Influence of Administrative Challenges, Funding Limitations, And Political Will on Healthcare Access Under Nhis In South-East Nigeria's Federal Tertiary Institutions

Abstract

Persistent administrative inefficiencies, unstable financing, and inconsistent political commitment continue to limit healthcare access under the National Health Insurance Scheme in Nigeria, especially within federal tertiary institutions in the South East. Despite the scheme’s two decades of operation, its implementation has not achieved equitable access or coverage. The study aimed to determine how administrative processes influence healthcare access, assess the effect of funding adequacy, and examine the role of political will in sustaining service delivery within these institutions from 2005–2021. A descriptive survey research design was employed, covering NHIS-registered staff and patients in federal tertiary hospitals across Abia, Anambra, Ebonyi, Enugu, and Imo States. A total of 400 respondents were selected through stratified random sampling. Data were collected using a structured questionnaire and analysed with descriptive statistics and multiple regression at a 0.05 significance level. Findings showed that administrative efficiency, adequate funding, and political commitment significantly affected healthcare access, jointly explaining 67.4 percent of the variance, with political commitment exerting the greatest influence. The study concludes that effective administration, sustained funding, and consistent political will are essential for achieving equitable healthcare delivery under the NHIS. It recommends capacity strengthening, timely fund disbursement, and stronger policy oversight.