Modeling Healthcare 4.0 Pathways to Effective and Efficient Universal Health Coverage for Neglected Tropical Diseases in Nigeria
Abstract:
Healthcare 4.0 technologies are increasingly recognized for their potential to strengthen Universal Health Coverage (UHC), yet the mechanisms through which they influence UHC performance for Neglected Tropical Diseases (NTDs) in resource-constrained settings remain insufficiently modeled. This study develops and empirically tests a socio-technical framework linking Healthcare 4.0 enablers, contextual conditions, and two key UHC performance dimensions, effectiveness and efficiency, in Nigeria. Primary data were collected from 314 experts across NTD, UHC, and digital health domains. A sequential analytical approach was implemented, including Principal Components Analysis, Confirmatory Factor Analysis, and Structural Equation Modeling. The final model demonstrated strong fit (RMSEA = 0.028; SRMR = 0.043; CFI = 0.99; NNFI = 0.99; χ²/df = 1.24), with all structural paths statistically significant (p < 0.001). Two distinct but complementary pathways were identified. Technologies that enable continuous data exchange, ongoing monitoring, and enhanced clinical care, such as cloud computing and the Internet of Things, show stronger associations with effectiveness. In contrast, governance-oriented and computational infrastructures, including blockchain systems and big data analytics, are more closely linked to efficiency. The strength of these relationships varies depending on institutional readiness and broader system alignment. Collectively, the findings position Healthcare 4.0 as an integrated system driver whose effects are pathway-specific and context-dependent. The study provides an empirically grounded basis for designing coordinated digital health strategies aimed at strengthening UHC for NTDs in resource-constrained settings.References:
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