, and Hygeia Nigeria Limited to provide access to basic healthcare for the people. After operating for 9 years, the programme stopped in 2016. This paper describes how social and political accountability shaped the introduction, functioning, and stoppage of the CBHI programme. The study adopted a qualitative approach for data collection, particularly in-depth (n = 22) and key informant interviews (n = 32). Findings indicate that the community-based health insurance programme was proposed by the foreign agency and that the state government was instrumental in the stoppage of the programm...
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Papers by Lawal F O L O R U N S H O Afeez
countries. Meanwhile, in the last three decades in Africa, Community-Based
Health Insurance (CBHI) has been promoted as an effective health financing
option for providing access to care for individuals in the informal sector and
toward attaining universal health coverage. However, these goals are often
truncated by certain challenges. Drawing from the experience of rural Nigeria,
this study aims to answer the question: what are the challenges that face CBHI
programs in Africa? Premised on the health policy triangle, this work analyzed
the challenges in relation to the roles played by the various partners in the
implementation of the program. The study found that each of these actors were partly responsible for the challenges that befell the program prior to the eventual
collapse. Public healthcare facilities in the rural areas are inadequate in terms of
number and spatial distribution to improve access to care. The health maintenance
organization was not able to meet the enrolment target and the healthcare providers
gave preference to those that were ready to pay out-of-pocket over
enrollees in the program. Government should endeavor to enforce substantial
financial and administrative commitment to healthcare provisioning in order to
attain universal healthcare coverage.
countries. Meanwhile, in the last three decades in Africa, Community-Based
Health Insurance (CBHI) has been promoted as an effective health financing
option for providing access to care for individuals in the informal sector and
toward attaining universal health coverage. However, these goals are often
truncated by certain challenges. Drawing from the experience of rural Nigeria,
this study aims to answer the question: what are the challenges that face CBHI
programs in Africa? Premised on the health policy triangle, this work analyzed
the challenges in relation to the roles played by the various partners in the
implementation of the program. The study found that each of these actors were partly responsible for the challenges that befell the program prior to the eventual
collapse. Public healthcare facilities in the rural areas are inadequate in terms of
number and spatial distribution to improve access to care. The health maintenance
organization was not able to meet the enrolment target and the healthcare providers
gave preference to those that were ready to pay out-of-pocket over
enrollees in the program. Government should endeavor to enforce substantial
financial and administrative commitment to healthcare provisioning in order to
attain universal healthcare coverage.