ArticleNigerian medical journal : journal of the Nigeria Medical Association
Healthcare Financing, Service Quality, and Utilisation in Delta State, Nigeria: An Integrative Literature Review.
Article in Nigerian medical journal : journal of the Nigeria Medical Association. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Nigeria's health system has been heavily dependent on out-of-pocket (OOP) payments, exposing households to financial hardship and limiting access to essential care. Empirical evidence on how financing arrangements shape service quality and healthcare utilisation at the subnational level is limited. This integrative review synthesised studies from Delta State to clarify these relationships and inform strategies for advancing Universal Health Coverage (UHC). Methodology: A systematic search of major biomedical and regional databases identified English-language primary studies published between 2010 and 2024 on healthcare financing, service quality, utilisation, and related access barriers in Delta State. Eight eligible studies were critically appraised using established tools and integrated through narrative synthesis. Results: Across the studies, OOP payments dominated healthcare financing, particularly at tertiary facilities. Prepayment through the NHIS and DSCHS was concentrated among formally employed, urban, or more health-literate groups. User fees, difficulties completing insurance enrolment, medicine stock-outs, long waiting times, and negative staff attitudes were consistently reported as barriers undermining both perceived service quality and actual service use. Maternal health evidence highlighted continued reliance on traditional birth attendants, driven by perceptions of more respectful interpersonal care and stronger sociocultural alignment. The studies suggest limited risk pooling, operational weaknesses in insurance schemes, and persistent organisational and sociocultural barriers interact to constrain equitable utilisation. Conclusion: Despite the small and heterogeneous evidence base, the findings suggest that reducing OOP dependence, strengthening State and National insurance schemes, and addressing service delivery and sociocultural barriers are essential for equitable progress toward UHC in Delta State.
Indexed as
Identifiers
42676799PMC13527810What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.