Political Economy of Eye Care Policy in Nigeria: Analysis of Decision-Making Processes and Stakeholder Power Dynamics

Eye care policy in Nigeria has historically been shaped by fragmented decision-making processes, donor-driven agendas, and opaque stakeholder dynamics that systematically disadvantage the most visually impaired communities. This study analyses the political economy of eye care policy in Nigeria, examining decision-making processes, power dynamics, and interest alignments that determine policy priorities and resource allocation. A qualitative political economy analysis will be conducted over 30 months, employing stakeholder analysis, process tracing, and document analysis as core methods. Data sources will include federal and state eye health policy documents, budget line items for eye care from 2015 to 2024, parliamentary Hansard records, and minutes of Federal Ministry of Health technical working groups. Seventy qualitative interviews will be conducted with ophthalmologists, Ministry of Health officials, legislators, development partners, patient advocacy groups, traditional rulers, and private sector actors across all six geopolitical zones. Stakeholder mapping and influence diagrams will characterise power relationships. The Abraham and Standing political economy framework for health policy will guide analysis. Eye care policy analysis in Africa predominantly focuses on technical and programmatic dimensions, neglecting the political processes that fundamentally shape what policies are adopted, funded, and implemented. This study generates original political science and health policy knowledge with direct relevance to the ophthalmology advocacy agenda in Nigeria. Findings will equip the Nigerian Ophthalmological Society and civil society organisations with evidence for more effective policy influencing. Recommendations will address coalition building, patient advocacy capacity, and parliamentary engagement strategies for sustained eye health investment. Keywords: political economy, eye care policy, health governance, Nigeria, stakeholder analysis