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Models for Expanding Access to Healthcare Services in Nigeria

This report discusses the importance of access to comprehensive and quality healthcare services for health equity and improving the overall quality of life. It presents five aspects of access that require evaluation and modeling: availability and adequacy, physical accessibility, financial/affordability, organizational/governance, and acceptability. The report also proposes various models for each aspect, including supply-side models, demand-side models, sustainable health financing models, organizational restructuring/governance models, and acceptability models. The conclusion emphasizes the need to measure access in terms of utilization and stresses the importance of considering the differing perspectives, health needs, and cultural settings of diverse groups in society.

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Models for Expanding Access to Healthcare Services in Nigeria

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  1. 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.

  2. 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: • Availability and Adequacy • Physical Accessibility • Financial/ Affordability • Organizational/Governance and • Acceptability: Social or Cultural barriers that limit the Utilization of Services.

  3. Supply Side Models • 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

  4. 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

  5. Models to create an enabling environment 4. Organizational Restructuring/Governance • Integrated 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

  6. 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

  7. Conclusion • All 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.

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