BACKGROUND There is widespread and growing interest in designing and implementing social health insurance schemes (SHIS) across many low- and middle-income countries as a means to improve financial protection and achieve universal health coverage. SHIS recently gained traction in Nigeria, but evidence regarding optimal design features of SHIS is sparse and there is lack of a simple and standardised checklist that scheme designers, implementers and researchers could use to assess, guide and inform the design of SHIS. This paper seeks to develop a checklist based on concepts as well as theoretical and empirical evidence that can inform and guide scheme designers and implementers on design options to maximise the effectiveness of the scheme. METHODS We conducted a review of literature exploring the relevant concepts for the development of a framework and checklist to identify the key factors or variables required to inform the design of SHIS. The checklist details critical considerations/questions to address and options for design. The developed checklist was then used to examine conditions for readiness and appropriateness of SHIS design in two states in Nigeria (Kaduna and Niger). RESULTS This paper describes the development of a SHIS checklist. The findings also demonstrate that the newly developed checklist, consisting of six design domains, can be used by scheme designers and policy-makers as a simple and effective tool to assess and inform SHIS design features across Nigeria to maximise the chances of the effectiveness of the schemes. CONCLUSION In conclusion, given that the development of SHIS in the Nigerian states is still in its early stages, applying the SHIS design checklist can serve as a first step to ensuring a feasible and sustainable insurance scheme. The introduction of SHIS, if properly designed and implemented, can be a significant first step towards improving the accessibility, equity and efficiency of healthcare in Nigeria.

中文翻译：

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设计健康保险计划的清单 - 尼日利亚各州的拟议指南。

背景 人们对在许多低收入和中等收入国家设计和实施社会健康保险计划（SHIS）产生了广泛且日益增长的兴趣，以此作为改善财务保护和实现全民健康覆盖的手段。SHIS 最近在尼日利亚受到关注，但有关 SHIS 最佳设计特征的证据很少，而且缺乏方案设计者、实施者和研究人员可以用来评估、指导和告知 SHIS 设计的简单且标准化的检查表。本文旨在开发一个基于概念以及理论和经验证据的清单，可以为方案设计者和实施者提供设计选项方面的信息和指导，以最大限度地提高方案的有效性。方法 我们对文献进行了回顾，探索了开发框架和清单的相关概念，以确定 SHIS 设计所需的关键因素或变量。该清单详细介绍了需要解决的关键考虑因素/问题以及设计选项。然后使用制定的清单来检查尼日利亚两个州（卡杜纳和尼日尔）SHIS 设计的准备情况和适当性条件。结果 本文描述了 SHIS 检查清单的制定。研究结果还表明，新开发的清单由六个设计领域组成，可以被方案设计者和政策制定者用作评估和告知尼日利亚全国 SHIS 设计特征的简单有效的工具，以最大限度地提高方案有效性的机会。计划。结论 总之，鉴于 SHIS 在尼日利亚各州的发展仍处于早期阶段，应用 SHIS 设计清单可以作为确保可行且可持续的保险计划的第一步。如果设计和实施得当，SHIS 的引入可以成为提高尼日利亚医疗保健的可及性、公平性和效率的重要第一步。