Volume 5, Issue 1, March 2020, Page: 1-8
Critical Determinants of Demand for Services in the Nigeria Formal Sector Social Health Insurance Programme
Obi Ikechukwu Vincent, Department of Health Management and Administration, University of Nigeria Enugu Campus, Enugu, Nigeria
Okoronkwo Ijeoma Lewechi, Department of Health Management and Administration, University of Nigeria Enugu Campus, Enugu, Nigeria; Department of Nursing Services, University of Nigeria Enugu Campus, Enugu, Nigeria
Iloh Gabriel Uche Pascal, Department of Medicine and Health Sciences, Rhema University, Aba, Nigeria
Nwonwu Elizabeth Uzoamaka, Department of Community Medicine, Ebonyi state university, Abakaliki, Nigeria
Ogbu Kenneth, Anambra State Office, National Health Insurance Scheme, Awka, Nigeria
Yakubu Adole Agada-Amade, Department of Health Management and Administration, University of Nigeria Enugu Campus, Enugu, Nigeria
Received: Jan. 29, 2020;       Accepted: Feb. 18, 2020;       Published: Feb. 26, 2020
DOI: 10.11648/j.hep.20200501.11      View  163      Downloads  86
Abstract
Introduction: Social health insurance programme was initiated in Nigeria with one of the aims being to improve the demand for quality healthcare services with a resultant reduction in catastrophic spending among the citizenry. Unfortunately, in this programme, healthcare providers who offer quality healthcare services still witness poor enrollee demand for services which has led to inability of the programme to achieve its set out objectives. Hence, the need to study the effects of selected critical determinants on demand for health insurance services and how much these determinants can collectively account for the demand for services in the programme. Design/Methodology: The study adopted a cross sectional design with a quantitative approach. The sample size was calculated using G - Power 3.1 software and the determined sample for the study was one thousand four hundred and thirty five (1435). Multistage sampling method was adopted. Data was analyzed using descriptive statistics and linear regression method with the aid of SPSS version 11. Result: The critical determinants of provider ownership, distance to healthcare provider, enrollee educational level have significant positive effect on the demand for health insurance services (<0.05) but the effect of enrollee income was positively insignificant (>0.05). Similarly, 75% of the changes in demand for health insurance services can be accounted for by the predictor variables in this study. Conclusion: The inability of the programme to address these selected critical determinants significantly will lead to out of pocket spending for healthcare services with a resultant catastrophic effect on families’ finances. Therefore, there is a need to take into account the effects of these determinants duringpolicy formulation, reviews and process implementation in the programme.
Keywords
Demand for Health Insurance Services, Distance to Healthcare Provider, Provider Ownership, Enrollee Educational Level, Enrollee Income
To cite this article
Obi Ikechukwu Vincent, Okoronkwo Ijeoma Lewechi, Iloh Gabriel Uche Pascal, Nwonwu Elizabeth Uzoamaka, Ogbu Kenneth, Yakubu Adole Agada-Amade, Critical Determinants of Demand for Services in the Nigeria Formal Sector Social Health Insurance Programme, International Journal of Health Economics and Policy. Vol. 5, No. 1, 2020, pp. 1-8. doi: 10.11648/j.hep.20200501.11
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
NHIS. (2015). National health insurance scheme operational guidelines. Abuja, Nigeria: NHIS.
[2]
Uzochukwu, B., Ughasoro, M. D., Etiaba, E., Okwuosa, C., Envuladu, E. & Onwujekwe, O. E. (2015). Health care financing in Nigeria: implications for achieving universal health coverage. Niger J Clin Pract. 18, 437-44.
[3]
Eriangga, D., Suhrcke, M., Ali, J. & Bloar, K. (2019). The impact of public health insurance on healthcare utilization, financial protection and health status in low- and middle- income countries. a systematic review. Plos One, 14, 8.
[4]
World Health Organization. (2013). The world health report: health systems improving performance. Geneva, Switzerland: World Health Organization.
[5]
Mohammed, S., Sambo, M. N. & Dong, H. (2011). Understanding client satisfaction with a health insurance scheme in Nigeria: factors and enrollees experiences. Health Res Policy System, 9, 20-21.
[6]
Plahar, R. T., Baozhen, D., Saddiqque, A. & Mensa, S. A. [2020]. Experiences of the insured and non-insured of the NHIS in accessing healthcare in Tema, Ghana. Journal of Public Administration and Governance, 10, 1.
[7]
Adewole, D. A., Adebayo, A. M. & Osungbade, K. O. (2017). A qualitative survey of pre-payment scheme for healthcare services in a rural Nigerian community. Afr. J. Biomed Res. 20, 17-24.
[8]
Dahida, D. P., Oyadiran, P. A., Obinna, I. C. & Nweke, O. I. (2019). Enrollees’ assessment of health maintenance organizations (HMOs) in the implementation of national health insurance scheme (NHIS) in Abuja, Nigeria. International Journal of Development Strategies in Humanities, Management and Social Sciences, 9, 1.
[9]
Adam, V. Y. & Aigbokhaode, A. Q. (2018). Socio-demographic factors associated with the healthcare-seeking behavior of heads of households in a rural community in southern Nigeria. Sahel Medical Journal, 21 (1), 31-36.
[10]
Adewole, D. A., Akanbi, S. A., Osungbade, K. O. & Bello, S. (2017). Expanding the insurance scheme in the informal sector in Nigeria, awareness as a potential demand-side tool. The Pan African Medical Journal, 27, 52.
[11]
Kipo-Sunyehzi, D. D. (2018). Principal-agent problems in implementation of Ghana’s health insurance scheme. Journal of Operations and Supply Chain Management, 11 (2), 59-74.
[12]
Obi, I. V., Okoronkwo, I. L, Adi, J. A, Iloh, G. U. P., Yakubu, A. A. & Ikwudinma, A. O. (2019). Strategies to improve the supply of services in the Nigerian social health insurance programme: healthcare provider perspective. Journal of Policy and Administration, 3 (4), 98-105.
[13]
Boateng, D. & Awunyor-utor, D. (2013). Health insurance in Ghana: evaluation of policy holders’ perceptions and factors influencing policy renewal in Volta region. International Journal of Equity in Health, 12, 50.
[14]
Dror, D. M., Hossan, S. A. S., Majunda, A., Perez, K. T. L., John, D. & Panda, P. K. (2016). What factors affect voluntary uptake of community–based health insurance scheme in low- and middle- income countries? A systematic review and meta-analysis. Plos One, 11, 11-31.
[15]
Donfouet, H. P., Makaudze, E., Mahieu, P. A. & Malin, E. (2011). The determinants of the willingness-to-pay for community-based prepayment scheme in rural Cameroon. Int J Health Care Finance Econ, 11, (3), 209-20.
[16]
Adebayo, E. F., Uthman, O. A., Wiysonje, C. S., Stern, E. A., Lamont, K. T. & Ataguba, J. E. (2015). A systemic review of factors that affect uptake of community based health insurance in low- and middle- income countries. BMC Health Serv Res. 15, 1-3.
[17]
Chuma, J., Mulupi, S. & McIntyre, D. (2013). Providing financial protection and funding health service benefits for the informal sector: evidence from sub-Saharan Africa. RESYST Working Paper 2. 2013. Accessed on 20 Dec 2019 at http://www.panafrican-med-journal.com/content/article/27/52/full/LE LIEN PROPREMENT DIT ICT.
[18]
Obi, I. V., Okoronkwo, I. L., Azuike, E. C., Obi, K. M. & Obi, I. F. (2019). Extent of healthcare provider adherence to national health insurance scheme (NHIS) operational guideline: The Nigeria experience. Journal of Public Administration and Governance, 9, 3.
[19]
Agba, M. S. (2010). Perceived impact of the national health insurance scheme among registered staff in federal polytechnique, Idah, Kogi State. Nigerian Studies in Sociology of Science 1. (1), 44-49.
[20]
Obi, I. V., Okoronkwo, I. L. & Adi, J. A. (2019). Critical determinants of supply of services in the Nigeria formal sector social health insurance programme. European Journal of Clinical and Biomedical Sciences, 5 (6), 79-84.
[21]
Sanusi, R. A. & Awe, A. T. (2009). Perception of National health insurance scheme (NHIS) by healthcare consumers in Oyo State Nigeria. Medwell journals, 6 (1), 48-53.
[22]
Osungbade, K. O., Obembe, T. A. & Oludoyi, A. (2014). Users Satisfaction with Service Provided under National Health Insurance Scheme in South Western Nigeria. International Journal of Tropical Disease and Health, 4 (5), 595-607.
[23]
Benedict, O. H. & Ukpere, W. I (2012). Brain drain and African development: any possible gain from the drain. African Journal of Business Management, 6, 7.
[24]
Kelland, K. (2012). Doctor brain drain costs Africa $2 Billion. BMC Health Services Research, 17 (5), 19-24.
[25]
Okoro, R. N. & Shekari, B. G. (2013). Physicians’ drug prescribing patterns at the national health insurance scheme unit of a teaching hospital in the North Eastern Nigeria. Achieves of Pharmacy Practice, 4 (1), 3-8.
[26]
Agba, A. M., Ushie, E. M. & Osuchukwu, N. C. (2010). National health insurance scheme (NHIS) and employee access to healthcare services in Cross River State, Nigeria. Global Journal of Human Social Science Research, 10, 7.
[27]
Adefolaju T. (2014). Repositioning Health Insurance in Nigeria: prospects and challenges. International Journal of Health Sciences, 2 (2), 151-162.
[28]
Obi, I. V., Okoronkwo, I. L., Nwonwu, E. U., Obi, K. M. & Obi, I. R. (2020). Strategies to improve demand for services in the social health insurance programme: Nigerian enrollee perspective. International Journal of Social Science Research, 8, 1.
[29]
NHIS. (2015). Annual report of the national health insurance scheme. Abuja, Nigeria: National Health Insurance Scheme.
[30]
Ayorinde, F. O. (2009). Determination of modern healthcare facility utilization in Oyo State, Nigeria In: Applied Econometrics and Macro econometric modelling in Nigeria. Ibadan: University press University of Ibadan.
[31]
Gertler, P., Locay, L & Sanderson, P. (1987). Are user fees regressive? The welfare implications of health care financing proposals in Peru. Journal of Econometrics, 36, 67–88.
[32]
Onwujekwe, O., Hanson, K., & Uzochukwu, B. (2012). Examining inequities in incidence of catastrophic health expenditures on different healthcare services and health facilities in Nigeria. PLoS One, 7, 7.
[33]
Kazemi-galougahi, M., Dadgar, E. & Kavosi, Z. (2019). Increase of catastrophic health expenditure while it does not have socio-economic anymore; finding from a district on Tehran after recent extensive health sector reform. BMC Health Serv Res, 19, 569.
[34]
Aremo, A. G. & Ibukun, C. O. (2017). Health insurance and healthcare demand pattern among staff and students of selected universities in Southwestern Nigeria. British Journal of Education, Society &Behavioural Science, 20 (2), 1-13.
[35]
Nurgadi, A. & Artawan Elia Putra, I. W. G. (2017). Demand analysis of the osing community for first level health facility service of the national health insurance programme. Journal of Public Health, 3, 54-63.
[36]
Ajemunigbonhun, S. A., Aduloju, S. A., Sogura, A. B. & Azeez, F. T. (2017). Demand for health insurance among individual households in Lagos state: effects of socio-demographic variables. European Journal of Accounting, Financial & Business, 5, 13.
[37]
Nanu, A. (2002). Determinants of demand for healthcare services and their implications on health financing: the case of Bure town. Ethiopia Journal of Economics, 11, 1.
[38]
Ali, K. J. & Norman, A. N. (2013). Determinants of demand for healthcare in Bangladesh: an econometric analysis. World Journal of Social Sciences, 3 (6), 153-163.
[39]
Musyoka, P. K., Korir, J., Omolo, J. & Nzai, C. C. (2018). An empirical analysis of the effect of poverty on healthcare utilization in Kenya. BMC Health Services Research, 24, 78.
[40]
Tsegay, W., Measho, G., Molla, M., Hailay, G., Brhane, A., Alemtsehay, T…… Yodit, Z. (2018). Demand for healthcare service and associated factors among patients in the community of Tsegedie district, Northern Ethiopia. BMC Health Service Research, 18, 697.
Browse journals by subject