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Achieving universal health coverage in Nigeria one state at a time: A public-private partnership community-based health insurance model

Jun 15, 2013

Brooke Shearer Working Paper Series
Global Economy and Development at Brookings

Most people would agree with the idea that all individuals should have access to health services and should not face financial hardship as a result of health care costs. Universal health coverage (UHC), the concept that encompasses these goals, has gained wide attention and support in recent years. How to achieve UHC however, is a more complex question with a variety of disparate viewpoints.

In this paper, we discuss UHC in the context of Nigeria, a middle-income country that nevertheless is facing enormous health challenges. We discuss the constraints that have prevented Nigeria from attaining UHC to date. We then present promising evidence from large and small-scale insurance interventions in other parts of the developing world. Next, we describe a public- private partnership model of community-based health insurance currently operating in Nigeria and other parts of Africa and show evidence of the program’s ability to increase health care utilization, provide financial protection and improve health status in target communities.

We contend that UHC in Nigeria can only be achieved by addressing both supply and demand-side constraints simultaneously. The solution must also include building on existing public and private institutions and informal networks, leveraging existing capital, and empowering clients and local communities. An innovative model such as the one presented here that has been implemented successfully in one Nigerian state, could be replicated in others; tackling this challenge one state at a time, to eventually achieve the goal of access to health care and financial protection for all.

Click here to read the introduction and download the full paper.



Author: Gustafsson-Wright, E. and Schellekens, O.

Date: June 2013


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