Level and Correlates of Health Insurance Coverage in Nigeria: Evidence from 2013 Nigeria Demographic and Health Survey

Abstract

Background: Health insurance provides a veritable means of achieving Universal Health Coverage (UHC), i.e., the ability of people to gain  access to healthcare they need without experiencing financial hardship as a result. Nigeria has a national health insurance scheme,  but coverage has been reported to be very low for various reasons. Gaps exist in literature as previous studies on health insurance in Nigeria have not assessed the level and predictors of ownership of health insurance using a national survey. Hence, this study  investigates the level and correlates of health insurance coverage in Nigeria. The findings will be of great importance to health  programmers and government and extend the body of knowledge on the determinants of health insurance in Nigeria while also offering  recommendations.

Method: Using data from 2013 Nigeria Demographic and Health Survey (n=54,948), individual (women) and men  recode were merged, and the data were analyzed at three stages of univariate, bivariate, and multivariate using Stata 14. The bivariate  level involved the use of chi-square to determine the association between selected socio-economic and demographic variables and  health insurance. The multivariate level involved the fitting of two binary logistic regression models.

Findings: The findings showed that  health insurance coverage is low in Nigeria as the majority of the respondents reported not having a health insurance, and the factors  that were found to significantly determine ownership of health insurance in Nigeria include; age (OR=1.69; CI: 1.35 – 2.12), level of education (OR = 13.61; CI: 8.15 – 22.70), household wealth index (OR=80.97; CI: 21.31 – 307.65), type of occupation (OR = 1.28; CI: 1.02 –  1.60), ethnicity (OR=1.99; CI: 1.42 – 2.78) and level of exposure to mass media (OR=0.65; CI: 0.48 – 0.87).

Conclusion: The paper concludes  that the level of health insurance coverage in Nigeria is low; which does not augur well for plans of achieving UHC. The national  government as part of recommendations, should consider subsidizing health insurance coverage not just for government workers but  the population at large as it is done at the state levels.