Author:
Njie Hassan,Ilboudo Patrick G. C.,Gopinathan Unni,Chola Lumbwe,Wangen Knut Reidar
Abstract
Abstract
Background
The Government of The Gambia introduced a national health insurance scheme (NHIS) in 2021 to promote universal health coverage (UHC). Provider payment systems (PPS) are strategic purchasing arrangements that can enhance provider performance, accountability, and efficiency in the NHIS. This study assessed healthcare workers’ (HCWs’) preferences for PPS across major service areas in the NHIS.
Methods
A facility-based cross-sectional study was conducted using a probability proportionate to size sampling technique to select an appropriate sample size. Health care workers were presented with options for PPS to choose from across major service areas. Descriptive statistics explored HCW socio-demographic and health service characteristics. Multinomial logistic regressions were used to assess the association between these characteristics and choices of PPS.
Results
The majority of HCW did not have insurance coverage, but more than 60% of them were willing to join and pay for the NHIS. Gender, professional cadre, facility level, and region influenced HCW’s preference for PPS across the major service areas. The preferred PPS varied among HCW depending on the service area, with capitation being the least preferred PPS across all service areas.
Conclusion
The National Health Insurance Authority (NHIA) needs to consider HCW’s preference for PPS and factors that influence their preferences when choosing various payment systems. Strategic purchasing decisions should consider the incentives these payment systems may create to align incentives to guide provider behaviour towards UHC. The findings of this study can inform policy and decision-makers on the right mix of PPS to spur provider performance and value for money in The Gambia’s NHIS.
Publisher
Springer Science and Business Media LLC
Reference42 articles.
1. Cometto G, Buchan J, Dussault G. Developing the health workforce for universal health coverage. Bull World Health Organ. 2020;98(2):109–16.
2. World Health Organisation. Health workforce requirements for universal health coverage and sustainable development goals. Geneva: World Health Organisation; 2016. Available from: https://apps.who.int/iris/bitstream/handle/10665/250330/9789241511407-eng.pdf?sequence=1&isAllowed=y. Cited 2022 21 February.
3. Reid M, Gupta R, Roberts G, Goosby E, Wesson P. Achieving Universal Health Coverage (UHC): dominance analysis across 183 countries highlights importance of strengthening health workforce. PLoS One. 2020;15(3):e0229666.
4. World Health Organization. Global strategy on human resources for health workforce 2030. Geneva: World Health Organization; 2016. Available from: https://apps.who.int/iris/bitstream/handle/10665/250368/9789241511131-eng.pdf. Cited 2023 29 March.
5. Pittman P, Chen C, Erikson C, Salsberg E, Luo Q, Vichare A, et al. Health workforce for health equity. Med Care. 2021;59(Suppl 5):S405–8.