Review Article

Influence of the Basic Health Care Provision Fund (BHCPF) on Financial Risk Protection in Nigeria: A Systematic Review and Evidence Synthesis with Focus on Bauchi State

Abstract

Financial risk protection is a core component of Universal Health Coverage (UHC), aimed at preventing catastrophic health expenditure and impoverishment. In Nigeria, high outof- pocket (OOP) payments remain a major barrier to healthcare access. The Basic Health Care Provision Fund (BHCPF) was introduced to strengthen primary healthcare financing and improve financial protection. However, evidence of its effectiveness remains fragmented. A systematic review was conducted in accordance with PRISMA guidelines. Electronic databases including PubMed, Scopus, Web of Science, Google Scholar, and African Journals Online (AJOL) were searched for studies published between 2010 and 2024. Eligible studies included observational and policy evaluation studies examining financial risk protection outcomes related to BHCPF or similar health financing mechanisms. Data extraction and quality assessment were performed using standardized tools. A total of 58 studies met the inclusion criteria. Evidence indicates that BHCPF has contributed to reduced OOP expenditure, improved affordability of healthcare services, and lower incidence of catastrophic health expenditure among beneficiaries. However, the magnitude of impact varies due to limited coverage, supply-side constraints, informal payments, and weak accountability systems. BHCPF has improved financial risk protection in Nigeria, particularly among beneficiaries, but has not achieved universal coverage. Strengthening implementation, expanding population coverage, and integrating BHCPF with broader health financing systems are essential to achieving UHC.