Perception of Factors Influencing Primary Health-Care Facility Choice Among National Health Insurance Enrollees of a Northwest Nigerian Hospital

Abstract

Background: The National Health Insurance Scheme (NHIS) of Nigeria was designed to eliminate known cultural, physical, and resource-related barriers to quality health-care access. Although choice of primary health-care facility (PHF) remains in the domain of the scheme enrollees, little is known about factors influencing their choice. Hence, the study of the perception of factors influencing PHF choice among NHIS enrollees of a northwest Nigerian hospital becomes imperative. Methods: This was a cross-sectional study of 284 principal enrollees randomly selected from patients attending the NHIS clinic of Aminu Kano Teaching Hospital, Kano, Nigeria, using a designed, pretested, investigator-administered questionnaire. Their sociodemographics and factors influencing their choice of the clinic were assessed. Results: Respondents’ mean age was 40.9 ± 9.0 years and they were predominantly males (83.1%) with tertiary education. Median distance between their homes and PHF was 7.6 ± 12.5 km. Most respondents were aware of other accredited PHFs in the city and believed it was their right to choose a PHF. Among the various factors influencing their choice of index PHF were better functioning equipment (83.5% of respondents), more specialists/trained health workers (78.5%), ease in receiving specialist care (69.4%), and better overall quality of care (78.9%). Conclusion: There are multiple factors associated with enrollee choice of PHF in this study. The NHIS enrollees value the presence of functioning equipment/facilities, ease in receiving specialist care, and overall high quality of care in their choice of PHF. Improving enrollee enrollment at accredited PHF may require addressing these factors.

The Role of Trust in the Pattern of Enrollment to a Social Health Insurance Scheme and Distribution of Healthcare Facilities in Ibadan, Southwest Nigeria

“…41 This is also supported by other studies in recent times. 17,42,47 Healthcare facilities could receive poor patronage or outrightly abandoned as a result of perceived poor quality of service. 15,48 This invariably affected pattern of distribution of healthcare consumers across facilities.…”

A Five-year Retrospective Study of the Pattern of General Surgical Procedures Performed at a Tertiary Health Institution in Nigeria

“…Most of them chose AKTH even though over 75% of them were aware of NHIS services offered by three other government hospitals in the city and 81% of them were aware of similar services offered at two large private hospitals in the city. [ 29 ]…”

Health insurance awareness and its uptake in India: a systematic review protocol

“…2 The aforementioned factors may also determine the consumer preference in selecting the health insurance. 17 Inadequate claim returns, poor accountability and non-transparent operations hinders the uptake of health insurance. 18 In Indian studies, a scant that is, 34% of the participants who did not have health insurance were willing to pay for any health insuance.…”

“…1 2 19 Individuals usually enrol into health insurance because of their personal experiences, awareness or word-of-mouth advertisements. 17 Mass media such as newspaper, radio and television play an important role in making people aware of health insurance schemes. 1 Friends, community meetings, school gatherings and health workers have an influence on increasing the health insurance awareness of the people.…”