Table 2 Strengths and weaknesses of Governance & Information infrastructure for SHP
State budgetary allocation for health | State Social health Insurance Scheme |
|---|---|
Strengths include existence of - Abia SMOH as the primary purchasing agency with the mandate and autonomy to ensure standard of care - Purchasing function is primarily governed by the approved state budget and public procurement law - Unified information system (DHIS 2) and data governance structure | Strengths include existence of - Legal framework that established the purchasing agency (Abia State House of Assembly law 2017, vide no. 2) - Governing board that oversees and regulates the activities of the agency - Client complaints portal for gathering grievances/appeals - Quarterly performance monitoring of key indicators by the M&E unit of the agency |
Weaknesses include - Weak capacity to implement strategic purchasing - Operation of zero and incremental budget - Weak accountability structure - Lack of implementation of sanctions/penalties for poor accountability - Lack of IT infrastructure and limited IT skills | Weaknesses include - Lack of information technology (IT) infrastructure and staff with relevant IT skills - Lower thresholds for accreditation of public providers who are the majority - Possibility of incomplete release of equity funds by state government |
Opportunities | Opportunities |
- Capacity strengthening for strategic purchasing to improve linkage of budget to operational plans and achievement of health system goals - Properly defined governance structure for strategic purchasing with clear oversight and accountability | - Maximize purchasing power by employing this single pool - Develop IT infrastructure and ensure integration with state level IT architecture |
Threat - Rigid budget reduces the opportunity for efficiency and more strategic purchasing | Threats - Inadequate data-driven decision-making processes due to manual processes - Distrust by the provider population due to the application of different standards for different sectors - Changes in political landscape leading to delays in disbursement of funds |