National Health Insurance Scheme: Perception and participation of Federal Civil Servants in Ibadan

Abstract

Introduction: The National Health Insurance Scheme is a social health insurance programme designed by the Federal Government of Nigeria to complementsources of financing the health sector and to improve access to health care forthe majority of Nigerians. Presently, the enrolment level on the Scheme is majorly among those in the formal sector and user experiences have been different. This study seeks to determine the perception and participation of Civil Servants regarding the National Health Insurance Scheme in Ibadan

Methods: A descriptive cross-sectional study was conducted among 273 civil servants working at the Federal Secretariat, Ikolaba, between October and November 2015. An interviewer-administered questionnaire was used to collect information on socio-demographic characteristics, awareness, and  membership of the NHIS, perception of NHIS, and health-seeking behaviour. Participation was defined as  the number of civil servants registered or enrolled under the scheme, in other words, members of the  scheme. Information on perceptions was sought using a 3-point Likert scale. Descriptive statistics and  chi-square tests were used for data analysis at a 5% level of significance.

Results: About 60.1% of the respondents were males. The average age was 39.7+9.1 years, with 85.0% of  the respondents being married. The majority (65.2%) of the respondents were mid-level cadre workers,  17.62% were working as senior-level workers and the remaining 17.6% were low cadre workers. The  majority (88.9%) completed tertiary education, while just 11.1% completed basic education. The mean  household size was 2.5+0.6. Awareness of the National Health Insurance Scheme was very high (95.2%)  with 83.5% enrolled under the scheme. About (50%) of the respondents joined the scheme because it is  cheap and affordable. There was a significant association between awareness, level of education,  knowledge of NHIS, and registration into the scheme by respondents. The majority of the respondents  (87.3%) claimed that NHIS is a better means of settling healthcare costs than Out-of-pocket-payment. The  majority of the respondents thought that health insurance is a viable programme.

Conclusion:The perception of health insurance among civil servants was varied while participation was  high. Relevant intervention should be introduced to remove bottlenecks to accessing and operating the scheme.