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Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria / JENSON FOFAH

Swansea University Author: JENSON FOFAH

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DOI (Published version): 10.23889/SUthesis.57024

Abstract

There is increasing pressure for low and middle-income countries to move towards achieving universal healthcare coverage (UHC). According to WHO (2013), UHC guarantees the right to affordable health care for every individual, without financial hardship. The Director-General to the World Health Organ...

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Published: Swansea 2021
Institution: Swansea University
Degree level: Doctoral
Degree name: Ph.D
Supervisor: Rea, David M., Beech, Ian M.
URI: https://cronfa.swan.ac.uk/Record/cronfa57024
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first_indexed 2021-06-03T13:26:01Z
last_indexed 2021-06-04T03:23:05Z
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The Director-General to the World Health Organization, Margaret Chan (WHO, 2010 p. 1), says UHC “is the single most powerful concept that public health has to offer”.In recent years, UHC has come onto the policy agenda, but Nigeria has been criticised for its slow progress. This study investigates why and how the UHC policy is developed by focusing on the roles and interactions of policy actors, their policy setting, and ‘how’ their actions influence the policy process and outcome of UHC so far in Nigeria. It will provide evidence of Nigeria’s policy process that will enhance the understanding of the politics of such health care policy implementation processes, which is fundamental to the success of policy networks of UHC in low- and middle-income settings.This is an empirical study using a mixed method approach involving quantitative and qualitative research components. The study combines the social network analysis (the quantitative component) with a more general policy process framework (the qualitative component). Data collected between March 2016 and February 2017 involved face-to-face structured interviews, face-to-face semi-structured interviews and documentary analysis to identify members of relevant policy networks and describe the pattern of relationships and influence within the UHC discourse.The SNA analysis displayed a full structural network taxonomy of the UHC policy process and identified key members of the UHC discourse into four key institutions and organisations- such as the power actors, peripheral actors, gatekeepers or brokers, isolated actors, and policy actors connected to the power actors.The theoretical policy process framework highlights five key gaps that exist as challenges and obstacles which impedes the implementation process of UHC Nigeria. These challenges and obstacles include, changing political climate, concerns about system capacity and finance, poor coordination between federal and state levels, corruption and problems with the private sector – HMOs. These challenges and obstacles limit the government’s ability to provide social and financial risk protection and access to quality health services to vulnerable Nigerian communities.Drawing on the theoretical framework and intervention, this thesis concludes that the political, policy, financial and organizational constraints of the health system limit UHC Nigeria implementation progress. 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spelling v2 57024 2021-06-03 Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria 3fcd304eaf52d4917afe25102a887b47 JENSON FOFAH JENSON FOFAH true false 2021-06-03 There is increasing pressure for low and middle-income countries to move towards achieving universal healthcare coverage (UHC). According to WHO (2013), UHC guarantees the right to affordable health care for every individual, without financial hardship. The Director-General to the World Health Organization, Margaret Chan (WHO, 2010 p. 1), says UHC “is the single most powerful concept that public health has to offer”.In recent years, UHC has come onto the policy agenda, but Nigeria has been criticised for its slow progress. This study investigates why and how the UHC policy is developed by focusing on the roles and interactions of policy actors, their policy setting, and ‘how’ their actions influence the policy process and outcome of UHC so far in Nigeria. It will provide evidence of Nigeria’s policy process that will enhance the understanding of the politics of such health care policy implementation processes, which is fundamental to the success of policy networks of UHC in low- and middle-income settings.This is an empirical study using a mixed method approach involving quantitative and qualitative research components. The study combines the social network analysis (the quantitative component) with a more general policy process framework (the qualitative component). Data collected between March 2016 and February 2017 involved face-to-face structured interviews, face-to-face semi-structured interviews and documentary analysis to identify members of relevant policy networks and describe the pattern of relationships and influence within the UHC discourse.The SNA analysis displayed a full structural network taxonomy of the UHC policy process and identified key members of the UHC discourse into four key institutions and organisations- such as the power actors, peripheral actors, gatekeepers or brokers, isolated actors, and policy actors connected to the power actors.The theoretical policy process framework highlights five key gaps that exist as challenges and obstacles which impedes the implementation process of UHC Nigeria. These challenges and obstacles include, changing political climate, concerns about system capacity and finance, poor coordination between federal and state levels, corruption and problems with the private sector – HMOs. These challenges and obstacles limit the government’s ability to provide social and financial risk protection and access to quality health services to vulnerable Nigerian communities.Drawing on the theoretical framework and intervention, this thesis concludes that the political, policy, financial and organizational constraints of the health system limit UHC Nigeria implementation progress. Addressing the reasons why these issues ensue would be helpful in taking strategic steps towards achieving financial protection and access to basic health services through UHC for many Nigerians. E-Thesis Swansea Universal Health Coverage, Social Network Analysis, Health Policy, Power in Health Policy, Multiple Stream Framework, Nigeria. 3 6 2021 2021-06-03 10.23889/SUthesis.57024 COLLEGE NANME COLLEGE CODE Swansea University Rea, David M., Beech, Ian M. Doctoral Ph.D Self-funded Not Required 2023-06-28T16:41:43.0547930 2021-06-03T14:16:12.2816476 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine JENSON FOFAH 1 57024__20057__5309d6be182842d897c840efdd1b1963.pdf Jenson_G._Fofah.v.finalPhD.v1.1.pdf 2021-06-03T15:14:18.5628279 Output 9364009 application/pdf E-Thesis – open access true Copyright: The Author, Jenson Gawain Fofah, 2021 true eng
title Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria
spellingShingle Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria
JENSON FOFAH
title_short Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria
title_full Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria
title_fullStr Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria
title_full_unstemmed Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria
title_sort Obstacles and Challenges affecting the move towards Universal Healthcare Coverage in Nigeria
author_id_str_mv 3fcd304eaf52d4917afe25102a887b47
author_id_fullname_str_mv 3fcd304eaf52d4917afe25102a887b47_***_JENSON FOFAH
author JENSON FOFAH
author2 JENSON FOFAH
format E-Thesis
publishDate 2021
institution Swansea University
doi_str_mv 10.23889/SUthesis.57024
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description There is increasing pressure for low and middle-income countries to move towards achieving universal healthcare coverage (UHC). According to WHO (2013), UHC guarantees the right to affordable health care for every individual, without financial hardship. The Director-General to the World Health Organization, Margaret Chan (WHO, 2010 p. 1), says UHC “is the single most powerful concept that public health has to offer”.In recent years, UHC has come onto the policy agenda, but Nigeria has been criticised for its slow progress. This study investigates why and how the UHC policy is developed by focusing on the roles and interactions of policy actors, their policy setting, and ‘how’ their actions influence the policy process and outcome of UHC so far in Nigeria. It will provide evidence of Nigeria’s policy process that will enhance the understanding of the politics of such health care policy implementation processes, which is fundamental to the success of policy networks of UHC in low- and middle-income settings.This is an empirical study using a mixed method approach involving quantitative and qualitative research components. The study combines the social network analysis (the quantitative component) with a more general policy process framework (the qualitative component). Data collected between March 2016 and February 2017 involved face-to-face structured interviews, face-to-face semi-structured interviews and documentary analysis to identify members of relevant policy networks and describe the pattern of relationships and influence within the UHC discourse.The SNA analysis displayed a full structural network taxonomy of the UHC policy process and identified key members of the UHC discourse into four key institutions and organisations- such as the power actors, peripheral actors, gatekeepers or brokers, isolated actors, and policy actors connected to the power actors.The theoretical policy process framework highlights five key gaps that exist as challenges and obstacles which impedes the implementation process of UHC Nigeria. These challenges and obstacles include, changing political climate, concerns about system capacity and finance, poor coordination between federal and state levels, corruption and problems with the private sector – HMOs. These challenges and obstacles limit the government’s ability to provide social and financial risk protection and access to quality health services to vulnerable Nigerian communities.Drawing on the theoretical framework and intervention, this thesis concludes that the political, policy, financial and organizational constraints of the health system limit UHC Nigeria implementation progress. Addressing the reasons why these issues ensue would be helpful in taking strategic steps towards achieving financial protection and access to basic health services through UHC for many Nigerians.
published_date 2021-06-03T16:41:38Z
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