ABSTRACT
Background: Nigeria’s healthcare system has been characterized by a decline in healthcare service providers due to the inability of governments to adequately fund healthcare services over the years. Thus, this study aims to assess the knowledge and perception among public/civil servants toward the National Health Insurance Scheme (NHIS) in Minna, Niger State, Nigeria. Materials and Methods: The study was conducted using mixed qualitative and quantitative research methods. The study employed a descriptive research design that is also comparative. Data were collected using questionnaires and presented and analyzed using IBM-SPSS version 25.0 for Windows with the help of tables and graphs. Results: Most respondents were aware of the National Health Insurance Scheme (NHIS), but there was an overall unimpressive perception of NHIS funding, cost, and coverage. Age, gender, marital status, education, and grade level were not considerably associated with knowledge of NHIS (P > 0.05), but those spending more than 5000.00 Nigerian Naira (NGN) monthly on medical bills were more aware of NHIS than those paying ?2000 (P < 0.05). The perception of NHIS was not significantly associated with gender, marital status, grade level, education attainment, and monthly expenses on healthcare services (P > 0.05) but was significantly associated with age. Conclusion: The study concluded that there is a high awareness of NHIS among the study respondents, although not all had in-depth knowledge of the operations of the health insurance scheme. More efforts are required to increase awareness of NHIS and its benefits among public/civil servants in Minna, Niger State, Nigeria, to improve participation in the scheme.
ABSTRACT
Background: Although there has been growing awareness on the need for professional assistance at delivery, and this has improved health-seeking behavior and the use of antenatal care (ANC) of pregnant women, presenting for ANC does not directly imply that a woman would use a skilled birth attendant (SBA) at delivery. This study analyzed the trend in the use of SBAs at delivery among Nigerian reproductive women from 2007 to 2017. Materials and Methods: The study used the United Nations Children’s Fund, Multiple Indicator Cluster Surveys data for the years 2007 (n = 1021), 2011 (n = 2927), and 2016/2017 (n = 4155). Multivariate logistic regression was used to determine the relationship between the use of SBAs and demographic characteristics of women aged 15–49 years in Nigeria. Results: There was a significant decline in the utilization of SBAs at delivery from 82.7% in 2007 to 71.8% in 2016/2017 (P < 0.001). There was a decline in the proportion of doctors and nurses/midwives as birth attendants from 28.3% and 54.4% in 2007 to 22.8% and 49.0% in 2016/2017, respectively (P < 0.001), whereas the use of traditional birth attendants increased from 5.2% to 8.0% during the periods (P = 0.003). Urban residence [adjusted odds ratio (AOR)=1.32, 95% confidence interval (CI)=1.18–1.47, P < 0.01], higher maternal age (AOR=1.49, 95% CI=1.30–1.70; P < 0.01), and education attainment (AOR=3.78, 95% CI=3.39–4.22; P < 0.001) were associated with higher odds of the utilization of SBAs. Conclusion: There is a need for intervention programs for women in rural areas and women with a low level of education and lower maternal age. This will further reduce the maternal mortality ratios of the country.
ABSTRACT
Background: Enrollees’ knowledge, behavior, and perception of health insurance substantially influence a decision about the uptake of sustainability of the program. This study assessed enrollees’ knowledge, satisfaction, and barriers to the National Health Insurance Scheme (NHIS) uptake in Benue State, Nigeria. Materials and Methods: The study was a descriptive survey conducted among hospital clients enrolled in the formal sector program of the health insurance scheme in Makurdi, Benue State, Nigeria. A structured questionnaire was used to collect respondents’ demographic information and data related to the knowledge, satisfaction, and barriers to the uptake of NHIS in Nigeria. IBM-SPSS version 25.0 was used to analyze the data. Results: The study comprised 53.2% males, and 46.8% were females. The majority (82.9%) of the enrollees were aware of the objectives of the NHIS, but only 33.4% were aware of their benefits as enrollees and only 56.0% were satisfied with NHIS services. Factors that significantly influenced enrollees’ satisfaction include sex, age, education level, income, and knowledge of enrollees’ entitlements (P < 0.05), but the family size and knowledge of the objectives of the NHIS were not significantly associated with the level of satisfaction (P > 0.05). The most common barriers to the uptake of the NHIS include cultural and religious norms (67.4%) and poor social infrastructures (60.6%). Conclusion: This study revealed that the enrollees had poor knowledge of their entitlements for enrolling in the NHIS and a low level of satisfaction. There is a need for more awareness interventions across Nigeria to sensitize citizens of the scheme’s importance, objectives, and benefits.