Ukana West 2 Community-Based Health Initiative
A pilot community-based health initiative based in a rural area in South-South Nigeria involved in ensuring the provision of equitable and accessible healthcare services through community participation.
CONTINENT
Africa
COUNTRY
Nigeria
Location
Ukana West 2 Ward, Ikot Ideh Town, Essien Udim Local Government Area
Health Focus
Primary Healthcare
Website
ukanawestcbhi.org
Founding year
2014
Organizational structure
Non-governmental organisation
Actors involved
Ukana West 2 Community, National Health Insurance Scheme (NHIS), Local Government Council (LGC), and Ministry of Health (MoH)
Programme Focus
Community Health Insurance, Community Engagement, Access To Affordable and Quality Healthcare
Health System Focus
Service Delivery, Health Financing
CHALLENGE
Nigeria is the most populous country in Africa and the seventh most populous country in the world. The insufficient programs designed to address the numerous health problems of such a densely populated country have led to little improvement in health status. The overall life expectancy at birth is 54 years and the infant mortality rate is 86 per 1,000 live births, while the maternal mortality ratio is 840 per 100,000 live births.
“Low service uptake at the health facility, dysfunctional facility, high mortality/morbidity rate, and the inability by the majority to afford medical fees was the prevailing situation before the introduction of CBHI.”
– Employee
INTERVENTION
The CBHI aims to ensure that health services are affordable and accessible for all by eliminating barriers at the point of care through resource pooling. Through the full participation of the community in the CBHI, healthcare service delivery and uptake have improved at the health facility.The program was designed to facilitate community financial participation in the health facility’s funding. Concurrently, it provided the most economically disadvantaged with equitable access by using resource mobilization from partners to sponsor their enrollment.
“With the right type of funding in place, the scheme would be able to attract and retain persons skilled and knowledgeable enough to enhance the scheme even with remuneration that is just sufficient enough to keep them going, while waiting for better employment opportunities.”
– Founder, CBHI
Impact
Unlike what most obtain across the Nigerian healthcare system, with the enrollment payment of NGN 10,000 (USD 26.25) as premium per head for a year, the CBHI ensures that beneficiaries receive healthcare services for all levels of healthcare without any fee. This initiative has ensured that up to 11,600 people in the community and its environs have accessed affordable healthcare without discrimination.
CASE INSIGHTS
Community-owned health insurance models like Ukana West 2 CBHI reduce out-of-pocket payments and improve service uptake, offering a practical pathway to equitable healthcare access in underserved communities. Their long-term sustainability depends on strong political commitment and diversified resource mobilization beyond member premiums, highlighting the need for integration into broader health financing systems. By enabling communities to manage their own primary healthcare schemes, these models promote positive health-seeking behaviors, ease the burden on higher-level facilities, and demonstrate the transformative impact of grassroots governance on health service delivery.