Utilization and perception of Community Health Insurance Scheme services by enrolees in Obio Cottage Hospital, Port Harcourt, Nigeria.

Abstract

Background: Community Based Health Insurance Scheme is a social service organized at community level. It is a mutual health organization or micro-insurance scheme that targets informal sector and applies the basic principles of risk-sharing and pooling of funds for healthcare. As part of her corporate social responsibility. Shell in collaboration with four communities in Obio-Akpor LGA, Port Harcourt, started a Community Health Insurance Scheme in February 2010. An evaluation of enrollees' utilization and perception of the services provided was done.
Methodology: Quantitative data were collected by the use of structured interviewer questionnaire. Two hundred and fifty enrollees who utilized the health facility before and after the introduction of the scheme were selected and interviewed. Also a two year review of monthly out-patients and ante natal attendance records before and after the Scheme was introduced were done. The quantitative data was analyzed using SPSS version 17 and presented as contingency tables and bar charts for comparisons.
Results: A high proportion (80.9%) of the respondents said they were satisfied with Community Health Insurance services provided at the hospital. Consultations by the doctors had the highest rate (91.7%) of client's satisfaction followed closely by the laboratory services. The staff attitude to patients had the least (76.2%) satisfaction rate. Over 75% of the enrollees felt that the various services being rendered now are better than what they had before the introduction of the scheme. A month after the introduction of the scheme out patients' attendance doubled while ante natal clinic attendance tripled.
Conclusion: Most of the enrollees said that they were satisfied with all the services provided in the Health Insurance Scheme. There was a sharp increase of healthcare utilization with the introduction of Community Health Insurance Scheme. There is the need for the employment of more staff and expansion of existing infra-structure to accommodate increasing patronage. Re-orientation of staff for better attitude to work and patient relationship is advocated.

Keywords: Healthcare, Community Health Insurance, Perception, Utilization.