ABSTRACT
This chapter examines the opportunities and challenges faced by healthcare and eldercare cooperatives in providing access to quality and affordable care in Nigeria and Ontario, Canada. The authors were motivated by the glaring gap between what care is offered in theory and the actual access to those services in practice. The market-based approach to healthcare provision is constrained by excludability and an individual’s inability to pay for the services. Shareholders’ primacy issues within for-profit firms offering care services do not allow for aspirational approaches to social development that include quality care. The aspirational nature of cooperatives makes healthcare a suitable space for cooperatives to address the needs of about two-thirds of the world’s poor who are at the bottom of the pyramid
BoP. Those at the BoP are mostly found in Africa, Asia, and South America, but the poor in Ontario are also excluded from care due to the inability to pay for services. Following a literature survey approach, we found that eldercare cooperatives are better positioned in Canada than in Nigeria to address the care service gap.
In Ontario, Canada, eldercare cooperatives have access to some public funding, while in Nigeria, membership contribution is the main source of funding. In addition to funding constraints, healthcare cooperatives face the challenge of lack of regulatory and policy support in Nigeria, unlike in Ontario, Canada, where policy on eldercare cooperatives is developed and implemented. Interestingly, healthcare cooperatives in both countries face similar operational challenges of marketization, resulting in limited bed space available to seniors in need of care. Despite these challenges, healthcare cooperatives are seen as sustainable partners in promoting global health through healthcare insurance, community-based eldercare supported by public funding, and increased education and awareness of the cooperative movement in healthcare. For Nigeria and other developing countries, the authors recommend policy advocacy for a 5% firm-level profit commitment towards healthcare cooperative funding, investment in health-related technology for seamless care services provision and reception, community-based cooperative through age-grade systems and democratization of the governance structure of existing cooperatives to encourage innovation and best practices in healthcare. In Canada, minimizing bureaucratic hurdles allowing greater access to government funding for eldercare would provide seniors access to much-needed care. Development of a community-based cooperative eldercare system would decrease the need for provincial-level oversight and speed access to care services.
