Healthcare Providers and Access to Quality Services Under the National Health Insurance Authority in Kano State, Nigeria

Abstract

Lack of effective operational facilities and manpower among healthcare facilities has also been attributed to poor operational practices, mismanagement of the government’s health care funds, increased health care spending, and a negative impact on patient health outcomes. Like health maintenance organizations (HMOs), healthcare facilities are providers of National Health Insurance Authority (NHIA) for enrollees in the states. However, the roles of these facilities in implementation of social health insurance under the national health insurance Authority of Nigeria are not very well defined in terms of providing health care services as either providers or as well as purchasers. This qualitative, single case study was to explore the roles of these healthcare facilities as regards their impacts in contributing to implementation of the national social health insurance scheme in Kano state, Nigeria. A dominant qualitative design was employed in the study of health maintenance organizations officers using Key stakeholders’ interview. Copious notes and transcribed interviews were analyzed. NVIVO version 12 with verbatim transcription was used for thematic analysis of qualitative data. Thus, analysis of the general outcomes showed a significant association between health facilities and quality of services provided. Conversely, findings support that, NHIA providers who attain accreditations and appropriate approvals were short of providing efficient and effective services and maximize their performances in terms of patient’s outcome in ensuring achieving universal health coverage.