Institutionalizing implementation research in Nigeria's Basic Health Care Provision Fund.

Under Nigeria's 2014 National Health Act, the Basic Health Care Provision Fund (BHCPF) was created as a key health financing mechanism to bolster primary healthcare and promote progress towards Universal Health Coverage (UHC). The BHCPF, disbursed through four gateways, has catalyzed important healt...

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Publicado en:Discover Public Health Vol. 23; no. 1; pp. 1 - 13
Autores principales: Adamu, Abdu A., Ibrahim, Kamal A., Adamu, Hyelhirra, Umar-Sadiq, Firdausi
Formato: tables/charts Journal Article
Publicado: Springer Nature 6/23/2026
Acceso en línea:Ver este registro en EBSCOhost
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      place: New York, New York
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        atl: Institutionalizing implementation research in Nigeria's Basic Health Care Provision Fund.
      aug:
        au:
          Adamu, Abdu A.
          Ibrahim, Kamal A.
          Adamu, Hyelhirra
          Umar-Sadiq, Firdausi
        affil: Independent Researcher, Kano, Kano State, Nigeria
      sug:
        subj:
          Health Care Reform
          Primary Health Care Legislation and Jurisprudence
          Financing, Government
          Universal Health Care
          Implementation Science
          Conceptual Framework
          Health Policy
          Accountability
          Health Expenditures
          Low and Middle Income Countries
          Nigeria
      ab: Under Nigeria's 2014 National Health Act, the Basic Health Care Provision Fund (BHCPF) was created as a key health financing mechanism to bolster primary healthcare and promote progress towards Universal Health Coverage (UHC). The BHCPF, disbursed through four gateways, has catalyzed important health systems gains, including improved facility financing predictability and the nationwide creation of State Social Health Insurance Agencies. However, persistent bottlenecks, including weak oversight, lax fiduciary controls, poor accountability, and disparities in implementation quality, have constrained progress. These challenges precipitated a comprehensive set of reforms outlined in the 2025 BHCPF guidelines (BHCPF 2.0). These reforms introduce performance-linked disbursement, tiered direct facility financing, capitation-plus payment systems, and strengthened governance structures. Yet policy reform alone does not guarantee equitable and effective implementation, particularly in Nigeria's complex, decentralized, and heterogeneous health system. This Commentary argues that institutionalizing implementation research in BHCPF's governance framework offers a structured, evidence-driven pathway to bridge the gap between reform intent and real-world outcomes. Specifically, implementation research can: build theory-driven understanding of why and how reforms succeed or fail across diverse subnational contexts; monitor implementation fidelity and outcomes during rollout; distinguish necessary adaptations from fidelity drift; and test context-specific strategies to overcome barriers and promote facilitators. Ultimately, country-led, integrated implementation research is essential for fully realizing the transformative potential of BHCPF.
      pubtype: Academic Journal
      doctype:
        tables/charts
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      ougenre: Article
    language: English
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