The weak structure of the health system in Nigeria, its lack of vertical and horizontal integration, slow deployment of evidence-based decisions to impact health outcomes and weak synergy between government and other stakeholders, has led to minimal innovations in health care services. The introduction of community-based health insurance scheme (CHIS) at Obio Cottage Hospital changed the processes of service. The increased number of clients led to opportunities for innovation across the spectrum of health care. This included the ‘Green hospital energy’ initiative which reduced cost of power from an average of $300 - $1500/month to $180 – $500/month, increased facility utilization to an average of 340 patients /day. LEAN process led to a 51% reduction in patient transit time from mean of 3.8hours to 1.7 hours. There was also a 53% improved process efficiency through a cut down in process steps from 72 to 35 and introduction of the aired-oven which reduced specimen processing from 2hours 25mins to 13 minutes. CHIEASY reduced the lengthy registration process including curtailing the manual handling of client records. It provided an electronic and authentication system to track enrolment and financial accountability thus improving quality of care. Remote health through Vsee saved lives and cut cost of 10 patients diagnosed through video and audio report. These innovations brought about general clients' satisfaction and increased demand in health care in the facility.

Healthcare innovations to clients have multiplier effects in the provision of safe, timely, sustainable and quality-assured health care services and can be delivered at minimal costs. This analysis aimed to examine the use of innovative methods in improving efficiency in service delivery in a resource limited setting

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