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Blockchain-Enabled Smart Contract Monitoring and Universal Health Coverage Efficiency for Neglected Tropical Diseases in Nigeria

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DOI: 10.21522/TIJAR.2014.13.03.Art010

Authors : Yilchini Yilben Ishaku, Amitabye Luximon-Ramma, Abiodun Olaiya Paul

Abstract:

This study examines the role of blockchain-enabled monitoring systems in enhancing the efficiency of Universal Health Coverage (UHC) for Neglected Tropical Diseases (NTDs) in Nigeria. Despite ongoing policy efforts, UHC delivery remains constrained by fragmented governance structures, weak financial transparency, and limited real-time performance monitoring. Blockchain technology, operationalized through smart contract–based mechanisms, offers a pathway to strengthen accountability, improve resource tracking, and optimize system efficiency. A quantitative cross-sectional design was employed using data from 314 health system stakeholders across three expert groups: UHC and NTD specialists, Healthcare 4.0 and IT experts, and international digital health professionals. Data were analyzed using Principal Components Analysis (PCA), reliability testing, Confirmatory Factor Analysis (CFA), and Structural Equation Modeling (SEM). The model demonstrated strong fit (RMSEA = 0.028; SRMR = 0.043; CFI = 0.99). Findings show that blockchain-enabled monitoring systems significantly influence UHC efficiency, with Blockchain systems (HBC) (β = 0.40) and fund utilization monitoring (β = 0.39) as the strongest drivers. Big data (β = 0.33), fog computing (β = 0.36), socio-cultural acceptance (β = 0.36), and economic readiness (β = 0.39) also showed significant effects. Efficiency gains are driven by integrated monitoring architectures that align governance mechanisms, data infrastructure, and contextual readiness conditions. These findings provide policy-relevant evidence for strengthening transparent and efficient UHC systems for NTD control in resource-constrained settings.

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