Submission ID 131101
| Issue/Objective | Nigeria's progress toward Universal Health Coverage (UHC) is constrained by low social health insurance (SHI) coverage and high out-of-pocket expenditure, particularly among rural populations. Community Pharmacists (CPs) and Patent and Proprietary Medicine Vendors (PPMVs), despite being the first point of care for many, remain excluded as care providers from the formal financing systems. This study explores how integrating these providers into SHI can expand financial protection and address structural inequities. |
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| Methodology/Approach | The IntegratE project (2017-2025) implemented a public-private partnership model across 11 Nigerian states, training over 5,200 CPs and PPMVs in FP and PHC services provision, referrals, health promotion, and data reporting. Routine program data were analyzed to assess service delivery outcomes and potential alignment with health financing systems. |
| Results | Over 1,023,140 women received family planning services, contributing 312,588 couple years of protection and averting 90,025 unintended pregnancies. Additionally, 850,224 children were treated for common illnesses. Strengthened referral pathways resulted in 47,417 referrals to PHC facilities for long-acting reversible contraceptives and 13,446 referrals of children under five for conditions such as severe malaria, malnutrition, pneumonia, tuberculosis, and diarrhea. Providers maintained data reporting rates above 85%, meeting quality benchmarks for SHI accreditation eligibility |
| Discussion/Conclusion | These findings demonstrate the broad reach and effectiveness of private providers in expanding access to essential services when adequately supported. Excluding them from SHI perpetuates a two-tier system where the poor pay out-of-pocket while formal employees access subsidized care Integrating CPs and PPMVs into SHI can address this structural inequity, reduce financial barriers, strengthen PHC systems and accelerate progress toward Universal Health Coverage in Nigeria. This aligns with the conference theme by presenting a practical financing strategy to restore equity in fragmented health systems. |
| Presenters and Affiliations | Delafrida Ukaga Society for Family Health Emeka Okafor Society for Family Health Michael Alagbile Society for Family Health |
