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<p>The Basic Health Care Provision Fund (BHCPF) under Nigeria’s National Health Act (NHA) includes the establishment of a national emergency medical response service. This study evaluated the early implementation process of this service as perceived by key stakeholders, which is essential for sustainability and scalability. This cross-sectional mixed-methods study was conducted among national and state-level stakeholders involved in early implementation. Data collection included a self-designed knowledge assessment of national and international emergency care guidelines and a semi-structured open-ended interview adapted from the Consolidated Framework for Implementation Research (CFIR). Qualitative data were analyzed using a deductive framework approach, with construct ratings assigned by consensus. Inter-rater reliability was assessed using Cohen’s kappa. Associations between knowledge scores and CFIR construct ratings were explored using Spearman’s rank correlation. Eight stakeholders from three states with active implementation participated. Respondents expressed strong agreement regarding the source of innovation, tension for change, and available resources, reflecting broad recognition of the need for innovation. Notable variability was observed in goals and feedback, and in available resources, with narrative differences across states. Knowledge assessment scores varied widely (median 60%). A strong positive association was observed between knowledge scores and ratings of goals and feedback (ρ = 0.743, <i>p</i> = 0.035), although findings are exploratory given the small sample size. Early implementation of Nigeria’s emergency medical response system is characterized by strong stakeholder motivation but uneven knowledge, resource availability, and goal-feedback mechanisms. Targeted capacity-building, improved communication, and structured feedback processes may strengthen implementation and support future scale-up under the NHA.</p>

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Evaluation of the implementation of an emergency medical care system in Nigeria as perceived by stakeholders utilizing the consolidated framework for implementation research

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月30日

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  • Ola Elechi,
  • SimileOluwa Onabanjo,
  • Enoch Olatoye,
  • Ahmed Saidu,
  • Emuren Doubra,
  • Christine Ngaruiya

摘要

The Basic Health Care Provision Fund (BHCPF) under Nigeria’s National Health Act (NHA) includes the establishment of a national emergency medical response service. This study evaluated the early implementation process of this service as perceived by key stakeholders, which is essential for sustainability and scalability. This cross-sectional mixed-methods study was conducted among national and state-level stakeholders involved in early implementation. Data collection included a self-designed knowledge assessment of national and international emergency care guidelines and a semi-structured open-ended interview adapted from the Consolidated Framework for Implementation Research (CFIR). Qualitative data were analyzed using a deductive framework approach, with construct ratings assigned by consensus. Inter-rater reliability was assessed using Cohen’s kappa. Associations between knowledge scores and CFIR construct ratings were explored using Spearman’s rank correlation. Eight stakeholders from three states with active implementation participated. Respondents expressed strong agreement regarding the source of innovation, tension for change, and available resources, reflecting broad recognition of the need for innovation. Notable variability was observed in goals and feedback, and in available resources, with narrative differences across states. Knowledge assessment scores varied widely (median 60%). A strong positive association was observed between knowledge scores and ratings of goals and feedback (ρ = 0.743, p = 0.035), although findings are exploratory given the small sample size. Early implementation of Nigeria’s emergency medical response system is characterized by strong stakeholder motivation but uneven knowledge, resource availability, and goal-feedback mechanisms. Targeted capacity-building, improved communication, and structured feedback processes may strengthen implementation and support future scale-up under the NHA.