Abstract
This thesis investigates the ethical issues and design logic of AI-integrated health insurance
platforms in Nigeria, in attempting to align such innovations with the principles
of Universal Health Coverage (UHC). Its focus is on AI and mobile technology’s
role in increasing access and reducing costs, especially for underserved populations.
This research is based on grounded theory and uses data from semi-structured interviews,
in-depth interviews, and focus group discussions with some stakeholders,
technology specialists, and marginalised users. In addition, this study uses walkthrough
methods and secondary data from technology organisations’ websites to analyse the
ethical and value-laden aspects of AI platform designs. Thematic analysis was used to
interpret the multiple collected datasets through an ethical and policy context.
The findings unfolded into two parts. On one hand, AI is broadly acknowledged as a
tool for improving efficiency, diagnosis, and healthcare access, but on the other hand,
ethical issues exist, such as data privacy violations, algorithmic bias, regulatory shortcomings,
and socio-economic exclusion. Users reported a lack of trust in AI health systems,
complaining of discriminatory pricing, inadequate service provisions, and underinsurance.
Developers admitted ethical neglect concerning system constructs, while
policymakers pointed out prevailing fragmented institutional structures and inertia in
regulatory enforcement.
Responding to these concerns, the study advocates the establishment of a national
Nigerian ethical policy for AI in health insurance, tailored to the socio-cultural and
economic realities of Nigeria, which focuses on transparency, fairness, and inclusivity.
Enhancing the Data Protection Act and creating strong, accountable institutions
is critical. AI system designers must adopt user-responsive and participatory design
methodologies centered on the realities of the diverse Nigerian population. Moreover,
collaborative action with civil society, healthcare professionals, and technologists is
essential for integrating ethical perspectives. Stakeholders must be sensitized on the
implementation of ethical AI in public health systems as part of the capacity-building
initiatives. Such measures would improve the positive use of technology in the health
systems in Nigeria, protecting its people’s rights and integrity.
platforms in Nigeria, in attempting to align such innovations with the principles
of Universal Health Coverage (UHC). Its focus is on AI and mobile technology’s
role in increasing access and reducing costs, especially for underserved populations.
This research is based on grounded theory and uses data from semi-structured interviews,
in-depth interviews, and focus group discussions with some stakeholders,
technology specialists, and marginalised users. In addition, this study uses walkthrough
methods and secondary data from technology organisations’ websites to analyse the
ethical and value-laden aspects of AI platform designs. Thematic analysis was used to
interpret the multiple collected datasets through an ethical and policy context.
The findings unfolded into two parts. On one hand, AI is broadly acknowledged as a
tool for improving efficiency, diagnosis, and healthcare access, but on the other hand,
ethical issues exist, such as data privacy violations, algorithmic bias, regulatory shortcomings,
and socio-economic exclusion. Users reported a lack of trust in AI health systems,
complaining of discriminatory pricing, inadequate service provisions, and underinsurance.
Developers admitted ethical neglect concerning system constructs, while
policymakers pointed out prevailing fragmented institutional structures and inertia in
regulatory enforcement.
Responding to these concerns, the study advocates the establishment of a national
Nigerian ethical policy for AI in health insurance, tailored to the socio-cultural and
economic realities of Nigeria, which focuses on transparency, fairness, and inclusivity.
Enhancing the Data Protection Act and creating strong, accountable institutions
is critical. AI system designers must adopt user-responsive and participatory design
methodologies centered on the realities of the diverse Nigerian population. Moreover,
collaborative action with civil society, healthcare professionals, and technologists is
essential for integrating ethical perspectives. Stakeholders must be sensitized on the
implementation of ethical AI in public health systems as part of the capacity-building
initiatives. Such measures would improve the positive use of technology in the health
systems in Nigeria, protecting its people’s rights and integrity.
| Original language | English |
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| Awarding Institution |
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| Supervisors/Advisors |
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| Award date | 12 Mar 2026 |
| Place of Publication | Rotterdam |
| Publication status | Published - 12 Mar 2026 |
