Trends and correlates of patient satisfaction with services under the National Health Insurance Scheme of Nigeria: A review

Background: In spite of over a decade of operations, the National Health Insurance Scheme (NHIS) of Nigeria has continuously been criticized for its quality of services. Healthcare consumer satisfaction surveys (an important measure of service quality worldwide) in this domain have presented differing accounts of satisfaction with the services of the NHIS from their vantage perspectives. This narrative review aimed at studying the preliminary trends in the utilization of and patient satisfaction with the NHIS services. The correlates of patient satisfaction were also studied. Materials and Methods: We searched local literature whose full texts were accessible using predominantly Google Scholar. Results: We found progressive improvement in scheme enrolment, service utilization, and above-average overall satisfaction scores (i.e., >50% of respondents were satisfied) from most studies. Overall satisfaction scores/ratings were associated patients' level of education, knowledge of the scheme, years of enrolment, facility cleanliness, consultation time, pharmaceutical services, ease in accessing medical records and laboratory results, health worker availability, health worker friendliness, and responsiveness to patients' requests. Conclusion: The observed trajectory in service utilization, satisfaction scores, and their correlates may be useful for strategic planning to improve NHIS services in the country toward universal health coverage

Assessment of level of satisfaction of national health insurance scheme enrolees with services of an accredited health facility in Northern Nigerian

Introduction: Consumer satisfaction is one of the driving goals of goods and service production. Patient satisfaction surveys, as a means of periodic evaluation of the quality of services offered by the National Health Insurance Scheme (NHIS) accredited facilities, is necessary to ensure that the goals of the scheme are achieved and sustained. Materials and Methods: This was a cross-sectional study of 202 respondents randomly selected from NHIS enrolees attending the Staff Clinic of Aminu Kano Teaching Hospital. It assessed respondents' perceived waiting time, level of satisfaction at the clinic's service units, and overall clinic satisfaction using a modified general practice assessment questionnaire. Results: The mean age of respondents was 36.4 ± 8.1 with a near equal sex ratio. They were predominantly civil servants (79.2%) with tertiary education (75.7%). Most respondents (70.3%) felt waiting time was too long; with 79.7% of those, feeling they spend at least 30 min after arrival at the registration unit to see their doctor. A majority of respondents: 90.1%, 86.8%, 79%, 76.8%, 75.9%, 77.5%, and 80.6% were satisfied with the consultation time, doctors' consultation, medical records, pharmacy, laboratory, accounts, and nursing services, respectively. However, 65.8% were satisfied with the overall clinic services. The perceived sufficiency of the consultation time was associated with overall satisfaction (χ2 = 6.199, P = 0.013). Conclusion: Although 65.8% of respondents were satisfied with the clinic services, the perceived clinic waiting time was dissatisfactory; therefore, further studies on the determinants of overall satisfaction may be required if improvement in the proportion of satisfied service consumers is desired by the clinic managers

The Effect of Co-infection of HIV and Hepatotropic Viruses on Selected Biochemical and Haematological Markers of Patients in Northeastern Nigeria.

Background: As deaths caused by HIV declines with the use of HAART, liver disease associated with co-infection of HIV with hepatotropic viruses has become an increasing cause of morbidity and mortality. Aim: To assess the effect of HIV-mono and co-infections with hepatotropic viruses on haematological and biochemical markers of the patients. Methodology: 109 HIV patients from tertiary health facilities in northeastern Nigeria were initially screened with Immuno chromatographic kit for HIV antibody and confirmed by western blot prospectively and consecutively. However, Hepatitis B virus surface antigen (HBsAg) and Hepatitis C virus (HCV) antibody were detected on the HIV positive patients by ELISA. Blood donors served as control. The study was conducted between January and October 2012. Results: Of the HIV patients 12.8% and 4.6% had HBsAg and HCV antibody respectively. The prevalence rate of Hepatitis B virus (HBV) infection among males was 12.8% while females had 12.9% but lower rates of HCV were obtained in both males (5.1%) and females (3.3%). However, HIV mono-infections had higher mean baseline values for haemogblobin (Hb), CD4 and platelet counts, protein C (PC) and protein S (PS) in comparison with HIV/ HBV/HCV co-infections (P<0.05). In addition, Prothrombin time and partial thromboplastin time were lower in HIV mono- infection in contrast to co-infections (P<0.05). Similarly, the mean values of Serum liver enzymes such as Aspartate transaminase (AST), Alanine transaminase (ALT), Akaline Phosphatase (ALP) and creatinine were lower in HIV mono-infection compared with HIV/HBV or HIV/HCV co-infection (P<0.05). Total white blood cell count (WBC), total cholesterol (TCH), Random blood sugar (RBS) and potassium (K+) were not significantly different (P>0.05) in both groups. Conclusion: Co-infections of HIV and hepatotropic viruses do occur. Haematological and biochemical parameters serve as pointers for early detection of liver disease in HIV patients. The development of novel therapeutic approaches to impede co-infection of HIV and hepatotropic viruses is encouraged.