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Negotiating Access to Health Care for All through Social and Political Accountability: A Qualitative Study in Rural Nigeria

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  • Afeez Folorunsho Lawal

    (Department of Science and Technology, National Research Foundation South African Research, Chair Initiative in Social Policy, University of South Africa, Pretoria 0002, South Africa)

  • Elsbet Lodenstein

    (Sustainable Economic Development and Gender, Royal Tropical Institute (KIT), 1090 HA Amsterdam, The Netherlands)

Abstract

Social accountability is an important strategy towards ensuring that political leaders and actors implement the right policies in the interest of the entire society. In 2007, a community-based health insurance programme was implemented in selected rural communities in Kwara State, Nigeria, through collaboration between the Dutch Health Insurance Fund, PharmAccess Foundation, the Kwara State Government, and Hygeia Nigeria Limited to provide access to basic healthcare for the people. After operating for 9 years, the programme stopped in 2016. This paper describes how social and political accountability shaped the introduction, functioning, and stoppage of the CBHI programme. The study adopted a qualitative approach for data collection, particularly in-depth ( n = 22) and key informant interviews ( n = 32). Findings indicate that the community-based health insurance programme was proposed by the foreign agency and that the state government was instrumental in the stoppage of the programme. Also, the change in government (via voting against a political bloc that had been in power since 2003) in Kwara State during the 2019 general elections was among the accountability measures employed by the citizenry in reaction to the stoppage of the Community-Based Health Insurance programme. The implication of this is that the current government, expectedly, will not only draw up a more robust healthcare policy for implementation but will also ensure that the people are carried along through adequate social and political accountability mechanisms.

Suggested Citation

  • Afeez Folorunsho Lawal & Elsbet Lodenstein, 2022. "Negotiating Access to Health Care for All through Social and Political Accountability: A Qualitative Study in Rural Nigeria," Social Sciences, MDPI, vol. 11(3), pages 1-14, March.
    • Handle: RePEc:gam:jscscx:v:11:y:2022:i:3:p:128-:d:771434
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    References listed on IDEAS

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    1. Bonfrer, Igna & Van de Poel, Ellen & Gustafsson-Wright, Emily & van Doorslaer, Eddy, 2018. "Voluntary health insurance in Nigeria: Effects on takers and non-takers," Social Science & Medicine, Elsevier, vol. 205(C), pages 55-63.
    2. Mladovsky, Philipa & Mossialos, Elias, 2008. "A Conceptual Framework for Community-Based Health Insurance in Low-Income Countries: Social Capital and Economic Development," World Development, Elsevier, vol. 36(4), pages 590-607, April.
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