Benefit incidence of National Health Insurance Scheme in Enugu State, Southeast Nigeria

Abstract

Background: Nigeria has introduced National Health Insurance Scheme (NHIS) as a financial risk protection option against ill health. This  paper therefore assesses the benefit incidence of the NHIS to the employees of the federal establishments in Enugu, Southeast  Nigeria. It provides empirical evidence necessary for scaling up the scheme.

Methods: The study area was Enugu urban. The beneficiary  survey was undertaken on a random sample of federal employees. A 2-stage  process was used to select beneficiaries. First, employers were selected with probability proportionate to size (number of  employees). Then, a random sample of employees was made for the beneficiary survey. A pre-tested intervieweradministered  questionnaire was used to elicit information on household socioeconomic status, utilization of health services, and expenditures for  health services, including payment of NHIS premium.

Results: All the socioeconomic groups sought health care and benefited through NHIS. The poorest group (Quartile 1) received the  highest gross and net annual benefits for outpatient and inpatient care while the poor (Quartile 3) group received the highest gross  annual benefit for delivery. Concentration index for total net Out of pocket payments (OOPs) on covered individuals showed that the  lower socioeconomic group made more payments for outpatient and inpatient cases than their higher socioeconomic group  counterparts, while the better off socioeconomic group paid more than the lower socioeconomic group counterparts for delivery.

Conclusion: The study showed high benefit incidence for federal enrolees who sought for health care through NHIS. There is therefore  every need to improve on NHIS and possibly scale it up to other formal and informal sectors of the economy.