CONSTRAINTS TO EFFECTIVE UTILIZATION OF NATIONAL HEALTH INSURANCE SCHEME (NHIS) BY BENEFICIARIES IN ENUGU METROPOLIS

CONSTRAINTS TO EFFECTIVE UTILIZATION OF NATIONAL HEALTH INSURANCE SCHEME (NHIS) BY BENEFICIARIES IN ENUGU METROPOLIS

ABSTRACT

Introduction

The abysmal failure of public healthcare system in Nigeria has attracted comments and criticism from local, national and even international levels. In spite of the current health sector reforms by the government, the public healthcare system in Nigeria is still inefficient in all ramifications. It is therefore argued that the problems facing the health system in Nigeria could be traced to poor implementation of National health Insurance Scheme (NHIS) as well as individual and health-related constraints. The major objective of the study was to assess constraints to the utilization of NHIS by beneficiaries in Enugu Metropolis.

Method

The study population was 1997 from six federal institutions in Enugu metropolis. It comprised of 250 staff from Federal School of Dental Technology , 731 staff from Federal Neuropsychiatric Hospital Enugu, 889 National Orthopaedic Hospital Enugu, 61 staff from Bureau of Statistics Enugu (zonal), 35 staff from National Agency for Food and Drug Administration and Control (NAFDAC) and 31 staff from Federal Ministry of Education (zonal). A sample size of 333 was determined in line with Taro Yamani (1967) formula. Multistage sampling technique was adopted which comprised of simple random sampling, proportionate sampling, and purposeful sampling to select respondents from the stratified population. The data for the study was generated from both primary and secondary sources. The instrument of primary data utilised in this research included questionnaire administered to purposefully selected workers in the six federal establishments in Enugu metropolis used for the study.

Results

The study established some health related and individual factors that constrained beneficiaries of NHIS in Enugu state. The health system factors include inadequate drugs, inadequate health facilities and the poor attitudinal factors from health service provider among others. Individual factors include the inability of the NHIS scheme to cover the beneficiaries health needs, secondly, accessibility to health facilities, poor quality of healthcare delivery rendered.

Conclusion 

The study recommended proper monitoring and sensitization of all the accredited facilities in the country and the setting up of NHIS beneficiaries/stakeholders forum.  

CHAPTER ONE

INTRODUCTION

Background to the Study

The establishment of the National Health Insurance Scheme (NHIS) in Nigeria was targeted to ensure equal access to health care for all Nigerians and as a form of social health insurance since the launching in 2005. Kannegiesser (2009) reports show that its uptake has been very slow. For example about 4% of the total population have been enrolled (public sector workers), and no indication of what percentage of this enrollees have benefited from the scheme. However, experience from low income countries show that individuals are at risk of unexpected ill health and incurring possible large unplanned expenditure from ill health (Mclntyre, 2007; WHO 2008). In addition, the health indicators in Nigeria have been worse when compared to other countries within and beyond Africa. For instance, maternal mortality ratio and child mortality rates have remained very high. These and other factors necessitated the establishment of the NHIS in Nigeria.

National Health Insurance Scheme (NHIS) simply defined, is a social health insurance programme designed by the federal government of Nigeria to complement sources of financing the health sector, and to improve access to health care for the majority of Nigerians (Osuorji, 2006). Report in Nigeria has also indicated that National health insurance has been used by most advanced countries in it various forms to fund health care (Awosika, 2005). This same report indicated that insurance in one form or the other remains a veritable and sustainable tool for financing the hard way, delivery structure and systems of healthcare. However, it is only recently being applied by low income nations to address the glaring problem of inadequate healthcare provision, which was hitherto financed exclusively from public taxation (Awosika, 2005).

CONSTRAINTS TO EFFECTIVE UTILIZATION OF NATIONAL HEALTH INSURANCE SCHEME (NHIS) BY BENEFICIARIES IN ENUGU METROPOLIS