Implementing Community Based Health Insurance Schemes: A Mechanism for Health Care Service Delivery in Kano Metropolis
1 Department of Public Administration, Bayero University Kano
2 Department of Political Science, Bayero University Kano
3 Department of Public Administration Faculty of Management Sciences Bayero University, Kano-Nigeria
4 Department of Public Administration Faculty of Management Sciences Bayero University, Kano
* Corresponding author: fatimaoyineibrahim@femsbukjournals.org.ng/bjpa
2 Department of Political Science, Bayero University Kano
3 Department of Public Administration Faculty of Management Sciences Bayero University, Kano-Nigeria
4 Department of Public Administration Faculty of Management Sciences Bayero University, Kano
* Corresponding author: fatimaoyineibrahim@femsbukjournals.org.ng/bjpa
Abstract
The lethargic nature of the Nigerian health system, ravaged by numerous operational and
administrative crises, had necessitated the establishment of National Health Insurance
Scheme (NHIS) as one of Nigerian government’s health reform measure aimed at securing
better health care for Nigerians. However, only the formal sector insurance scheme was fully
operational while the informal sector scheme like Community Based Health Insurance
Schemes (CBHIS) was not implemented particularly in Kano state and other Northern States
where it is much needed. This study aimed at identifying how the implementation of CBHIS
would ensure the actualization of NHIS major objectives, the challenges affecting its
implementation and the politico-economic implications of both these challenges and the
scheme itself. Mixed method approach where both qualitative and quantitative data were
utilized. The qualitative data was obtained from in-depth interviews with relevant
stakeholders such as traditional, religious, women and Youth leaders. The National Health
Insurance Agency officials, health management organizations, and Civil Society
Organizations were also interviewed. Quantitative data was obtained through the
administration of questionnaires to healthcare enrollees of the NHIA and the Leaders of
selected community based associations in the State. Quantitative data was analysed using
frequency and percentage tables and qualitatively through selected themes relevant to the
study. Findings revealed that the health situations of many in the communities are ravaged by
many challenges ranging from inadequate finances (poverty), proximity issues, poor road
networks, poor state of health facilities, inadequate drugs, adverse government policies,
inadequate support from the government, lack of knowledge on the Islamic position of
insurance among others. Additionally, findings revealed that the CBHIS is built on the
premise of reducing existing gaps of inequality in access to quality healthcare and a
financing strategy, yet its implementation is blurred by numerous challenges such as poor
awareness about the scheme, low level of acceptance, poor government commitment, lack of
trust on both government and board of trustees on the part of community members among
others. The study concluded that, CBHIS would have served as the best health financing
option that would strengthen community support for health care needs of members and help
accepting health care financing as a collective responsibility of government and the
community.
Keywords
Community-Based
Health Insurance Schemes
Health Care Service Delivery
Kano state
References
- Adejumobi, S. (2005). Identity, Citizenship and Conflict: The African Experience. The Crisis of the State and Regionalism in West Africa: Identity, Citizenship and Conflict. Eds. W. Alade Fawole and Charles Ukeje. Dakar: CODESRIA. 19-41
- Adinma, E.D, Adinma B.J. (2010). Community based healthcare financing: An untapped option to a more effective healthcare funding in Nigeria. Nigerian Medical Journal. 51:95-100
- Ainul, M.A (2021). Insurance Perspective of Yusuf Qardhawi and Abdul Wahab Khalaf, Eduvest – Journal of Universal Studies, 1: (12): 1-10
- Ansell, C. and Gash, A. (2007). Collaborative Governance in Theory and Practice, Journal of Public Administration Research and Theory, 18(4), 543-571.
- Aregbeshola, B. S. (2017) Enhancing Political Will for Universal Health Coverage in Nigeria," International Journal of Cuban Health and Medicine 19(1)
- Carrin G, Waelkens MP, Criel B. (2005) Community-based health insurance in developing countries: a study of its contribution to the performance of health financing systems. Trop Med Int Health ;10:799-811.
- Dolgoff, R. (2012), Understanding Social welfare: A Search for Social Justice (9th Edition). Maryland, Pearson Publishers'
- Donfouet, H.P.P., Mahieu, P.A., 2012. Community-based health insurance and social capital: A Review. Heal. Econ. Rev. 2 (1), 1–5. https://doi.org/10.1186/2191-1991- 2-5.
- Howlett, M. and Ramesh, M. (2003) Studying Public Policy: Policy Cycles and Policy Subsystems, Oxford University Press.
- Ijeoma, A., Adebayo, O., Babatunde, O., & Angela, E. (2019). Community based health insurance as a viable option for health financing: An assessment of household willingness to pay in Lagos, Nigeria. Journal of Public Health and Epidemiology, 11(2), 49-57.
- Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington (DC): National Academies Press; 2001 https://doi.org/10.17226/10027,
- Naiman, R. and Watkin, N. (1990). Surveys of the Impact of IMF Structural Adjustment in Africa: Growth Social Spending and Debt Relief. http://www.hartford-hwpcom/archives/30/111.html.
- Obben, C. and Illesanmi, O. (2018), Community Based Health Insurance Scheme: Preferences of Rural Dwellers of the Federal Capital Territory Abuja, Nigeria, Journal of Public Health in Africa
- Olukoshi, A.O. (ed) (1993). The Politics of Structural Adjustment in Nigeria. Portsmouth: Heinemann Educational Books.
- Osaghae, E.E. (2007). "Fragile State". Development in Practice. 17 (4&5): 691-699.
- Otite, O. (2000). Ethnic Pluralism, Ethnicity and Ethnic Conflicts in Nigeria. Ibadan: SHANESON.
- Richard T. (2012), Welfare and Wellbeing. London, Policy Press Publishers
- Riman H, Akpan B, Emmanuel S (2012). Healthcare Financing and Health outcomes in Nigeria: A State Level Study using Multivariate Analysis. International Journal of Humanities and Social Science 2(15):296-309.
- United Nations (2005). "UN Millenium Development Goals". Human Development Index. United Nations Development Programme 2004. http://www.un.org.
- United Nations Development Programme 2004. http://www.un.org.
- Wright, G.E and Schellekens, O. (2013) Achieving Universal Health Coverage in Nigeria one State at a Time, A Public-Private Partnership Community Based Health Insurance Model, Brooke Shearer Working Paper Series, Working Paper 2, June 2013
- Yakasai, Y.H. (2022) An Evaluation of the Implementation of National Health Insurance Scheme in Kano State Nigeria, 2005 – 2018, Being a Thesis Submitted To The Department of Political Science, Faculty of Social Sciences, Bayero University.
How to Cite
Ibrahim, F. O., Ismail, A. A., Tabiu, A., Yakasai, H. Y., & Umar, U. A. (2023). Implementing Community Based Health Insurance Schemes: A Mechanism for Health Care Service Delivery in Kano Metropolis. Bayero Journal of Public Administration, 3(1), 110-128. https://doi.org/10.67894/bjpa.2023.mqxrt2d8
F. O. Ibrahim, A. A. Ismail, A. Tabiu, H. Y. Yakasai, and U. A. Umar, "Implementing Community Based Health Insurance Schemes: A Mechanism for Health Care Service Delivery in Kano Metropolis," Bayero Journal of Public Administration, vol. 3, no. 1, pp. 110-128, December 2023. doi: 10.67894/bjpa.2023.mqxrt2d8