{"id":"https://openalex.org/W2204516609","doi":"https://doi.org/10.35202/ajhe.2014.3203","title":"THE DISTRICT HEALTH SYSTEM IN ENUGU STATE, NIGERIA: AN ANALYSIS OF POLICY DEVELOPMENT AND IMPLEMENTATION","display_name":"THE DISTRICT HEALTH SYSTEM IN ENUGU STATE, NIGERIA: AN ANALYSIS OF POLICY DEVELOPMENT AND IMPLEMENTATION","publication_year":2014,"publication_date":"2014-01-01","ids":{"openalex":"https://openalex.org/W2204516609","doi":"https://doi.org/10.35202/ajhe.2014.3203","mag":"2204516609"},"language":"en","primary_location":{"id":"doi:10.35202/ajhe.2014.3203","doi":"https://doi.org/10.35202/ajhe.2014.3203","is_oa":false,"landing_page_url":"https://doi.org/10.35202/ajhe.2014.3203","pdf_url":null,"source":{"id":"https://openalex.org/S4210234195","display_name":"African Journal of Health Economics","issn_l":"2006-4802","issn":["2006-4802","2504-8686"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4310311022","host_organization_name":"University of Nigeria","host_organization_lineage":["https://openalex.org/P4310311022"],"host_organization_lineage_names":["University of Nigeria"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"African Journal of Health Economics","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5088486542","display_name":"Benjamin S C. Uzochukwu","orcid":"https://orcid.org/0000-0002-0794-0455","observed_orcids":["https://orcid.org/0000-0002-0794-0455"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Benjamin SC Uzochukwu","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086867664","display_name":"Obinna Emmanuel Onwujekwe","orcid":"https://orcid.org/0000-0002-1214-4285","observed_orcids":["https://orcid.org/0000-0002-1214-4285"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Obinna E Onwujekwe","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5113718786","display_name":"Nkoli Ezumah","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Nkoli Ezumah","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.5751,"has_fulltext":false,"cited_by_count":20,"citation_normalized_percentile":{"value":0.80477107,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":89,"max":97},"biblio":{"volume":"03","issue":"02","first_page":"01","last_page":"14"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.8521000146865845,"subfield":{"id":"https://openalex.org/subfields/2003","display_name":"Finance"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T11531","display_name":"Healthcare Systems and Reforms","score":0.8521000146865845,"subfield":{"id":"https://openalex.org/subfields/2003","display_name":"Finance"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T14186","display_name":"Healthcare Systems and Practices","score":0.07729999721050262,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10629","display_name":"Health Policy Implementation Science","score":0.03590000048279762,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/district-health-system","display_name":"district health system","score":0.8889999985694885},{"id":"https://openalex.org/keywords/health-policy-implementation","display_name":"health policy implementation","score":0.9440000057220459},{"id":"https://openalex.org/keywords/enugu-state","display_name":"Enugu State","score":0.8149999976158142},{"id":"https://openalex.org/keywords/health-care-financing","display_name":"health care financing","score":0.6430000066757202},{"id":"https://openalex.org/keywords/health-workforce-recruitment","display_name":"health workforce recruitment","score":0.7889999747276306},{"id":"https://openalex.org/keywords/intergovernmental-relations","display_name":"intergovernmental relations","score":0.7609999775886536},{"id":"https://openalex.org/keywords/local-government-accountability","display_name":"local government accountability","score":0.7300000190734863},{"id":"https://openalex.org/keywords/health-facility-infrastructure","display_name":"health facility infrastructure","score":0.43299999833106995},{"id":"https://openalex.org/keywords/health-care-demand","display_name":"health care demand","score":0.8040000200271606},{"id":"https://openalex.org/keywords/policy-sustainability","display_name":"policy sustainability","score":0.44999998807907104},{"id":"https://openalex.org/keywords/stakeholder-consultation","display_name":"stakeholder consultation","score":0.5860000252723694}],"concepts":[{"id":"https://openalex.org/C48103436","wikidata":"https://www.wikidata.org/wiki/Q599031","display_name":"State (computer science)","level":2,"score":0.6806854605674744},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.3973536491394043},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.369570791721344},{"id":"https://openalex.org/C45355965","wikidata":"https://www.wikidata.org/wiki/Q1643441","display_name":"Socioeconomics","level":1,"score":0.338104248046875},{"id":"https://openalex.org/C205649164","wikidata":"https://www.wikidata.org/wiki/Q1071","display_name":"Geography","level":0,"score":0.3355702757835388},{"id":"https://openalex.org/C17744445","wikidata":"https://www.wikidata.org/wiki/Q36442","display_name":"Political science","level":0,"score":0.32161542773246765},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.2571863830089569},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.17606332898139954},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.17211174964904785},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.07989293336868286},{"id":"https://openalex.org/C11413529","wikidata":"https://www.wikidata.org/wiki/Q8366","display_name":"Algorithm","level":1,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.35202/ajhe.2014.3203","doi":"https://doi.org/10.35202/ajhe.2014.3203","is_oa":false,"landing_page_url":"https://doi.org/10.35202/ajhe.2014.3203","pdf_url":null,"source":{"id":"https://openalex.org/S4210234195","display_name":"African Journal of Health Economics","issn_l":"2006-4802","issn":["2006-4802","2504-8686"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4310311022","host_organization_name":"University of Nigeria","host_organization_lineage":["https://openalex.org/P4310311022"],"host_organization_lineage_names":["University of Nigeria"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"African Journal of Health Economics","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.8560000061988831},{"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10","score":0.7578999996185303},{"display_name":"Peace, justice, and strong institutions","id":"https://metadata.un.org/sdg/16","score":0.4399999976158142}],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":14,"referenced_works":["https://openalex.org/W612396548","https://openalex.org/W1506562644","https://openalex.org/W1506695811","https://openalex.org/W1558799599","https://openalex.org/W1694605583","https://openalex.org/W1975746435","https://openalex.org/W1995669894","https://openalex.org/W2018249746","https://openalex.org/W2040460188","https://openalex.org/W2058869603","https://openalex.org/W2074107703","https://openalex.org/W2115938495","https://openalex.org/W2336425228","https://openalex.org/W4285719527"],"related_works":["https://openalex.org/W846556396","https://openalex.org/W4385185522","https://openalex.org/W2974901338","https://openalex.org/W3213279442","https://openalex.org/W143954163","https://openalex.org/W1940694960","https://openalex.org/W2622940462","https://openalex.org/W1518242805","https://openalex.org/W7139957289","https://openalex.org/W7082312641"],"abstract_inverted_index":{"The":[0,34,94,162],"District":[1],"Health":[2],"System":[3],"(DHS)":[4],"is":[5,56],"a":[6,28,45,191,198,224],"form":[7],"of":[8,11,44,53,74,91,99,115,149,154,164,193,203,207,215,222,226,237,255,281],"decentralised":[9],"provision":[10,254],"health":[12,15,17,105,135,155,175,182,204,240,247],"care":[13,18],"where":[14],"facilities,":[16],"workers,":[19,205],"management":[20],"and":[21,59,72,127,137,152,157,177,220,230,234,260,287,298,316],"administrative":[22],"structures":[23],"are":[24,305],"organised":[25],"to":[26,82,171,186,242,252,266,272,295,329],"serve":[27],"specific":[29],"geographic":[30],"region":[31],"or":[32],"population.":[33],"system":[35],"was":[36],"introduced":[37],"in":[38,77,80,107,117,166,174,276],"Enugu":[39,78,108,167],"state":[40,109,261],"following":[41],"the":[42,70,75,84,89,92,141,201,213,216,243,269,279,310,319],"election":[43],"new":[46,289],"government.":[47,245],"However,":[48,184],"experiences":[49],"suggest":[50],"that":[51,87,111],"implementation":[52,73,90,163,188,274,308,333],"this":[54],"policy":[55,273,332],"particularly":[57],"complex":[58],"can":[60],"be":[61,250,293],"hindered":[62],"by":[63],"several":[64],"factors.":[65],"This":[66],"study":[67,95,143],"therefore":[68],"investigated":[69],"development":[71],"DHS":[76,165],"State":[79,168,229,244,320],"order":[81],"reveal":[83],"underlying":[85],"factors":[86],"affected":[88],"policy.":[93],"involved":[96],"case":[97],"studies":[98],"two":[100],"communities":[101],"from":[102,318],"different":[103],"district":[104],"authorities":[106],"Nigeria":[110],"had":[112],"varying":[113],"levels":[114],"success":[116],"implementing":[118,288],"DHS.":[119,284],"In-depth":[120],"interviews":[121],"were":[122,132,159],"conducted":[123,133],"with":[124,134,297],"21":[125],"policymakers":[126],"12":[128],"focus":[129],"group":[130],"discussions":[131],"workers":[136,241,248],"community":[138],"members":[139],"at":[140,268,309],"2":[142],"sites.":[144],"In":[145],"addition,":[146],"document":[147],"reviews":[148],"relevant":[150],"documents":[151],"observation":[153],"facilities":[156,176],"infrastructure":[158],"carried":[160],"out.":[161],"has":[169,178,264],"led":[170,265],"significant":[172],"improvements":[173],"stimulated":[179],"demand":[180],"for":[181,196,283,307],"services.":[183],"challenges":[185],"successful":[187],"persist":[189],"including":[190],"lack":[192,206,225],"government":[194,232,239,262],"funding":[195,315],"heath,":[197],"ban":[199],"on":[200],"recruitment":[202],"24":[208],"hour":[209],"services,":[210,256],"uncertainty":[211],"about":[212],"sustainability":[214],"DHS,":[217],"irregular":[218],"monitoring":[219],"evaluation":[221],"staff,":[223],"trust":[227],"between":[228,258],"local":[231,238,259,270,311,322],"officials":[233],"no":[235],"accountability":[236],"Additional":[246],"should":[249,292],"employed":[251],"maintain":[253],"Mistrust":[257],"actors":[263,324],"resistance":[267],"level":[271,323],"and,":[275],"some":[277],"instances,":[278],"withdrawal":[280],"funds":[282],"When":[285],"planning":[286],"policies,":[290],"efforts":[291],"made":[294],"consult":[296],"engage":[299],"all":[300],"actors,":[301],"especially":[302],"those":[303],"who":[304],"responsible":[306],"level.":[312],"Without":[313],"dedicated":[314],"support":[317,330],"government,":[321],"will":[325],"have":[326],"limited":[327],"ability":[328],"effective":[331]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":1},{"year":2024,"cited_by_count":3},{"year":2022,"cited_by_count":4},{"year":2020,"cited_by_count":3},{"year":2019,"cited_by_count":3},{"year":2018,"cited_by_count":2},{"year":2014,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}
