Health insurance: Principles, models and the Nigerian National Health Insurance Scheme

Onwujekwe, Obinna; Uzochukwu, Bsc; Ezeoke, OP; Np, Uguru

doi:10.4314/jcm.v16i1.8

Cited by 10 publications

(18 citation statements)

References 0 publications

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“…In our study, most of the respondents among the healthcare workers 93% are willing to participate in NHIS. This is similar to the study done in Ghana on willingness to participate and pay for the health insurance where over 90% of the respondents agreed to participate in the scheme [41], but it is different from the study conducted in Ilorin where only 66.1% are willing to participate [35]. The difference might be due to the fact the actual implementation has commenced and now more health workers are willing to participate in the scheme because of adequate attention on the scheme presently by the government.…”

Section: Discussionsupporting

confidence: 78%

“…This difference in level of awareness could be as a result of the fact that our study was done about two years after the NHIS started in Nigeria. The studies done in Ilorin and in South-East, Nigeria on awareness and attitude of medical practitioners towards NHIS revealed 100% awareness of the scheme [35] [36]. The difference with this study might be because all the categories of health workers were participants in our study unlike the studies in Ilorin and South-East that involved only medical doctors and radiographers respectively.…”

Section: Discussioncontrasting

confidence: 57%

“…The difference with this study might be because all the categories of health workers were participants in our study unlike the studies in Ilorin and South-East that involved only medical doctors and radiographers respectively. Also, in this study, most respondents major sources of information among the heads of households are Radio and Television, but in the study done among medical practitioners, their major source of information are newspapers, while seminars in the hospitals were noted to be major source of information among radiographers [35] [36]. This could be due to differences in the literacy level.…”

Section: Discussionmentioning

confidence: 82%

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Household Perceptions, Willingness to Pay, Benefit Package Preferences, Health System Readiness for National Health Insurance Scheme in Southern Nigeria

Omotowo¹,

Ezeoke²,

Ikechukwu³

et al. 2016

Health

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Introduction: Several Nigerians are completely denied access to adequate health care because of cultural, temporal and financial factors with inequity. Objectives: To ascertain the household perceptions, willingness to pay, benefit package preferences, and health systems readiness for Insurance Scheme. Methods: A cross-sectional study of 400 heads of households and 43 health workers in Enugu, Southern Nigeria. Results: Awareness of NHIS among the heads of household was 56.8%, while it was 86% among the health workers. Awareness of NHIS among heads of households was significantly associated to both educational level (X 2 = 16.083, P = 0.001), and occupation (X 2 = 5.694, P = 0.017). More males (61.6%) had correct perceptions of NHIS compared to females (58.6%), but not statistically significant (X 2 = 0.336, P = 0.562). Majority of households respondents 89% are willing to pay for NHIS. Willingness to pay was significantly associated to occupation (X 2 = 5.169, df = 1, P = 0.023), but willingness to pay mandatory 5% premium was not significantly associated to occupation (X 2 = 0.884, P = 347). Only 11.6% of the health facilities are enlisted as providers in the scheme. Conclusion: Willingness to pay was high, but majority are not ready to pay 5% premium of their earnings. Awareness creation programmes should be improved for the public, and more health facilities enlisted for wider coverage.

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Section: Discussionsupporting

confidence: 78%

Section: Discussioncontrasting

confidence: 57%

Section: Discussionmentioning

confidence: 82%

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Household Perceptions, Willingness to Pay, Benefit Package Preferences, Health System Readiness for National Health Insurance Scheme in Southern Nigeria

Omotowo¹,

Ezeoke²,

Ikechukwu³

et al. 2016

Health

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“…However, the insured enrollees that seek healthcare services in the programme tend to indulge in risky behaviors which ordinarily they would not undertake if they were paying for the healthcare services themselves. This situation has led to enrollees utilizing healthcare services more than required and the cost of healthcare services transferred to the health insurance companies (Onwujekwe, Uzochukwu, Ezeoke & Uguru, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…Another situation regarding enrollee moral hazard is the non-disclosure of all the relevant preexisting conditions by the enrollee to the provider (Stavropoulou, 2012;Onwujekwe et al, 2011) especially when the enrollee feels that these may bias the health insurance services they will receive from the provider.…”

Section: Introductionmentioning

confidence: 99%

Strategies to Improve Demand for Services in the Social Health Insurance Programme: Nigerian Enrollee Perspective

Ikechukwu

Okoronkwo²,

Nwonwu³

et al. 2020

IJSSR

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Globally, the World Health Organization has championed the introduction of various forms of health insurance as a means of improving the utilization of quality healthcare service which is targeted at achieving universal health coverage. Unfortunately, the operations of the Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the demand for healthcare services as a result of moral hazard and this is evidenced by the non-achievement of set-out objective of the programme in Nigeria. Design/Methodology: The study adopted a qualitative approach which comprised of 3 focus group discussions (N=24). Key informants were purposely selected for the focus group discussion from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The focus group participants relayed their experiences in the programme which includes poor identification system, choice of only one provider except on emergency, benefit package not being comprehensive which has enabled moral hazard and suggested ways to improve it. Conclusions: Most of the enrollees do not show diligence in areas of demand for services and these were shown to emanate principally from economic issues around the enrollees desire to utilize the premium paid thereby leading to moral abuse. Therefore, certain measures need to be put in place so as to curtail observed market failures in the SHIP programme.

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Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective

Vincent¹,

Lewechi²,

Ashumate³

et al. 2019

JPPA

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Introduction: The Nigerian government has introduced various forms of health insurance programme as a means of supplying quality healthcare services to its citizens all in attempt to attain the universal health coverage. Unfortunately, these various forms of Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the supply of healthcare services and this is evidenced by observed adverse selection and supplier induced demands which are major causes of market failure in health insurance industry. Therefore, there is a need to deduce unique strategies to improve supply of health insurance so as to reduce the barest minimum the incidence of market failure which has impacted negatively on the health insurance industry. Methods: The study adopted qualitative approach by using in-depth interviews (IDIs) method. Nine (9) key informants were purposely sampled from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The interviewees relayed their experiences in the programme which includes provider non-adherence to accreditation pattern, poor reimbursement and tariff structure, fluctuations in prices of input, inadequate funding of the programme and low number of enrollees registered in private facilities and consequently proffered strategies on how to eliminate adverse selection and supplier induced demand with a resultant improvement in supply of health insurance services. Conclusions: Evidence from this qualitative study have shown various strategies if implemented will reduce the incidence of adverse selection and supplier induced demand which are mostly implicated as common causes of market failures.

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Health insurance: Principles, models and the Nigerian National Health Insurance Scheme

Cited by 10 publications

References 0 publications

Household Perceptions, Willingness to Pay, Benefit Package Preferences, Health System Readiness for National Health Insurance Scheme in Southern Nigeria

Household Perceptions, Willingness to Pay, Benefit Package Preferences, Health System Readiness for National Health Insurance Scheme in Southern Nigeria

Strategies to Improve Demand for Services in the Social Health Insurance Programme: Nigerian Enrollee Perspective

Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective

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