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

Abstract

Introduction: The Nigerian government has introduced various forms of health insurance programme as a means of supplying quality healthcare services to its citizens all in attempt to attain the universal health coverage. Unfortunately, these various forms of Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the supply of healthcare services and this is evidenced by observed adverse selection and supplier induced demands which are major causes of market failure in health insurance industry. Therefore, there is a need to deduce unique strategies to improve supply of health insurance so as to reduce the barest minimum the incidence of market failure which has impacted negatively on the health insurance industry. Methods: The study adopted qualitative approach by using in-depth interviews (IDIs) method. Nine (9) key informants were purposely sampled 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 interviewees relayed their experiences in the programme which includes provider non-adherence to accreditation pattern, poor reimbursement and tariff structure, fluctuations in prices of input, inadequate funding of the programme and low number of enrollees registered in private facilities and consequently proffered strategies on how to eliminate adverse selection and supplier induced demand with a resultant improvement in supply of health insurance services. Conclusions: Evidence from this qualitative study have shown various strategies if implemented will reduce the incidence of adverse selection and supplier induced demand which are mostly implicated as common causes of market failures.