scholarly journals Strategies to Improve Demand for Services in the Social Health Insurance Programme: Nigerian Enrollee Perspective

2020 ◽  
Vol 8 (1) ◽  
pp. 53
Author(s):  
Obi Vincent Ikechukwu ◽  
Ijeoma Lewechi Okoronkwo ◽  
Elizabeth Uzoamaka Nwonwu ◽  
Kamtoochukwu Maduneme Obi ◽  
Ifunanya Rosemary Obi
Keyword(s):  
Health Insurance ◽  
Focus Group ◽  
Moral Hazard ◽  
Social Health Insurance ◽  
Social Health ◽  
World Health ◽  
Identification System ◽  
The Social ◽  
Insurance Programme ◽  
Health Insurance Programme

Globally, the World Health Organization has championed the introduction of various forms of health insurance as a means of improving the utilization of quality healthcare service which is targeted at achieving universal health coverage. Unfortunately, the operations of the Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the demand for healthcare services as a result of moral hazard and this is evidenced by the non-achievement of set-out objective of the programme in Nigeria. Design/Methodology: The study adopted a qualitative approach which comprised of 3 focus group discussions (N=24). Key informants were purposely selected for the focus group discussion 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 focus group participants relayed their experiences in the programme which includes poor identification system, choice of only one provider except on emergency, benefit package not being comprehensive which has enabled moral hazard and suggested ways to improve it. Conclusions: Most of the enrollees do not show diligence in areas of demand for services and these were shown to emanate principally from economic issues around the enrollees desire to utilize the premium paid thereby leading to moral abuse. Therefore, certain measures need to be put in place so as to curtail observed market failures in the SHIP programme.

scholarly journals Critical Determinants of Demand for Services in the Nigeria Formal Sector Social Health Insurance Programme

2020 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Obi Ikechukwu Vincent ◽  
Okoronkwo Ijeoma Lewechi ◽  
Iloh Gabriel Uche Pascal ◽  
Nwonwu Elizabeth Uzoamaka ◽  
Ogbu Kenneth ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
Formal Sector ◽  
Insurance Programme ◽  
Health Insurance Programme

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

2019 ◽  
Vol 3 (4) ◽  
pp. 98
Author(s):  
Obi Ikechukwu Vincent ◽  
Okoronkwo Ijeoma Lewechi Okoronkwo Ijeoma Lewechi ◽  
Adi Jesse Ashumate ◽  
Iloh Gabriel Uche Paschal ◽  
Yakubu Adole Agada-Amade ◽  
...  
Keyword(s):  
Health Insurance ◽  
Healthcare Provider ◽  
Social Health Insurance ◽  
Social Health ◽  
Provider Perspective ◽  
Insurance Programme ◽  
Health Insurance Programme

scholarly journals Participatory and responsive governance in universal health coverage: an analysis of legislative provisions in Thailand

2021 ◽  
Vol 6 (2) ◽  
pp. e004117
Author(s):  
Aniqa Islam Marshall ◽  
Kanang Kantamaturapoj ◽  
Kamonwan Kiewnin ◽  
Somtanuek Chotchoungchatchai ◽  
Walaiporn Patcharanarumol ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Universal Coverage ◽  
Civil Servant ◽  
Social Health ◽  
Health Coverage ◽  
Medical Benefit ◽  
The Social ◽  
Universal Health ◽  
Universal Coverage Scheme

Participatory and responsive governance in universal health coverage (UHC) systems synergistically ensure the needs of citizens are protected and met. In Thailand, UHC constitutes of three public insurance schemes: Civil Servant Medical Benefit Scheme, Social Health Insurance and Universal Coverage Scheme. Each scheme is governed through individual laws. This study aimed to identify, analyse and compare the legislative provisions related to participatory and responsive governance within the three public health insurance schemes and draw lessons that can be useful for other low-income and middle-income countries in their legislative process for UHC. The legislative provisions in each policy document were analysed using a conceptual framework derived from key literature. The results found that overall the UHC legislative provisions promote citizen representation and involvement in UHC governance, implementation and management, support citizens’ ability to voice concerns and improve UHC, protect citizens’ access to information as well as ensure access to and provision of quality care. Participatory governance is legislated in 33 sections, of which 23 are in the Universal Coverage Scheme, 4 in the Social Health Insurance and none in the Civil Servant Medical Benefit Scheme. Responsive governance is legislated in 24 sections, of which 18 are in the Universal Coverage Scheme, 2 in the Social Health Insurance and 4 in the Civil Servant Medical Benefit Scheme. Therefore, while several legislative provisions on both participatory and responsive governance exist in the Thai UHC, not all schemes equally bolster citizen participation and government responsiveness. In addition, as legislations are merely enabling factors, adequate implementation capacity and commitment to the legislative provisions are equally important.

Consolidating the social health insurance schemes in China: towards an equitable and efficient health system

The Lancet ◽  
2015 ◽  
Vol 386 (10002) ◽  
pp. 1484-1492 ◽  
Author(s):  
Qingyue Meng ◽  
Hai Fang ◽  
Xiaoyun Liu ◽  
Beibei Yuan ◽  
Jin Xu
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Social Health Insurance ◽  
Social Health ◽  
The Social

scholarly journals Burden of disease due to hip, knee, and unspecified osteoarthritis in the Peruvian social health insurance system (EsSalud), 2016

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 238
Author(s):  
Roger V. Araujo-Castillo ◽  
Carlos Culquichicón ◽  
Risof Solis Condor
Keyword(s):  
Health Insurance ◽  
Burden Of Disease ◽  
Hip Osteoarthritis ◽  
Social Health Insurance ◽  
Social Health ◽  
World Health ◽  
Health Insurance System ◽  
Insurance System ◽  
Life Years ◽  
Social Health Insurance System

Introduction: Since its introduction by the World Health Organization (WHO), the concept of burden of disease has been evolving. The current method uses life expectancy projected to 2050 and does not consider age-weighting and time-discounting. Our aim is to estimate the burden of disease due to hip, knee, and unspecified osteoarthritis using this new method in the Peruvian Social Health Insurance System (EsSalud) during 2016. Methods: We followed the original 1994 WHO study and the current 2015 Global Burden of Disease (GBD) methods to estimate disability adjusted life years (DALY) due to osteoarthritis, categorized by sex, age, osteoarthritis type, and geographical area. We used disability weights employed by the Peruvian Ministry of Health, and the last update issued by WHO. Results: Overall, EsSalud reported 17.9 new cases of osteoarthritis per 1000 patients per year. Annual incidence was 23.7/1000 among women, and 72.6/1000 in people above 60 years old. Incidence was 5.6/1000 for knee osteoarthritis and 1.1/1000 for hip. According to the 1994 WHO method, there were 399,884 DALYs or 36.6 DALYs/1000 patients per year due to osteoarthritis. 12.4 and 2.2 DALYs/1000 patients per-year were estimated for knee and hip osteoarthritis, respectively. Using the 2015 GBD method, there were 1,037,865 DALYs or 94.9 DALYs/1000 patients per year. 31.4 and 5.3 DALYs/1000 patients per year were calculated for knee and hip osteoarthritis, respectively. Conclusions: In the Peruvian social health insurance subsystem, hip, knee, and unspecified osteoarthritis produced a high burden of disease, especially among women and patients over 60. The 2015 GBD methodology yields values almost three times higher than the original recommendations.

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