System improvement in Nigeria: Examining senior healthcare programs from citizens' perspectives.

摘要

Purpose. This dissertation had 4 predominant purposes: (a) to examine and identify major barriers that may significantly impact reforming the senior care program in Nigeria, (b) to investigate the types of senior care programs that policy analysts consider promising in Nigeria, (c) to determine the feasibility of a U.S.-type Medicare program for Nigeria’s seniors, and (d) to investigate how demographic characteristics influence the healthcare program for Nigeria’s aging population.;Theoretical Framework. The theoretical framework and research model for this study were influenced by the institutional analysis and development (IAD) framework developed by American political economist and 2009 Nobel Prize winner Elinor Ostrom (2011), as well as theories based on organizational change and conflict (Burke, 2011; Denhardt et al., 2009), and theories based on complex systems and crisis management, called complexity theory and contingency theory, respectively (Holtzhausen & Roberts, 2009; Klijn, 2008).;Methodology. Personal interviews that utilized questionnaires were administered to a sample population of 44 citizens in the Ilorin East Local Government Area (IELGA) of Nigeria in order to collect data for this study. The research questions for this study were explored by qualitative and quantitative research methods, and the research design was exploratory in nature.;Findings. The results showed that citizens feel that the current healthcare system does not meet elderly persons’ needs in terms of homecare and healthcare. The results also revealed that citizens overwhelmingly indicated a “lack of genuine political conviction of the need for action on aging” as the primary barrier to reforming the senior care program.;Conclusion and Recommendations. The study showed that citizens feel that one of the primary problems of the Nigerian healthcare system is the unwillingness of the elected public officials to develop or adopt a national senior healthcare program that provides solutions to the senior care program accountability and sustainability problems. A study is recommended to examine the impact of overall Nigerian political culture on healthcare policy. A study is also recommended to evaluate the effectiveness of government administrative structure. Finally, a study is recommended to investigate the level of relationship between accountability and citizen participation, as well as its impact on healthcare system performance.