Acceptability of the National Health Insurance scheme and preferred benefit package among civil servants in Rivers State, Nigeria
Health-care insurance is one of the financial risk protection tools available to clients in the health-care industry. In most developing countries, citizens are in favor of paying for their health-care expenses out of pocket, a payment mode that potentially tips these people into poverty. This study aims to determine the level of acceptance of and the preferred benefit package available in the National Health Insurance Scheme (NHIS) among civil servants in Rivers State, Nigeria. In this descriptive cross-sectional study, respondents were selected through simple random sampling. The collected data were cleaned and analyzed with Statistical Product and Service Solution version 23. Out of the 351 respondents, male subjects accounted for the big majority of the sample (n = 208; 59.3%); only 30 (8.5%) had any form of health insurance; and about two-thirds of the respondents, at around 223 (63.5%), expressed acceptance of using NHIS as a strategy for payment. The most preferred benefits package was the one that covers all services 178 (50.7%). The poor and the poorest showed a preference for the health-care benefits package that covers all expenses, whereas the rich showed a preference for services covering basic diseases. The overall acceptability of the NHIS was statistically associated with socio-economic status (p ≤ 0.05). Thus, the opinions of the consumers and their health needs must be taken into consideration when planning a health insurance benefits package.
Adebiyi, O., & Adeniji, F.O. (2021). Factors affecting utilization of the national health insurance scheme by federal civil servants in rivers state, Nigeria. Inquiry, 58. https://doi.org/10.1177/00469580211017626
Agba MS. (2010). Perceived impact of The National Health Insurance (NHIS) among Registered Staff in Federal Polytechnic, Idah, Kogi State Nigeria. Studies in Sociology of Science. 1:44-49
Ahmed, A.A., & Aliyu, A. (2019). Acceptance and satisfaction of national health insurance scheme services among civil servants in Sokoto metropolis, Sokoto State-Nigeria. Texila International Journal of Public Health, 7(4):26. https://doi.org/10.21522/TIJPH.2013.07.04.Art026
Amu, H., Dickson, K.S., Kumi-Kyereme, A., & Maafo Darteh, E.K. (2018). Understanding variations in health insurance coverage in Ghana, Kenya, Nigeria, and Tanzania: Evidence from demographic and health surveys. PLoS One, 13(8):e0201833. https://doi.org/10.1371/journal.pone.0201833
Anderson, I.E., & Adeniji, F.O. (2019). Urban self-employed social health insurance program as an option in financing healthcare within the informal sector? An insight into the acceptability of the scheme by the self-employed in rivers State, Nigeria. Asian Journal of Advanced Research and Reports, 7:1-9. https://doi.org/10.9734/ajarr/2019/v7i330180
Aregbeshola, B.S. (2018). A tax-based, noncontributory, health-financing system can accelerate progress toward universal health coverage in Nigeria. MEDICC Review, 20(4):40-45. https://doi.org/10.37757/mr2018.v20.n4.9
Claeson, M., Griffin, C.C., Johnston, T.A., McLachlan, M., Soucat, A.L., Wagstaff, A. (2001). Poverty Reduction and the Health Sector - the Health, Nutrition, and Population Network’s Chapter in the World Bank’s Poverty Reduction Strategy Sourcebook. World Bank. Available from: https://documents1. worldbank.org/curated/en/936521468147314026/pdf/ multi0page.pdf [Last accessed on 2023 Dec 07].
Eboh, A., Akpata, G.O., & Akintoye, A.E. (2016). Healthcare financing in Nigeria: An assessment of the national health insurance scheme (NHIS). European Journal of Business and Management, 8:24-34.
Erinoso, O., Oyapero, A., Familoye, O., Omosun, A., Adeniran, A., & Kuyinu, Y. (2023). Predictors of health insurance uptake among residents of Lagos, Nigeria. Population Medicine, 5:19. https://doi.org/10.18332/popmed/169666
Jerkel, J.F., Katz. D.L., Elmore, J.G., & Wild, D.M. (2007). Epidemiology, Biostatistics and Preventive Medicine. USA: Saunders Elsevier.
Latunji, O.O., & Akinyemi, O.O. (2018). Factors influencing health-seeking behaviour among civil servants in Ibadan, Nigeria. Annals of Ibadan Postgraduate Medicine, 16(1):52.
Marvel, E.O. (2018). An appraisal of clients’ utilization of national health insurance scheme (NHIS) services at the Kubwa General Hospital. International Letters of Social and Humanistic Sciences, 84:35-46.
Mulupi, S., Kirigia, D., & Chuma, J. (2013). Community perceptions of health insurance and their preferred design features: Implications for the design of universal health coverage reforms in Kenya. BMC Health Services Research, 13(1):474.
NHIS. (2020). National Health Insurance Scheme Operational Guidelines Reprint-2020. Abuja, Nigeria: NHIS.
Nigeria: Administrative Division (States and Local Government Areas) - Population Statistics, Charts and Map. (2024). Available from: https://www.citypopulation.de/en/nigeria/ admin [Last accessed on 2024 Apr 11].
Okpani, A., & Abimbola, S. (2015). Operationalizing universal health coverage in Nigeria through social health insurance. Nigerian Medical Journal, 56(5):305. https://doi.org/10.4103/0300-1652.170382
Omole, G.D., Olokoba, L.B., Tairu, S.K., Ojeniran, T.P., Ayinde, O.V., Afolabi, A.A., et al. (2023). Acceptance of health insurance scheme among civil servants in ilorin West Local Government Area, Kwara State, Nigeria. The Nigerian Health Journal, 23(4):943-951.
Onwujekwe, O., Onoka, C., Uguru, N., Nnenna, T., Uzochukwu, B., Eze, S., et al. (2010). Preferences for benefit packages for community-based health insurance: An exploratory study in Nigeria. BMC Health Services Research, 10:162. https://doi.org/10.1186/1472-6963-10-162
Rivers State Ministry of Health. (2010). State Strategic Health Development Plan 2010-2015. Rivers, Nigeria: Rivers State Ministry of Health.
Shobiye, H.O., Dada, I., Ndili, N., Zamba, E., Feeley, F., & de Wit, T.R. (2021). Determinants and perception of health insurance participation among healthcare providers in Nigeria: A mixed-methods study. PLoS One, 16(8):e0255206. https://doi.org/10.1371/journal.pone.0255206
The Federal Government of Nigeria. (2022). The National Health Insurance Authority Act. Federal Republic of Nigeria Official Gazette. Abuja, Nigeria: The Federal Government of Nigeria.
The Federal Republic of Nigeria. (2019). Nigeria Demographic and Health Survey 2018 National Population Commission Abuja, Nigeria. Available from: https://www.dhsprogram. com [Last accessed on 2023 Dec 07].
Uriah, O.A., Ololube, N.P., & Egbezor, D.E. (2015). Academic background, socio-economic status and gender socio-economic stayouth restiveness and educational development in rivers State. International Journal of Applied Sociology, 5(1):16-30. https://doi.org/10.5923/j.ijas.20150501.03
Uzochukwu, B.S.C., Ughasoro, M.D., Etiaba, E., Okwuosa, C., Envuladu, E., & Onwujekwe, O.E. (2015). Healthcare financing in Nigeria: Implications for achieving universal health coverage. Nigerian Journal of Clinical Practice, 18(4):437-444. https://doi.org/10.4103/1119-3077.154196
Wikipedia. (2020). Available from: https://en.wikipedia.org/wiki/ rivers_state_civil_servant [Last accessed on 2020 Apr 01].