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Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective

Received: 21 November 2019     Accepted: 13 December 2019     Published: 24 December 2019
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Abstract

Introduction: The Nigerian government has introduced various forms of health insurance programme as a means of supplying quality healthcare services to its citizens all in attempt to attain the universal health coverage. Unfortunately, these various forms of Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the supply of healthcare services and this is evidenced by observed adverse selection and supplier induced demands which are major causes of market failure in health insurance industry. Therefore, there is a need to deduce unique strategies to improve supply of health insurance so as to reduce the barest minimum the incidence of market failure which has impacted negatively on the health insurance industry. Methods: The study adopted qualitative approach by using in-depth interviews (IDIs) method. Nine (9) key informants were purposely sampled from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The interviewees relayed their experiences in the programme which includes provider non-adherence to accreditation pattern, poor reimbursement and tariff structure, fluctuations in prices of input, inadequate funding of the programme and low number of enrollees registered in private facilities and consequently proffered strategies on how to eliminate adverse selection and supplier induced demand with a resultant improvement in supply of health insurance services. Conclusions: Evidence from this qualitative study have shown various strategies if implemented will reduce the incidence of adverse selection and supplier induced demand which are mostly implicated as common causes of market failures.

Published in Journal of Public Policy and Administration (Volume 3, Issue 4)
DOI 10.11648/j.jppa.20190304.14
Page(s) 98-105
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Supply of Health Insurance Services, Social Health Insurance Programme, Market Failure, Adverse Selection, Supplier Induced Demand

References
[1] Awosika, L. (2007). Health insurance and managed care in Nigeria. Ann Ibadan Postgrad Med. 3 (2), 40-51.
[2] Adibe, M. O., Udeogaranya, P. O. & Ubaka, C. M. (2011). Awareness of national health insurance scheme activities among employees of a Nigerian university, Int. J. Drug Dev. & Res. 3 (4): 78-85.
[3] Osungbade, K. O., Obembe, T. A., & Oludoyi, A. (2014). Users Satisfaction with Service Provided under National Health Insurance Scheme in South Western Nigeria. International Journal of Tropical Disease and Health, 4 (5): 595-607.
[4] Gabel, J. (2008). Where do I send thee? Does physician ownership affect referral patterns to ambulatory surgery centers? Health Affairs, 27, 165–174.
[5] NHIS. (2015). National health insurance scheme operational guidelines. Abuja, Nigeria: National Health Insurance Scheme.
[6] Nguyen, H. (2011). The principal-agent problems in healthcare: evidence from prescribing patterns of private providers in Vietnam. Health Policy Plan, 26, 52-62.
[7] Arrow, K. (1963). Uncertainty and the welfare economics of medical care. American Economic Review, 53 (5), 941-973.
[8] Cromwell J., & Mitchell, J. B. (1986). Physician-induced demand for surgery. Journal of Health Economics, 5, 293-313.
[9] McGuire, T. G. (2000). Physician agency. In Culyer, A. J & Newhouse, J. P. (Eds). Handbook of Health Economics, (pp. 461-536). Amsterdam: Elsevier Science.
[10] Folland, S., Goodman, A. & Stano, M. (2013). The economics of Health and Health care (7thed.). Boston, MA: Pearson.
[11] Weinberger, S (2011). Providing high value, cost conscious care: a critical seventh general competency for physicians. Annals of Internal Medicine, 155, 386–388.
[12] Stavropoulou, C. & Glycopantis, D. (2009), The doctor-patient relationship under general conditions of uncertainty. Imperial Business School Discussion Paper Series, Discussion Paper No 2009/06. Access on 14/5/16 at http://www.ibs.org/documents/health/MrktStrOfHlthIns.pdf.
[13] Onwujekwe, O. E., Uzochukwu, B. S., Ezeoke, O. P., & Uguru, N. P. (2011). Health insurance principles, models and the Nigeria national health insurance scheme. International Journal of Medicine and Health Development, 16, 1-3.
[14] Cheng, T. C., Haisken- DeNew, J & Yong, Y. (2014). Cream Selection and hospital transfers in a mixed public-private system. Health Policy, 11 (1), 43-45.
[15] NPC. (2006). National census figures. Abuja, Nigeria: National Population Commission.
[16] Anderson, C. (2010). Presenting and evaluating qualitative research. American journal of pharm. Education, 74 (8), 141.
[17] Cho, J. Y. & Lee, E. (2014). Reducing Confusion about Grounded Theory and Qualitative Content Analysis: Similarities and Differences. The Qualitative Report, 19 (32), 1-20.
[18] Creswell, J. W. (2007). Qualitative inquiry and research: choosing among the five traditions (2ned). Thousand oaks, CA: Sage Publications.
[19] Shreier, M. (2012). Qualitative content analysis in practice. Thousand Oaks, CA: Sage Publications.
[20] Boyatzis, R. E. (1998) Transforming qualitative information: Thematic analysis and code development. Thousand Oaks, CA: Sage Publications.
[21] Eggleston, K., & Hsieh, C. R. (2004). Healthcare payment incentives: a comparative analysis of reforms in Taiwan, South Korea and China. Appl Health Econ Health Policy, 3 (1): 47-56.
[22] Robyn, P. J., Sauerborn, R., & Baarnighausen, T. (2012). Provider payment in community-based health insurance schemes in developing countries: a systematic review. Health Policy and Planning, 28 (2): 111-122.
[23] Alshreef, A. (2019). Provider payment mechanism: effective policy tools for achieving universal and sustainable healthcare coverage. Accessed on 7/10/2019 at https://www.intechopen.com/online-first/provider-payment-mechanism-effective-policy-tools-for-achieving-universal-and-effective-healthcare-coverage.
[24] Dalinjong, P. A., & Laar, A. S. (2012). The national health insurance scheme: perceptions and experiences of healthcare providers and clients in two districts of Ghana. Health Economic Review, 2, 13-16.
[25] Ankomah, M. (2009). Reforms in the provider tariff for the NHIS: Key implementation issues. NBER working paper series, 12 (3), 7206-7209.
[26] Onoka, C. A., Hanson, K., Mills, A. (2014). Growth of health maintenance organization in Nigeria and the potential for a role in promoting universal coverage efforts. Social Science and Medicine, 58, 70-74.
[27] Flodgren, G., Eccles, M., Shepperd, H., Scott, A., Pamelli, E. & Beyer, F. (2011). An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes. International Journal of Science and Research, 38, 7.
[28] Eljkenaar, F., Emmert, M., Scheppard, M. & Schoffski, O. (2013). Effects of pay for performance in healthcare: a systematic review. Health Policy, 110 (23), 150-80.
[29] Uzochukwu, B., Ughasoro, M. D. Etiaba, E., Okwuosa, C., Envuladu, E., & Onwujekwe, O. E. (2015). Health care financing in Nigeria: implications for achieving universal health coverage. Niger J Clin Pract. 18, 437-44.
Cite This Article
  • APA Style

    Obi Ikechukwu Vincent, Okoronkwo Ijeoma Lewechi Okoronkwo Ijeoma Lewechi, Adi Jesse Ashumate, Iloh Gabriel Uche Paschal, Yakubu Adole Agada-Amade, et al. (2019). Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective. Journal of Public Policy and Administration, 3(4), 98-105. https://doi.org/10.11648/j.jppa.20190304.14

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    ACS Style

    Obi Ikechukwu Vincent; Okoronkwo Ijeoma Lewechi Okoronkwo Ijeoma Lewechi; Adi Jesse Ashumate; Iloh Gabriel Uche Paschal; Yakubu Adole Agada-Amade, et al. Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective. J. Public Policy Adm. 2019, 3(4), 98-105. doi: 10.11648/j.jppa.20190304.14

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    AMA Style

    Obi Ikechukwu Vincent, Okoronkwo Ijeoma Lewechi Okoronkwo Ijeoma Lewechi, Adi Jesse Ashumate, Iloh Gabriel Uche Paschal, Yakubu Adole Agada-Amade, et al. Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective. J Public Policy Adm. 2019;3(4):98-105. doi: 10.11648/j.jppa.20190304.14

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  • @article{10.11648/j.jppa.20190304.14,
      author = {Obi Ikechukwu Vincent and Okoronkwo Ijeoma Lewechi Okoronkwo Ijeoma Lewechi and Adi Jesse Ashumate and Iloh Gabriel Uche Paschal and Yakubu Adole Agada-Amade and Ikwudinma Augustine Obiora},
      title = {Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective},
      journal = {Journal of Public Policy and Administration},
      volume = {3},
      number = {4},
      pages = {98-105},
      doi = {10.11648/j.jppa.20190304.14},
      url = {https://doi.org/10.11648/j.jppa.20190304.14},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jppa.20190304.14},
      abstract = {Introduction: The Nigerian government has introduced various forms of health insurance programme as a means of supplying quality healthcare services to its citizens all in attempt to attain the universal health coverage. Unfortunately, these various forms of Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the supply of healthcare services and this is evidenced by observed adverse selection and supplier induced demands which are major causes of market failure in health insurance industry. Therefore, there is a need to deduce unique strategies to improve supply of health insurance so as to reduce the barest minimum the incidence of market failure which has impacted negatively on the health insurance industry. Methods: The study adopted qualitative approach by using in-depth interviews (IDIs) method. Nine (9) key informants were purposely sampled from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The interviewees relayed their experiences in the programme which includes provider non-adherence to accreditation pattern, poor reimbursement and tariff structure, fluctuations in prices of input, inadequate funding of the programme and low number of enrollees registered in private facilities and consequently proffered strategies on how to eliminate adverse selection and supplier induced demand with a resultant improvement in supply of health insurance services. Conclusions: Evidence from this qualitative study have shown various strategies if implemented will reduce the incidence of adverse selection and supplier induced demand which are mostly implicated as common causes of market failures.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective
    AU  - Obi Ikechukwu Vincent
    AU  - Okoronkwo Ijeoma Lewechi Okoronkwo Ijeoma Lewechi
    AU  - Adi Jesse Ashumate
    AU  - Iloh Gabriel Uche Paschal
    AU  - Yakubu Adole Agada-Amade
    AU  - Ikwudinma Augustine Obiora
    Y1  - 2019/12/24
    PY  - 2019
    N1  - https://doi.org/10.11648/j.jppa.20190304.14
    DO  - 10.11648/j.jppa.20190304.14
    T2  - Journal of Public Policy and Administration
    JF  - Journal of Public Policy and Administration
    JO  - Journal of Public Policy and Administration
    SP  - 98
    EP  - 105
    PB  - Science Publishing Group
    SN  - 2640-2696
    UR  - https://doi.org/10.11648/j.jppa.20190304.14
    AB  - Introduction: The Nigerian government has introduced various forms of health insurance programme as a means of supplying quality healthcare services to its citizens all in attempt to attain the universal health coverage. Unfortunately, these various forms of Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the supply of healthcare services and this is evidenced by observed adverse selection and supplier induced demands which are major causes of market failure in health insurance industry. Therefore, there is a need to deduce unique strategies to improve supply of health insurance so as to reduce the barest minimum the incidence of market failure which has impacted negatively on the health insurance industry. Methods: The study adopted qualitative approach by using in-depth interviews (IDIs) method. Nine (9) key informants were purposely sampled from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The interviewees relayed their experiences in the programme which includes provider non-adherence to accreditation pattern, poor reimbursement and tariff structure, fluctuations in prices of input, inadequate funding of the programme and low number of enrollees registered in private facilities and consequently proffered strategies on how to eliminate adverse selection and supplier induced demand with a resultant improvement in supply of health insurance services. Conclusions: Evidence from this qualitative study have shown various strategies if implemented will reduce the incidence of adverse selection and supplier induced demand which are mostly implicated as common causes of market failures.
    VL  - 3
    IS  - 4
    ER  - 

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Author Information
  • Department of Health Management and Administration, University of Nigeria, Enugu, Nigeria

  • Department of Health Management and Administration, University of Nigeria, Enugu, Nigeria

  • Department of Health Services, Federal University Wukari, Jalingo, Nigeria

  • Department of Family Medicine, Federal Medical Centre, Umuahia, Nigeria

  • Department of Health Management and Administration, University of Nigeria, Enugu, Nigeria

  • Department of Family Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria

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