Globalization of Health Care: Designing, Developing and Implementing a Just World Class Health System in a Frontier Market

摘要

The focus of this paper is the approach to design, development and implementation of a world-class health care system (WCHS) in Akwa Ibom State, an oil producing state in South-South Region of Nigeria. We report the Ustawi Research Institute’s emerging paradigm for design, development and implementation of a WCHS in a frontier market. This report draws from rich experience gained in design, development and implementation of a world-class academic medical center developed on a master-planned medical city, and connected to a franchised system of ambulatory, tertiary care medical centers distributed in the state of Akwa Ibom, Nigeria. We used a qualitative method to gather inductive data from stakeholders of health and human development in Nigeria. The grounded theory design facilitated theoretical sampling of key concepts about state of health services in Nigeria. Comparative analysis yielded a grounded theory that a WCHS in a frontier market has three distinct structures: (a) a community engagement structure, (b) a payment structure, and (c) a health services delivery structure. The three structures are necessary subsystems of a complete system that form a comprehensive entity for health production in a frontier market. Planners, designers, and architects of health care systems and facilities must be aware of the working principles of the three necessary structures for community engagement, payment and health services delivery when designing, developing and implementing world class health projects in frontier markets.