Structural violence and policy outcomes of Lagos State Health Insurance Scheme in selected ministries, Lagos State

Moyosoluwa Dele-Dada, Daniel Gberevbie, Fadeke Owolabi, Abolaji Atobatele

Article ID: 6902
Vol 8, Issue 11, 2024

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Abstract


The decentralization of the NHIS’s implementation to states intended to hasten progress towards universal health coverage, has not effectively addressed healthcare disparities, particularly in Lagos State. The implementation of the Lagos State Health Insurance Scheme appears to perpetuate structural violence, evident in increased out-of-pocket expenses, discrimination based on insurance type, and substandard healthcare delivery. The study therefore examined how structural violence has affected the policy outcomes of the Lagos State Health Insurance Scheme, with a specific emphasis on junior officers in grade level 01–07 in five selected ministries situated within Lagos State. Both primary and secondary data were collected using questionnaire, interview and literature search. Data gathered were analysed statistically and thematically. The findings of the study indicate that the policy outcome of the scheme has been adversely affected by structural violence, resulting in dissatisfaction, compensation claims for unresolved health issues and a shift in health insurance providers among enrolled junior officers.


Keywords


healthcare; insurance; junior officers; Lagos; structural violence

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References


Abiola, A. O., Ladi-Akinyemi, T. W., Oyeleye, O. A., et al. (2019). Knowledge and utilisation of the National Health Insurance Scheme among adult patients attending a tertiary health facility in Lagos State, South-Western Nigeria. African Journal of Primary Health Care & Family Medicine, 11(1), 1–7. https://doi.org/10.4102/phcfm.v11i1.2018

Adugna, M. B., Nabbouh, F., Shehata, S., & Ghahari, S. (2020). Barriers and facilitators to healthcare access for children with disabilities in low and middle income sub-Saharan African countries: a scoping review. BMC Health Services Research, 20(1), 1–11. https://doi.org/10.1186/s12913-019-4822-6

Alawode, G. O., & Adewole, D. A. (2021). Assessment of the design and implementation challenges of the National Health Insurance Scheme in Nigeria: a qualitative study among sub-national level actors, healthcare and insurance providers. BMC Public Health, 21(1), 1–12. https://doi.org/10.1186/s12889-020-10133-5

Alexander, R. (2018). Gender, structural violence, and peace. In: The Routledge Handbook of Gender and Security. Routledge. pp. 27–36.

Bacchi, C., & Goodwin, S. (2016). Poststructural policy analysis: A guide to practice. Springer.

Balogun, J. A. (2022). The Evolutionary Developments, Threats and Opportunities Within the Nigerian Healthcare System. In: The Nigerian Healthcare System: Pathway to Universal and High-Quality Health Care (. Cham: Springer International Publishing. pp. 47–85.

Churchwell, K., Elkind, M. S., Benjamin, R. M., et al. (2020). Call to action: structural racism as a fundamental driver of health disparities: a presidential advisory from the American Heart Association. Circulation, 142(24), e454–e468. https://doi.org/10.1161/cir.0000000000000936

Ekhator-Mobayode, U. E., Gajanan, S., & Ekhator, C. (2022). Does Health Insurance Eligibility Improve Child Health: Evidence from the National Health Insurance Scheme (NHIS) in Nigeria. Cureus, 14(9). https://doi.org/10.7759/cureus.28660

Gal, J., & Weiss-Gal, I. (2015). The ‘why and the ‘how’ of policy practice: An eight-country comparison. British Journal of Social Work, 45(4), 1083–1101. https://doi.org/10.1093/bjsw/bct179

Hamed, S., Thapar-Björkert, S., Bradby, H., & Ahlberg, B. M. (2020). Racism in European health care: structural violence and beyond. Qualitative health research, 30(11), 1662–1673. https://doi.org/10.1177/1049732320931430

Health Policy Commission. (2023). Attracting funding for the Nigerian Health Sector: outlining the opportunities, financing options and challenges. Available online: www.nesgroup.com (accessed on 10 March 2024).

Hill, M., & Hupe, P. (2021). Implementing public policy: An introduction to the study of operational governance. Sage.

Jackson, B., & Sadler, L. S. (2022). Structural violence: an evolutionary concept analysis. Journal of Advanced Nursing, 78(11), 3495–3516. https://doi.org/10.1111/jan.15341

Knill, C., & Tosun, J. (2020). Public policy: A new introduction. Bloomsbury Publishing.

Kraus, M. W., & Torrez, B. (2020). A psychology of power that is embedded in societal structures. Current opinion in psychology, 33, 86–90. https://doi.org/10.1016/j.copsyc.2019.07.018

Lee, B. X. (2016). Causes and cures VII: Structural violence. Aggression and Violent Behavior, 28, 109–114. https://doi.org/10.1016/j.avb.2016.05.003

Macassa, G., McGrath, C., Rashid, M., & Soares, J. (2021). Structural violence and health-related outcomes in Europe: a descriptive systematic review. International Journal of Environmental Research and Public Health, 18(13), 6998. https://doi.org/10.3390/ijerph18136998

Meckel, L. A. (2021). Structural violence in Éire: The bone histology of victims from the Great Famine (Kilkenny, Ireland 1845–1852) [PhD thesis]. University of Otago.

National Bureau of Statistics. (2022). Nigeria launches its most extensive national measure of multidimensional poverty. Available online: https://nigerianstat.gov.ng/news/78 (accessed on 10 March 2024).

Rylko-Bauer, B., & Farmer, P. (2016). Structural violence, poverty, and social suffering. In: The Oxford Handbook of the Social Science of Poverty. Oxford Academic. pp. 47–74. https://doi.org/10.1093/oxfordhb/9780199914050.013.4

Salusky, I. R., Kral, M., Amarok, B., & Wexler, L. M. (2022). Navigating between two the worlds of school and ‘being on the land’: Arctic Indigenous young people, structural violence, cultural continuity and selfhood. Journal of Youth Studies, 25(2), 170–192. https://doi.org/10.1080/13676261.2020.1858040

Sarpong, B., & Nketiah-Amponsah, E. (2022). Financial inclusion and inclusive growth in sub-Saharan Africa. Cogent Economics & Finance, 10(1), 2058734. https://doi.org/10.1080/23322039.2022.2058734

Shittu, A. K., & Afolabi, O. S. (2020). Community-Based health insurance scheme and state-local relations in rural and semi-urban areas of Lagos State, Nigeria. Public Organisation Review, 21, 19–31. https://doi.org/10.1007/s11115-020-00474-5

Shobiye, H. O., Dada, I., Ndili, N., et al. (2021). Determinants and perception of health insurance participation among healthcare providers in Nigeria: A mixed-methods study. Plos one, 16(8), e0255206. https://doi.org/10.1371/journal.pone.0255206

Stoker, G., & Evans, M. (2016). Evidence-based policy making and social science. In: Evidence-Based Policy Making in the Social Sciences. Policy Press. pp. 15–28.

The Lancet Global Health. (2016). Bridging the global health gap. Available online: www.thelancet.com (accessed on 10 March 2024).

Turnpenny, J., Jordan, A., Benson, D., & Rayner, T. (2015). The tools of policy formulation: an introduction. In: Jordan, A. J., & Turnpenny, J. R. (editors). The tools of policy formulation: actors, capacities, venues and effects, New horizons in public policy. Cheltenham Spa: Edward Elgar. pp. 3–29.

Vedung, E. (2017). Public policy and program evaluation. Routledge.

World Health Organisation. (2017). World Bank and WHO: Half the world lacks access to essential health services, and 100 million are still pushed into extreme poverty because of health expenses. Available online: https://www.who.int/news/item/13-12-2017-world-bank-and-who-half-the-world-lacks-access-to-essential-health-services-100-million-still-pushed-into-extreme-poverty-because-of-health-expenses (accessed on 10 March 2024).

World Health Organisation. (2022). More than half of the world’s population lack access to health services. Available online: https://www.icirnigeria.org/more-than-half-of-worlds-population-lack-access-to-health-services-who/ (accessed on 10 March 2024).




DOI: https://doi.org/10.24294/jipd.v8i11.6902

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