Utilization Of National Health Insurance Scheme(Nhis) Among Healthcare Providers Working At University Of Nigeria Teaching Hospital, Ituku- Ozalla, Enugu

Abstract

The difficulties encountered in out of pocket financing of healthcare have compelled the

introduction of pre paid health insurance in many countries, including Nigeria. This is borne

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out of a universal and equitable healthcare cover as a fundamental human right. This

initiative works on pooling of resources. This study assessed the utilization of National

Health Insurance Scheme among healthcare providers working at University of Nigeria

Teaching Hospital, Ituku-Ozalla. Descriptive survey design quantitative was used. Five

objectives were set,viz: to determine the number of healthcare providers registered, determine

the number that are card holders, assess access to benefit packages, determine the number of

the respondent’ dependents registered and are assessing the benefits and identify the

challenges encountered by the beneficiaries. A population of 311 who met the inclusion

criteria were selected using power analysis. A self structured questionnaire was used for data

collection. A pilot study was carried out with a reliability index of 0.83 after face and content

validation..frequencies, percentages and chi-square were used for descriptive and inferential

statistics for data analysis. Findings revealed that 50.3% of the respondents have partial

knowledge of the principles of the scheme, did not know the percentage they contribute and

that of the employers. It was also observed that majority of the respondents (83.6%) were

registered with the scheme, but the number of the registered dependents did not tally based on

the marital status of the respondents (70% as against 55.9%). This showed that the

respondents do not have confidence in the scheme. Furthermore, some of the respondents

were not registered, where registration is supposed to be mandatory and their money is

collected at source. Some of the registered beneficiaries do not have identity cards with

which to access healthcare. The waiting period for the cards was quite lengthy as 34.0%

indicated one year and above, while 5.5% indicated that they obtained their cards within the

normal 30 to 60days. The respondents were not accessing healthcare services as and when

due. There were a lot of challenges identified like delay or denial of healthcare services,

provision of low quality drugs, non accessibility of Health Maintenance Organization

(HMOs), especially out of pocket expenditures. In conclusion, the mandatory registration is

not enforced. In recommendation, there is a need for multiplication of Health Maintenance

Organizations for primary healthcare providers, in order to give the beneficiaries the room to

make informed choices, also seminars and workshops should be organized to update the

employees on the principles guiding the utilization of the scheme.