Assessment of The Implementation of National Health Insurance Scheme in The Federal Capital Territory, Abuja.

ABSTRACT

Effective, affordable and inclusive system of health care delivery for the citizens is a requirement for any nation that desires rapid socio-economic development. It is in realization of this that the 1999 constitution of Nigeria (as amended) under the chapter on Fundamental Objectives and Directive Principles of State Policy Section 1� sub-section 3(d) declares that; "the state shall direct its policy towards ensuring that there are adequate medical and health facilities for all persons. "Pursuant to this constitutional provision and coupled with the quest to extend the range of health care delivery the National Health Insurance Scheme (NHIS) was established by Decree 35, of 1999 (now Act 35) and became operational after it was officially launched by the Federal Government in 2005. The objective of the scheme, among others include to ensure effective, affordable and Universal Health Care Coverage (UHC) for all Nigerians. The scheme has existed for over a decade now and enough time to probe into its implementation. The study therefore, was motivated by the desire to interrogate the implementation of NHIS in FCT by identifying critical implementation issues such as health personnel medical equipment’s, drugs and consumable� health infrastructure, funding and hospital bureaucracy and assess their effects on the implementation of NHIS in FCT. The study adopts Andersen health behavioral theory as a framework of analysis. In line with the underlying assumption of the theory· for effective health care utilisation, certain factors from the angle of the individual, organisation and the community must be put in place. The study employed some descriptive and empirical approaches. The descriptive approach util ized documentary sources to generate secondary data. The empirical approach utilized survey research to elicit data from three categories of sampled population - NHIS enrollees, health workers and NHIS staff. At the encl a total of 851 questionnaires went for field survey and 765 were returned. This impressive level of returns provided the basis for analysi� interpretation of findings and generalization. Of the five hypotheses tested using T-test statistical tool of analysi� on the one hand, the null hypotheses were rejected in four and the alternate hypotheses accepted. On the other hand, the null hypothesis was accepted in one and the alternate hypothesis rejected. The finding reveals that identified issues of concern such as shortage of health personnel, inadequate medical equipments, drugs and consumables, poor health infrastructure, paucity of funds and hospital bureaucracy affect the effective implementation of NHIS in FCT to a high extent. The study recommends among others; the appointment of more health personnel training and retraining of personnel provision of branded drugs in health facilities, enhanced funding and reduced hospital procedures in other to bring about timely delivery of services