Principales variables

Following the question on facility manager’s awareness of the LSHS, they were asked about their perceived benefits of the LSHS. From the analysis, key emerging themes from the opportunities with the LSHS can be divided into facility and population level opportunities. The top 3 opportunities stated by facility managers include increase in patient volume (44/60), increase in revenue (38/60) and opportunity to invest in facility upgrade (22/60). These are all benefits at the facility level and are similar to the top 3 benefits of insurance participation described earlier by facility managers already participating in an insurance program. The following two opportunities facility managers anticipate from the LSHS are population level benefits and include opportunity to improve population’s access to free care (18/60) and a consequent improvement in the community’s health (15/60). Three facilities felt that the LSHS would offer no benefits to their facilities. See Table 37. The opportunities are expatiated below.

Table 37: Perceived opportunities from the LSHS among facility managers

Level Top emerging themes Private*

(n = 39) Public (n = 21) Total (n = 60) Facility level

Increase in patient volume 33 11 44

Increase in revenue 28 10 38

Opportunity to invest in facility upgrade 15 7 22 Population

level

Improve access to free care 14 4 18

Improve community’s health 7 8 15

Facility level

Increase in cash flow 10 3 13

Opportunity to improve quality of services 7 6 13 Increased capacity for facility planning &

management 5 5 10

Increase in profit 7 0 7

Increased recognition of facility by patients and

government 4 1 5

satisfaction

Increase in staff strength 2 2 4

Increase in competition among facilities 1 2 3

No benefits to the facility 2 1 3

*Private includes the two faith-based facilities

As described above, at the facility level, majority of the facility managers highlighted that the LSHS could bring about an increase in the volume of patients, revenue and profit (for the private facilities). In return, they stated that it could increase the availability of cash to upgrade the facility’s infrastructure, plan and manage the facility. Doing this, could also improve the confidence and facility’s ability to deliver quality care, which in turn could increase competition, and the potential for facility to be recognized by community members and the government for its quality services.

Increase in patient volume, revenue and infrastructure upgrade:

“Increase in patient volume coming to access care and in turn generates increased revenue, thereby boosting the facility’s income. This will enable the facility to grow [in] infrastructure, as money will be invested in necessary things. It is also an opportunity to increase staff strength, hence creating employment.” (Private Facility Manager)

“Wider coverage of patients, more revenue for the hospital, improved services, infrastructure upgrade.” (Public Facility Manager)

Increased capacity to plan and manage facility:

“…Running costs from the local government is not regular but the facility will benefit in terms of having the running costs allocated from the insurance.” (Public Facility Manager)

“It would help to pay for staff, run the hospital very well and upgrade our facility.” (Private Facility Manager)

Improve quality of care and facility’s confidence:

“Patient will access quality healthcare services [which would] boost confidence of healthcare providers as patients will be happy with services received.” (Private Facility Manager)

“It would save lives and improve confidence as a facility. When you give prompt treatment, it saves lives, so we are excited about the potential benefits of having an insurance scheme.” (Public Facility Manager)

Increase facility’s recognition by patients and government:

“It would increase brand recognition for us. It will also put us in good standing with the government.” (Private Facility Manager)

“Increased client flow, increased revenue, increased cash flow for the health facility, Health facility becomes more popular and ability to showcase our equipment.” (Public Facility Manager)

Competition and improvement in quality of care:

“…This will enable government hospital to render better services hence more competition.” (Private Facility Manager)

“It will allow us to improve quality of care because of more competition between private and public facilities.” (Public Facility Manager)

the communities by making care more affordable to patients, increasing access to care and consequently improving the lives of community members who would have not been able to access care in the first place.

Improve access to free care:

“It will also improve access to care for people within the community. Because they don't have money to come to the health facility, they go to the traditional medicine providers.” (Private Facility Manager)

“If it succeeds and has the basic thing for it to take off, it is for equity and would let everybody be equal in accessing care. It will decrease mortality and even morbidity to a great extent.” (Public Facility Manager)

Improve community’s health:

“Will improve quality of care being accessed by [the] informal sector… It will also deepen the reach of health care services in the state… [and] improve lives of citizens.” (Private Facility Manager)

“It will improve the health of the community because more people will be accessing care.” (Public Facility Manager)

Three managers felt that the LSHS would not bring any opportunity to their facilities.

“I don't foresee any opportunity it can bring to the facility. Most patients from informal sector, from personal opinion cannot benefit from LSHS using NHIS as a prototype." (Private Facility Manager)

“For now, I don't [see any benefit] because we are already choked as a health facility. We are thinking of how we can expand…” (Private Facility Manager) “I don’t see any benefits” (Public Facility Manager)