Perceived Utilization of National Health Insurance among Staff of University of Nigeria Teaching Hospital (UNTH), Ituku – Ozalla, Enugu, Southeast Nigeria

Abstract

Background: Daunting pressure of delivering needed healthcare with limited financial resources, in the face of increasing costs and poor health indices, led the Nigerian government to establish the National Health Insurance Scheme (NHIS). Notwithstanding, public sector participants who fall under the scheme’s Formal Sector Social Health Insurance Programme (FSSHIP), continue to have misconceptions about the programme.

Objective: This study assessed client’s knowledge, pattern of utilization, patient’s satisfaction with the services and perceived barriers to implementation, of the NHIS among staff of a tertiary health institution in South-East Nigeria.

Methods: A cross sectional quantitative design was adopted. Three hundred and eighty (380) enrollees insured for more than one year were recruited using a two stage sampling method. Data collection was by means of a validated questionnaire. Data analysis was achieved with Statistical Programme for Social Sciences version (SPSS) 16 using descriptive statistics and logistic regression.

Results: While the rate of monthly utilization is high (35%), majority of the respondents (77.4%) were dissatisfied with the services provided under the scheme. The rate of utilization is influenced by sex (p < 0.05) and salary/income level (p < 0.05). Client’s knowledge of various aspects of the health insurance scheme and its operations was low. Educational status (p < .05) positively influenced client’s satisfaction. The barriers to implementation were diverse and
included difficulties in obtaining referral code and medicines out-of-stock syndrome.

Conclusion: It is essential to eliminate observed and perceived, bottlenecks impeding effectiveness and efficiency of the programme. Hence, there is need for periodic review of the scheme by government to accommodate legitimate concerns of the consumer.