Challenges and Limitations of Implementing the Basic Health Care Provision Fund in Nasarawa State

Abstract

The Basic Health Care Provision Fund (BHCPF) was established in Nigeria to strengthen Primary Health Care (PHC) services, improve access to essential health interventions, and accelerate progress toward Universal Health Coverage (UHC). Despite its strategic importance, implementation challenges continue to hinder its effectiveness in several states, including Nasarawa State. This study examined the challenges and limitations associated with the implementation of the BHCPF in Nasarawa State, Nigeria. A descriptive cross-sectional design was adopted using qualitative and quantitative approaches among health managers, PHC workers, and community stakeholders across selected urban and rural Local Government Areas. Data were collected through structured questionnaires, key informant interviews, and document reviews, and analyzed using descriptive and thematic methods. Findings revealed that inadequate funding disbursement, delays in release of funds, weak financial accountability systems, shortage of skilled health personnel, poor infrastructure, insufficient medical commodities, and inadequate community awareness significantly affected BHCPF implementation. Other identified limitations included weak monitoring and evaluation mechanisms, political interference, limited capacity of health facility management committees, and poor inter-sectoral coordination. Rural health facilities were disproportionately affected due to transportation difficulties, insecurity, and limited supervisory support. The study further demonstrated that although the BHCPF has improved availability of some essential PHC services, sustainability and equity in service delivery remain major concerns. Strengthening governance structures, ensuring timely and transparent fund disbursement, enhancing workforce capacity, improving infrastructure, and promoting community participation are critical to optimizing BHCPF performance in Nasarawa State. The study concludes that addressing systemic and operational barriers is essential for achieving effective BHCPF implementation and improving health outcomes among vulnerable populations in the state.