Bibliography: leaves 268-317 / The 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 organisation officials and a researcher.
Findings revealed that transnational actors relied on various resources (e.g. fund and
‘expertise’) and formed alliances with local actors to drive the introduction of the programme.
As such, the design and implementation of the policy were dominated by international actors.
Despite the sustainability challenges faced by the programme, the study found that it benefitted
some of the enrolled community members. Though, even at the subsidised amount, enrolment
premium was still a challenge for many. The main reasons for the stoppage of the programme
are a paucity of fund and poor management. The stoppage of the programme, however,
signified a point of reversal in the relative achievements recorded by the CBHI scheme because
community members have deserted the healthcare facilities due to high costs of care. In view
of these, the thesis notes that short-term policies often lead to temporary outcomes and suggests
the need to repurpose the role of the state by introducing a long-term comprehensive healthcare
policy – based on the reality of the nation – to provide equitable healthcare services for the
citizenry irrespective of their capacity to pay. / Sociology / D. Phil. (Sociology)
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:unisa/oai:uir.unisa.ac.za:10500/27847 |
| Date | 10 1900 |
| Creators | Lawal, Afeez Folorunsho |
| Contributors | Adesina, Jimi O. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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