centre for health economics and developemnt models for expanding access to healthcare services in...

CENTRE FOR HEALTH ECONOMICS AND DEVELOPEMNT

Models for Expanding Access to Healthcare Services in Nigeria

Prepared by Kenneth Ojo, Ph.D.

for Health & Managed Care Association of Nigeria in Collaboration with Business Day Conferences on Healthcare Financing Roundtable 2012 titled “ÄIMING FOR GREATER INCLUSION FOR NIGERIANS” 10th December, 2012.


Access to comprehensive, quality health care services is important for the achievement of health equity and for increasing the quality of a healthy life for everyone.

Five aspects of Access Require Evaluation and Modeling:

1.Availability and Adequacy2.Physical Accessibility3.Financial/ Affordability 4.Organizational/Governance and5.Acceptability: Social or Cultural

barriers that limit the Utilization of Services.


Supply Side Models

1. Availability and Adequacy• Integrated Model of Service Delivery• At best Minimum/essential package of

care • What about long term and emergency

care?2. Physical Accessibility• Geographical Equity• Developing Criteria for Sitting of New

Health Facilities at all levels


Demand Side Models

Models on Sustainable Health Financing/ Financial Risk Protection:3. Financial/ Affordability• Social Health Insurance• Private Health Insurance• Community-based Health

Insurance • Other Pre-Paid schemes


Models to create an enabling environment

4. Organizational Restructuring/GovernanceIntegrated organizational change and

development re-orientation and strengthening of the

human resource capacities.Transparency and Accountability through

effective Public Expenditure Management and Anti-Corruption Measures


Models to create effective demand for services

5. Acceptability: Social or Cultural barriers that limit the utilization of services. Conditional Cash transfer;

Incentives to Traditional leaders, TBAs, Community Health Extension Workers (CHEWS) who achieve targets for selected indicators for ANC and family planning (FP)

Health Promotion and Communication Models


ConclusionAll these will be used in measuring access in

terms of utilization not merely adequacy of supply. Services available must be relevant and effective

if the population is to 'gain access to satisfactory health outcomes'.

The availability of services, and barriers to access, have to be considered in the context of the differing perspectives, health needs and material and cultural settings of diverse groups in society.

Equity of access may be measured in terms of the availability, utilization or outcomes of services.

centre for health economics and developemnt models for expanding access to healthcare services in...

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