. 2021 Dec 20;11:47. doi: 10.1186/s13561-021-00346-8

Table 2.

Strengths and weaknesses of Governance & Information infrastructure for SHP

State budgetary allocation for health	State Social health Insurance Scheme
Strengths include existence of - Abia SMOH as the primary purchasing agency with the mandate and autonomy to ensure standard of care - Purchasing function is primarily governed by the approved state budget and public procurement law - Unified information system (DHIS 2) and data governance structure	Strengths include existence of - Legal framework that established the purchasing agency (Abia State House of Assembly law 2017, vide no. 2) - Governing board that oversees and regulates the activities of the agency - Client complaints portal for gathering grievances/appeals - Quarterly performance monitoring of key indicators by the M&E unit of the agency
Weaknesses include - Weak capacity to implement strategic purchasing - Operation of zero and incremental budget - Weak accountability structure - Lack of implementation of sanctions/penalties for poor accountability - Lack of IT infrastructure and limited IT skills	Weaknesses include - Lack of information technology (IT) infrastructure and staff with relevant IT skills - Lower thresholds for accreditation of public providers who are the majority - Possibility of incomplete release of equity funds by state government
Opportunities	Opportunities
- Capacity strengthening for strategic purchasing to improve linkage of budget to operational plans and achievement of health system goals - Properly defined governance structure for strategic purchasing with clear oversight and accountability	- Maximize purchasing power by employing this single pool - Develop IT infrastructure and ensure integration with state level IT architecture
Threat - Rigid budget reduces the opportunity for efficiency and more strategic purchasing	Threats - Inadequate data-driven decision-making processes due to manual processes - Distrust by the provider population due to the application of different standards for different sectors - Changes in political landscape leading to delays in disbursement of funds

State budgetary allocation for health

State Social health Insurance Scheme

Strengths include existence of

- Abia SMOH as the primary purchasing agency with the mandate and autonomy to ensure standard of care

- Purchasing function is primarily governed by the approved state budget and public procurement law

- Unified information system (DHIS 2) and data governance structure

Strengths include existence of

- Legal framework that established the purchasing agency (Abia State House of Assembly law 2017, vide no. 2)

- Governing board that oversees and regulates the activities of the agency

- Client complaints portal for gathering grievances/appeals

- Quarterly performance monitoring of key indicators by the M&E unit of the agency

Weaknesses include

- Weak capacity to implement strategic purchasing

- Operation of zero and incremental budget

- Weak accountability structure

- Lack of implementation of sanctions/penalties for poor accountability

- Lack of IT infrastructure and limited IT skills

Weaknesses include

- Lack of information technology (IT) infrastructure and staff with relevant IT skills

- Lower thresholds for accreditation of public providers who are the majority

- Possibility of incomplete release of equity funds by state government

Opportunities

- Capacity strengthening for strategic purchasing to improve linkage of budget to operational plans and achievement of health system goals

- Properly defined governance structure for strategic purchasing with clear oversight and accountability

- Maximize purchasing power by employing this single pool

- Develop IT infrastructure and ensure integration with state level IT architecture

Threat

- Rigid budget reduces the opportunity for efficiency and more strategic purchasing

Threats

- Inadequate data-driven decision-making processes due to manual processes

- Distrust by the provider population due to the application of different standards for different sectors

- Changes in political landscape leading to delays in disbursement of funds