A Threat to Sustainable HealthCare Services? Examining the Effect of Structural Violence on the Policy Outcomes of Lagos State Health Insurance Scheme among Enrolled Junior Officers in the Lagos State Ministry of Works and Infrastructure

Abstract

In Nigeria, citizens face challenges accessing quality healthcare despite the National Health Insurance Scheme. Decentralizing the scheme's implementation to states, including Lagos, aimed at universal health coverage, has not effectively addressed disparities. The implementation of the Lagos State Health Insurance Scheme seems to perpetuate structural violence, reflected in increased expenses, discrimination, substandard services, and preferential treatment. Furthermore, the sustainability of the scheme remains questionable due to these systemic issues. Therefore, this study explores the effect of structural violence on policy outcomes of the Lagos State Health Insurance Scheme among enrolled junior officers in the Lagos State Ministry of Works and Infrastructure, using primary and secondary sources of data. Findings show unintended consequences emanating from the implementation of the policy such as dissatisfaction, provider shifts, non-adherence to treatment plans, increased compensation claims, and erosion of trust among users. From these findings, the study, therefore, recommends insurance broadening coverage, addressing medical conditions comprehensively, and implementing incentive programs for quality healthcare delivery, standards adherence, patient satisfaction and long-term sustainability within the scheme.