Background: Nigeria is one of the two epicenters of malaria transmission across the globe and contributes to 40 percent global malaria burden. The LLINs distribution campaign is one of the significant and nationally acceptable strategic routes of delivering nets to the entire population across the country. Micro planning of the campaign has been completed in the state in readiness for LLINs 2019 distribution campaign. This study therefore tends to highlight the achievements of this concluded micro-planning processes in identifying all the campaigns needs and challenges while plan and proffer solutions to achieve the high quality campaign outcomes. Study design: This is a qualitative study involving the engagement of all RBM stakeholders. It entailed desk reviews, meetings, community engagements, development and adaptation of programme tools, Akubue Augustine Uchenna et al.: Quality Micro-Planning Processes -Key Strategy for Achieving High Quality LLINs Campaign: Pilot Report from Cross-River State Nigeria quantification, estimation of all the campaign needs using the WHO standardized estimates and inauguration of formed campaign work streams required for quality LLINs campaign implementations. Average volume of a bale of 0.14cubic meter, minimum volume of 120% of expected space considering the 20% handling area within the store facility and average access door space of >2.95sq meter) were used as standards for estimation. All variables were analyzed using Microsoft excel package and Health Mappers. Results: Comprehensive Advocacy, logistic and training plans that included and defined the roles and expectations of all the many stakeholders were developed. Micro plan population of 4,251,387 for 2019 with 2,361,882 LLINs, 6.613.3 m 3 and handling areas requirement of 1,322m 3 were estimated. A total of 11,864 personnel with their responsibilities were identified and trained including estimated costs of NGN387,143,880 at unit operational cost of NGN 166.34 for the delivery of 1 LLIN to the household. Advocacy kits with print materials for the campaign were pre-tested by health educator and identified programme challenges were highlighted. Conclusion: This study therefore underscores the importance of good micro-planning process for high quality LLINs campaign as recommended by WHO for the achievement of LLINs universal coverage.
Introduction: Social health insurance programme was initiated in Nigeria with one of the aims being to improve the demand for quality healthcare services with a resultant reduction in catastrophic spending among the citizenry. Unfortunately, in this programme, healthcare providers who offer quality healthcare services still witness poor enrollee demand for services which has led to inability of the programme to achieve its set out objectives. Hence, the need to study the effects of selected critical determinants on demand for health insurance services and how much these determinants can collectively account for the demand for services in the programme. Design/Methodology: The study adopted a cross sectional design with a quantitative approach. The sample size was calculated using G-Power 3.1 software and the determined sample for the study was one thousand four hundred and thirty five (1435). Multistage sampling method was adopted. Data was analyzed using descriptive statistics and linear regression method with the aid of SPSS version 11. Result: The critical determinants of provider ownership, distance to healthcare provider, enrollee educational level have significant positive effect on the demand for health insurance services (<0.05) but the effect of enrollee income was positively insignificant (>0.05). Similarly, 75% of the changes in demand for health insurance services can be accounted for by the predictor variables in this study. Conclusion: The inability of the programme to address these selected critical determinants significantly will lead to out of pocket spending for healthcare services with a resultant catastrophic effect on families' finances. Therefore, there is a need to take into account the effects of these determinants duringpolicy formulation, reviews and process implementation in the programme.
Introduction: The Nigerian government has introduced various forms of health insurance programme as a means of supplying quality healthcare services to its citizens all in attempt to attain the universal health coverage. Unfortunately, these various forms of Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the supply of healthcare services and this is evidenced by observed adverse selection and supplier induced demands which are major causes of market failure in health insurance industry. Therefore, there is a need to deduce unique strategies to improve supply of health insurance so as to reduce the barest minimum the incidence of market failure which has impacted negatively on the health insurance industry. Methods: The study adopted qualitative approach by using in-depth interviews (IDIs) method. Nine (9) key informants were purposely sampled from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The interviewees relayed their experiences in the programme which includes provider non-adherence to accreditation pattern, poor reimbursement and tariff structure, fluctuations in prices of input, inadequate funding of the programme and low number of enrollees registered in private facilities and consequently proffered strategies on how to eliminate adverse selection and supplier induced demand with a resultant improvement in supply of health insurance services. Conclusions: Evidence from this qualitative study have shown various strategies if implemented will reduce the incidence of adverse selection and supplier induced demand which are mostly implicated as common causes of market failures.
Background: Total quality management (TQM) in any organization is a major determinant of efficient management of resources. In this era where hospitals provide the same type of services, it is only hospitals that have embraced TQM techniques that will survive. The study assessed the management preparedness to the implementation of TQM at University of Nigeria Teaching Hospital (UNTH) Ituku/ Ozalla from the Health workers perceptive. Methods: This study was a cross sectional descriptive study. Structured questionnaire was used to collect information on the demographic characteristics of the randomly selected staff of the UNTH and their assessment of UNTH under five major domains: organizational, interpersonal, facilities, environmental and economic. Focus group discussion was also used conducted among selected staff. Results: On influence of educational factors on level of response, the study showed it has no influence on staff awareness (p= 0.264) but it influenced quality of personnel (0.049), sufficient supervision (p = 0.039), feedback mechanism (p = 0.005) and record department being computerized (p = 0.04). Number of years on the job has influence on the availability of adequate resources (p = 0.027), quality of services (0.040) and record department being computerized (p = 0.041). On the influence of cadre, it showed that level of awareness was affected but quality of personnel (p = 0.014), quality of services (p = 0.019) and availability of functional diagnostic equipment (p = 0.027) was influenced. Conclusions: TQM have been shown to have improved the efficient management of resources with attendant maximization of output. It is important that management demonstrates commitment and provide enabling environment for its sustainability. Specifically, management should institute periodic performance measurement system and strengthen the training program in the hospital. There is a need to raise the awareness on the concept and develop methods and procedures in updating existing TQM guidelines.
Introduction: The principle underpinning the Supply of health insurance services in Nigeria is that as prices increases, the healthcare provider makes more profit and will be motivated to provide more health insurance services to the enrollees. These supplies of health insurance services are therefore influenced by critical determinants that will either make the provider to supply health insurance services or withhold it. Therefore, there is a need to look at those critical factors that can hinder the supply of services in the programme. This study sets out to examine the effect of identified critical determinants on supply of services and also show how much these critical determinants can collectively predict this supply of services. Design/Methodology: This is a cross sectional study using a quantitative approach. Sample size was determined using Cochran formular and calculated sample size was forty six (46). Multistage sampling technique was adopted. Variables were analyzed using descriptive statistics and linear regression method with SPSS version 11. Result: The critical determinants of reimbursement structure, tariff structure, facility number of enrollees and cost of hospital consumables studied had positive impact on the supply of service but the impact of cost of hospital consumable was insignificant (>0.5). Similarly, 95% of changes in the supply of services can be accounted for significantly by the independent variables in this study (p=0.000). Conclusion: Evidences from this study have shown that most of the identified critical determinants studied had significant effect and also collectively could account significantly for changes in the supply of services and so therefore there is a need to properly address these factors so as to achieve the set out objectives in the programme.
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