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Public Policy and Administration


Bethe Hagens


From 2004 to 2015, the health sector in Nigeria was substantially underfunded despite the existence of a federal health policy committing 15% of the national budget to health care financing. The purpose of this narrative and phenomenological study was to explore the nature and significance of economic claims made in this policy. The central research question examined the extent to which these economic claims were perceived to be realistic, attainable, and successful in meeting their intended policy objectives and impact. The study's conceptual framework combined Kingdon's ambiguity and multiple streams theory, Roe's narrative policy analysis, and Skocpol's policy feedback theory. Seventeen major health policy documents and transcripts from key informant interviews with a convenience sample of 15 representative health policy experts, were imported into a data software. Twenty-six nodes were identified and then manually organized into 3 themes to generate the findings. Policy experts perceived the 147 economic claims in the policy documents as marginally realistic, and a majority of these experts assessed the claims as unattainable and with limited chance of succeeding in addressing the underfunding of Nigeria's health sector. The study opened a new area of research inquiry in health policy and health care financing by linking the veracity of economic claims made in the national health policy with the actual financing of health care. Health policy experts can use study results to promote the formulation and use of evidence-based economic claims in future health policies. Increased use of specific, measurable, attainable, realistic, and time-bound economic claims will enhance future health policy contributions to human wellbeing and positive social change.