dc.date.accessioned | 2023-12-18T09:33:30Z | |
dc.date.available | 2023-12-18T09:33:30Z | |
dc.date.issued | 2023 | |
dc.identifier.isbn | 978-82-348-0312-3 | |
dc.identifier.uri | http://hdl.handle.net/10852/106394 | |
dc.description.abstract | Introduction
Universal health coverage (UHC) aims to provide all people with access to needed healthcare without financial hardship. Many Low- and Middle-Income Countries, including The Gambia, explore innovative financing mechanisms like the national health insurance scheme (NHIS) to finance their health systems.
Aim and Objectives
This thesis contributes evidence for NHIS implementation in The Gambia. Objectives include assessing population willingness to pay (WTP), healthcare worker (HCW) preferences for payment systems, procedural fairness in NHIS financing, and policy processes influencing the NHIS. The aim is to provide insights for successful NHIS implementation and contribute to achieving UHC.
Methods and Materials
This research uses cross-sectional surveys and case studies with probability, purposive, and snowballing sampling techniques. Data, collected through questionnaires and interviews, were analyzed using IBM SPSS Statistics and StataSE version 17, along with analytic coding.
Results
Paper I reveal an average population WTP of US$23 (GMD 1,120). Demographic and socio-economic factors were associated with the population’s WTP. Paper II shows HCW preferences in the NHIS were influenced by demographic, facility, and regional characteristics. Papers III highlight shortcomings in the NHIS Bill legislation process, lacking greater inclusiveness, active participation, and transparency. Paper IV identifies centralized oversight and decision-making in NHIS policy processes, raising concerns about transparency and stakeholder involvement.
Conclusion
This thesis explores NHIS implementation in The Gambia, offering valuable insights and recommendation. Findings emphasize the complexities of NHIS processes, including population’s WTP and HCW preferences in NHIS, procedural fairness, and the need for an informed, inclusive and active participatory approach. Lessons learned can guide evidence-informed decision-making during NHIS implementation and efforts to achieve UHC. | en_US |
dc.language.iso | en | en_US |
dc.relation.haspart | Paper I: Hassan Njie, Knut Reidar Wangen, Lumbwe Chola, Unni Gopinathan, Ibrahimu Mdala, Johanne S Sundby, Patrick G C Ilboudo Willingness to pay for a National Health Insurance Scheme in The Gambia: a contingent valuation study. Health Policy and Planning, Volume 38, Issue 1, January 2023, Pages 61–73, DOI: 10.1093/heapol/czac089. The article is included in the thesis. Also available at: https://doi.org/10.1093/heapol/czac089 | |
dc.relation.haspart | Paper II: Hassan Njie, Patrick G. C. Ilboudo, Unni Gopinathan, Lumbwe Chola, Knut Reidar Wangen. Preferences of healthcare workers for provider payment systems in The Gambia's National Health Insurance Scheme. BMC Health Serv Res 23, 853 (2023). DOI: 10.1186/s12913-023-09885-8. A submitted version is included in the thesis. The published version is available at: https://doi.org/10.1186/s12913-023-09885-8 | |
dc.relation.haspart | Paper III: Hassan Njie, Elin Dale, Unni Gopinathan. Procedural Fairness in Decision- Making for Financing a National Health Insurance Scheme: A Case Study from The Gambia. Health Policy and Planning, Volume 38, Issue Supplement_1, November 2023, Pages i73–i82, DOI: 10.1093/heapol/czad063. A submitted version is included in the thesis. The published version is available at: https://doi.org/10.1093/heapol/czad063 | |
dc.relation.haspart | Paper IV: Hassan Njie, Ruth Jane Prince, Mat Lowe, Unni Gopinathan. Ideas, interests, and institutions: the policy process behind the Gambia's national health insurance scheme. The paper is not available in DUO awaiting publishing. | |
dc.relation.uri | https://doi.org/10.1093/heapol/czac089 | |
dc.relation.uri | https://doi.org/10.1186/s12913-023-09885-8 | |
dc.relation.uri | https://doi.org/10.1093/heapol/czad063 | |
dc.title | Towards universal health coverage: evidence generation to inform national health insurance scheme implementation in The Gambia | en_US |
dc.type | Doctoral thesis | en_US |
dc.creator.author | Njie, Hassan | |
dc.type.document | Doktoravhandling | en_US |