Satisfaction of stakeholders with the implementation of the tertiary institutions social health insurance programme in Jos: a qualitative study

Abstract

Background:The tertiary Institutions Social Health Insurance programme was developed to provide access to quality health care services to students in institutions of higher learning in Nigeria but several authors have reported underutilization by students. The purpose of the study was to determine how the programme is implemented in tertiary institutions in Jos.
Methodology: A two-stage sampling technique was used to select respondents for the study. Data was collected using key informant interviews and focus group discussions with important stakeholders of the programme. The recorded interviews were transcribed and analysed using NVivo 12.
Results: Enrolment fees is compulsorily collected from students but most of them are not aware of the other steps they need to take to access services under the scheme. An initial medical examination is performed as part of the enrolment process in some schools but not in others. The school management collect premium on behalf of the health maintenance organizations but often delay remittance, in some cases, up to two consecutive sessions. There is also the strong belief among school clinic heads that the proportion of premium meant for provision of primary care services in often misappropriated. The Tertiary institution social health insurance programme management committees are non-functional in all the schools studied. Quality of primary care services provided by the school clinic is sub-optimal because of frequent drug stock out and lack of equipment and supplies. Most respondents were not satisfied with the implementation of the programme in their school.
Conclusion: Key stakeholders are dissatisfied with the implementation of TISHIP. The NHIA needs to supervise the implementation of the programme to ensure that the good intentions of the programme are not jeopardized.