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An Examination of Accounting Practices in Nigerian Healthcare Subsidies: A Case Study of the National Health Insurance Scheme (NHIS)

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Background of the Study
Healthcare subsidies are essential for improving access to quality medical services, particularly for vulnerable populations. In Nigeria, the National Health Insurance Scheme (NHIS) was established to reduce the financial burden of healthcare through subsidized premiums and services. Despite its potential, the NHIS has faced challenges related to poor fund management, fraud, and inefficiencies, leading to limited coverage and impact (Onyema & Okeke, 2024).

Accounting practices are central to the effective management of healthcare subsidies, ensuring that funds are properly allocated, tracked, and reported. However, weaknesses in financial oversight and reporting systems have hindered the scheme’s ability to achieve its objectives (Akinola & Olayemi, 2025). This study examines accounting practices within the NHIS, focusing on their effectiveness in ensuring financial accountability and program sustainability.

Statement of the Problem
The NHIS has been criticized for poor fund utilization, lack of transparency, and limited accountability. Issues such as delayed premium disbursements and fraudulent claims further undermine the scheme’s efficiency and public trust (Bassey & Adewole, 2023).

Although government accounting practices are in place, their effectiveness in addressing these challenges remains uncertain. This study investigates the role of accounting practices in managing healthcare subsidies under the NHIS, identifying areas for improvement.

Objectives of the Study

  1. To evaluate the effectiveness of accounting practices in managing healthcare subsidies under the NHIS.
  2. To identify challenges affecting financial accountability in the NHIS.
  3. To propose strategies for improving the management of healthcare subsidies through effective accounting practices.

Research Questions

  1. How effective are accounting practices in managing healthcare subsidies under the NHIS?
  2. What challenges affect financial accountability in the NHIS?
  3. What strategies can improve the management of healthcare subsidies?

Research Hypotheses

  1. Accounting practices significantly enhance the management of healthcare subsidies under the NHIS.
  2. Challenges in accounting practices negatively affect financial accountability in the NHIS.
  3. Improved accounting practices enhance the efficiency of healthcare subsidy management.

Scope and Limitations of the Study
The study focuses on the NHIS, covering the period from 2010 to 2024. Limitations include restricted access to financial records and potential biases in respondent feedback.

Definition of Terms

  • Accounting Practices: Procedures for recording, monitoring, and reporting financial transactions.
  • Healthcare Subsidies: Financial support provided to reduce the cost of healthcare services.
  • National Health Insurance Scheme (NHIS): A Nigerian government initiative to provide subsidized healthcare coverage.




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