Strategic purchasing for universal health coverage (UHC): examining the purchaser–provider relationship within a social health insurance scheme in Nigeria

Recognising how important purchasing is in social health insurance, this study critically assesses purchasing arrangements between Nigeria’s national health insurance scheme, health maintenance organisations and healthcare providers. It determines how the arrangements function from a strategic purchasing perspective within the formal sector social health insurance programme (FSSHIP) launched in 2005.

The authors found that the purchasing function was not being used strategically to influence provider behaviour and improve efficiency and quality in healthcare service delivery. Purchasing under the FSSHIP is more passive than strategic. Governance framework requires strengthening and clarity for optimal implementation so as to ensure that both levels of purchasers undertake strategic purchasing actions.

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Enyi Etiaba
Obinna Onwujekwe
Ayako Honda
Ogochukwu Ibe