{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T23:19:20Z","timestamp":1789255160018,"version":"build-2803163510"},"reference-count":62,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health\ufffdServ\ufffdInsights"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Many individuals in low- and middle-income countries with healthcare needs do not access the necessary, often lifesaving healthcare services. Existing universal health coverage (UHC) indicators do not account for a portion of the population with unmet healthcare needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To estimate the prevalence, wealth-related inequality, and determinants of unmet healthcare needs in Nigeria using data from the nationally-representative Nigeria Living Standards Survey, 2018-2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed data from a cross-sectional sample of 116\u2009320 Nigerians from 22\u2009110 households selected using multi-stage probability sampling. The outcome variable was self-reported unmet healthcare needs. We conducted concentration index (CIX) analyzes to assess wealth-related inequalities and performed multilevel logistic regression analysis to identify the determinants of unmet healthcare needs at the individual, household, and community levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The prevalence of unmet healthcare needs was 5.2% (95% CI: 5.0-5.5), representing about 11\u2009million Nigerians (95% CI:\u200910.5-11.5\u2009million). The most common reasons were high costs (unaffordability) and the perception that the illness or injury was not serious. Wagstaff-normalized CIX for unmet healthcare needs was pro-poor: \u22120.09730 for the general population and \u22120.10878 for those with chronic illnesses. Significant determinants of unmet healthcare needs include age (AOR: 0.99, 95% CI:\u20090.99-1.00), chronic illness (AOR: 8.73, 95% CI:\u20097.99-9.55), single-person households (AOR: 1.55, 95% CI:\u20091.20-2.02), poorest quintile households (AOR: 1.45, 95% CI:\u20091.19-1.78), and mildly (AOR: 1.17, 95% CI:\u20091.01-1.36) or moderately food-insecure households (AOR: 1.30, 95% CI:\u20091.11-1.51).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A significant proportion of Nigerians, particularly the very poor, chronically ill, those living alone, or food insecure, have unmet healthcare needs. This highlights the necessity for targeted interventions to ensure vulnerable populations can access essential healthcare services. To progress toward UHC, the Nigerian health system must address critical issues related to healthcare accessibility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11786329251330032","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T05:29:45Z","timestamp":1743398985000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Understanding Unmet Healthcare Needs in Nigeria: Implications for Universal Health Coverage"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7202-8676","authenticated-orcid":false,"given":"Paul","family":"Eze","sequence":"first","affiliation":[{"name":"Department of Health Policy and Administration, Penn State University, University Park, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chioma Lynda","family":"Aniebo","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Ilechukwu","sequence":"additional","affiliation":[{"name":"Health Projects, South Saharan Social Development Organization (SSDO), Independence Layout, Enugu, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5350-7441","authenticated-orcid":false,"given":"Lucky Osaheni","family":"Lawani","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61147-7"},{"key":"e_1_3_3_3_2","unstructured":"World Health Organization. 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