Do beneficiaries’ views matter in healthcare purchasing decisions?

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Experiences from the Nigerian tax-funded health system and the formal sector social health insurance program of the National Health Insurance Scheme.

Ogochukwu Ibe, Ayako Honda, Enyi Etiaba, Nkoli Ezumah, Kara Hanson and Obinna Onwujekwe , 2017
Nigeria

Purchasing is a health financing function that involves the transfer of pooled resources to providers on behalf of a covered population. Little attention has been paid to the extent to which the views of that population are reflected in purchasing decisions.

This article explores how purchasers in two financing mechanisms: the Formal Sector Social Health Insurance Programme operating under the Nigerian National Health Insurance Scheme, and the tax-funded health system perform their roles in light of their responsibilities to the populations.

The results reveal that both the tax-funded system and the FSSHIP include mechanisms that allow purchasers to reflect people's needs, choices and preferences in purchasing decisions. The mechanisms include:

  • quantitative and qualitative assessment of health needs
  • mechanisms to raise awareness on benefit entitlements
  • mechanisms to allow choice

However, purchasers are not using the mechanisms effectively to engage and hold themselves accountable to people they represent. The paper provides recommendations for bridging the implementation gaps.

Related resources

Project page: Multi-country purchasing study 

Topic overview: What is strategic purchasing for health?

Research brief: Strategic purchasing for universal health coverage: A critical assessment of the Formal Sector Social Health Insurance programme

Journal publication | Financing
Read the full paper online