Enrollees’ satisfaction with health service provision under the formal sector Social Health Insurance Scheme in South Eastern Nigeria

Abstract

Introduction : Healthcare financing is a critical global issue, particularly in low and middle-income countries (LMICs) grappling with underfunded health systems. Various financing approaches, such as fee-for-service, private insurance, general taxation, social insurance, community financing, loans, and grants, have been explored to bridge the funding gap. Health insurance, a mechanism involving resource pooling and risk sharing, plays a pivotal role in achieving Universal Health Coverage (UHC) and delivering quality healthcare. This study aimed to assess enrollees' satisfaction with the Formal Sector Social Health Insurance Scheme (FSSHIS) at the University of Nigeria Teaching Hospital (UNTH), with a focus on the registration process, waiting time, drug availability, and willingness to continue using the scheme.

Methods : A descriptive cross-sectional study was conducted at UNTH, Enugu, involving 470 enrollees. Data were collected using a pretested Patient Satisfaction Survey Questionnaire and analyzed using descriptive statistics. Enrollees' satisfaction was assessed on a 5-point Likert scale, a score of ≥ 3 signified enrollees’ satisfaction.

Results : Respondents were satisfied with the processes of registration (4.10±0.95), getting an identity card (3.50±0.72) and interest shown by the providers (3.80±0.83). They were dissatisfied with the referral process (2.7±0.41), level of their involvement in decision making (2.8±0.44), long waiting time (2.5±0.45), non-availability of drugs (1.8±0.24) and diagnostic facilities (1.5±0.22). The overall satisfaction was poor (43%) while 59% would not recommend a health insurance scheme in the facility for family or friends.

Conclusions : Enrollees' dissatisfaction with the FSSHIS suggests a need for immediate intervention and improvement in healthcare service delivery. Addressing these concerns can foster increased utilization of health services and contribute to the scheme's success in achieving its objectives.