Universal Healthcare Coverage and Medical Tourism: Challenges and Best Practice Options to Access Quality Healthcare and Reduce Outward Medical Tourism in Nigeria

Abstract

Background: Universal healthcare coverage (UHC) leads to access to quality healthcare. Improved quality healthcare can stem outward medical
tourism (MT). This review examined challenges and best practice policy options to implement UHC and how it can reduce outward MT in
Nigeria.

Methodology: The designed search terms used were “universal health coverage,” “quality healthcare” “medical tourism,” “access to healthcare,” “primary health care,” “healthcare financing,” “private health insurance,” “social health insurance,” and “Nigeria healthcare system.” Peer‑reviewed research articles and institutional reports published between January 2000 and March 2020 were searched using four databases: PubMed, National Library of Medicine, Web of Science, and Library of Congress. EndNote X9 software and Google search engine were used to access these databases and documents, and 124 publications were retrieved and 106 were reviewed.

Results: Majority of publications reviewed emphasized building health infrastructure, developing skills and human resources for health, and funding for equipment and drugs. Expanding healthcare coverage through social health insurance, developing a financial system to protect the  poor, access to quality healthcare, and reinvigoration of primary healthcare (PHC) were common themes. About 50% of the studies identified  unavailability of quality healthcare services, inequalities in the supply side of healthcare services, issue of human resources, and health sector  implementation shortfall as challenges to UHC. Another 50% of the studies reviewed identified poverty and poorly funded PHC as a barrier to UHC.  Almost all the studies (100%) identified cost‑effectiveness, safety, and quality of healthcare services as drivers of MT in all countries.

Conclusion:  Improving the quality of healthcare delivery, increasing accessibility, affordability, and timeliness of access by the population through UHC can stem  MT.

Keywords: Financing, medical tourism, Nigeria, quality, SHI, universal healthcare coverage