ArticleInternational journal for equity in health2020
The roles of health maintenance organizations in the implementation of a social health insurance scheme in Enugu, Southeast Nigeria: a mixed-method investigation.
Article in International journal for equity in health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Experiences of Strategic Purchasing of Healthcare in Nine Middle-Income Countries: A Systematic Qualitative Review.International journal of health policy and management · 2023Pooled it
- Understanding context in the implementation of emergency obstetric and neonatal care in health facilities in Osun State, Nigeria- a mixed-methods study.BMC pregnancy and childbirth · 2022Article
- Universal health insurance in Africa: a narrative review of the literature on institutional models.BMJ global health · 2022Review
- Successes and obstacles in implementing social health insurance in developing and middle-income countries: A scoping review of 5-year recent literatures.Frontiers in public health · 2022Article
- The bypassing of healthcare facilities among National Health Insurance Scheme enrollees in Ibadan, Nigeria.International health · 2021Article
- Determinants and perception of health insurance participation among healthcare providers in Nigeria: A mixed-methods study.PloS one · 2021Article
- The Impact of Health Maintenance Organizations in the Implementation of the Nigeria National Health Insurance Scheme in the Federal Capital Territory (Abuja), Nigeria.Nigerian medical journal : journal of the Nigeria Medical AssociationArticle
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2 authors.
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Abstract
backgroundIn Nigeria, health maintenance organizations (HMOs) are the purchasers of health insurance with a social National Health Insurance Scheme for civil servants. However the roles of HMOs in implementation of social health insurance are not clear. This study determined the roles of HMOs in implementation of the national social health insurance scheme in Enugu, Southeast Nigeria.
methodsA partially mixed sequential dominant status design was employed in the study. Quantitative data were collected from 613 Federal Government employees that are registered with the National Health Insurance Scheme (NHIS) as part of the Formal Sector Social Health Insurance Program (FSSHIP) using an interviewer-administered questionnaire. Test for sampling adequacy was ensured (KMO, 0.701) and likewise the sphericity of the data using Bartlett's test (Chi [1] 796.72, p-value < 0.001). For the qualitative study, there was document review and in-depth interviews. A total of 28 in-depth interviews were conducted with key stakeholders comprising of managers of HMOs, NHIS manager, providers of health care and personnel in the State Ministry of Health among others. Thematic analysis was used for the qualitative data.
resultsOne-third (31.5%) of respondents said that roles of HMOs were very important, while 23% said that their roles were not important. More than half (57.70%) ranked HMOs very low in their roles, while 24.10% ranked them highest. Concentration index shows that the poor were satisfied (-.10), while the rich were highly satisfied (0.13) with roles of HMOs. The qualitative data analysis showed that most of the respondents were not satisfied with the roles of HMOs based on the themes that were developed and analyzed.
conclusionThere is clear understanding of the functions of HMOs among respondents in the study although they generally think that HMOs are not meeting the expectations of the scheme. There is need for the Federal Government through the National Health Insurance Scheme to provide more effective guidelines for HMOs, supervise and monitor the implementation of such guidelines for HMOs to improve on their roles.
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