Enrollees’ awareness and attitudes toward the provision and utilization of NHIS services at a federal healthcare facility in Niger State, Nigeria

Abstract

Background: Awareness and acceptability of health insurance services by enrollees is critical for improved utilization and access to health care in order to achieve desired objectives. Hence, assessing enrollees’ level of awareness and attitude towards the National Health Insurance Scheme (NHIS) services in Nigeria is necessary for understanding their acceptability and extent of utilization to inform policy for improved performance. This study aimed to assess the knowledge, attitude and utilization of the NHIS services by the employees of a Federal healthcare facility in Niger State, North Central Nigeria.
Method: A descriptive cross-sectional survey of 308 employees of the Federal Medical Center (FMC) Bida, who are enrolled in the NHIS as federal staff, was undertaken. A semi-structured questionnaire was developed to collect relevant information on the knowledge and attitudes of the employees towards the scheme, while facility records were reviewed to obtain information on available packages and utilization rates. Data was collected and analyzed using SPSS 23.0.
Results: All the respondents (100%) indicated some level of awareness about the NHIS but less than 50% had adequate knowledge regarding the guiding principles. A greater percentage of (81.5%) revealed positive perceptions towards the scheme. However, this did not reflect in the level of utilization of NHIS services as only 22.8% of the respondents appeared to have utilized the services on a regular basis. Key challenges experienced by respondents while accessing care include out-of-stock syndrome for most medications, lack of quality medications and services, as well as high incidence of out-of-pocket payments.
Conclusion: Findings suggest poor utilization of the NHIS services among enrollees in the facility informed mostly by their inadequate knowledge of the scheme, in addition to challenges encountered in the course of receiving care, such as poor availability of medicines, high OOP payments among others. There is need for enhanced education of the employees regarding NHIS services and improved provision of basic services to enhance efficiency of the scheme.