Submission ID 129664
| Issue/Objective | Achieving universal health coverage (UHC) requires translating evidence into practical reforms, particularly in fragmented health systems. In Ekiti State, Nigeria, declining facility-based deliveries and persistent barriers to care threatened progress toward equity. This paper examines how research evidence informed the rollout of ULERAWA, a non-contributory health insurance model, demonstrating a pathway from data to action that collectively reclaims global health equity through accountable, pro-poor reforms. |
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| Methodology/Approach | GIZ-supported surveys examined barriers to healthcare utilization, willingness to pay for insurance, and community-level constraints to uptake across Ekiti State's 16 local government areas. Mixed-methods research assessed cost barriers, awareness levels, misinformation, distance to facilities, service readiness, and social dynamics including husband influence on women's care-seeking. Findings directly shaped ULERAWA's design and implementation strategy, with iterative community engagement informing rollout. |
| Results | Evidence triggered practical reforms: expanded community engagement, targeted awareness campaigns, and broader access to publicly financed coverage. Since rollout, over 510,000 persons have accessed services through ULERAWA, with 380,000 utilizations in 2024 alone. The state recorded more than 200% growth in service utilization between 2023-2024, alongside improved outpatient attendance and increased facility-based deliveries-directly addressing the initial decline that prompted the research. |
| Discussion/Conclusion | Ekiti State demonstrates that evidence-informed implementation can produce measurable improvements in accountability, equity, and service utilization. ULERAWA offers a replicable sub-national model for translating knowledge into action. Two concrete recommendations emerge: (1) scale publicly financed, non-contributory insurance for vulnerable groups-particularly women and poorer households-to remove cost barriers; (2) embed evidence into continuous community engagement to counter misinformation and social constraints. These approaches restore commitment to action by grounding reforms in community realities and holding systems accountable to those most excluded from UHC progress. |
| Presenters and Affiliations | Peter Oshaji NOIPolls Dr. Chike Nwangwu NOIPolls |
