AWARENESS AND COVERAGE OF THE NATIONAL HEALTH INSURANCE SCHEME AMONG FORMAL SECTOR WORKERS IN ILORIN, NIGERIA - African Journal of Biomedical Research, Vol. 19, No. 1, 2016, pp. 7-16

A prepayment method for health care financing has been adopted by many developing countries to ensure universal coverage for healthcare. In Nigeria, National health insurance scheme (NHIS) was established in 2005. The aim for this was scheme was to “secure universal coverage and access to adequate and affordable healthcare in order to improve the health status of Nigerians, especially for those participating in the various programs/products of the Scheme”. These policies however only target the formal sector workers mainly and that makes only about 4% of the population.  Furthermore, the enrolment to this coverage in Nigeria is only voluntary, it is not mandatory for people to sign up like in Ghana. The majority of the stakeholders in health insurance is government based.

Nigeria follows the federal system of government where the governance is shared by three levels (the national, state and local government). The states thus have a high degree of autonomy in many sectors that affect the well-being of its residences such as education and health. Earlier studies have shown that age, sex, education and socio-economic status along with other demographic factors are associated with the awareness of the program and the likelihood of people participating in heath promoting services and schemes. It is crucial to assess the different level of coverage of the NHIS among the formal sector  in order to attain lessons that could be used in the expansion of the program.

A cross-sectional, survey was carried out in Ilorin, Kwara state in Nigeria between February and March 2012. Ilorin is the capital of Kwara and has the population of 2371,089 people. Public/ civil servants over the age of 18 years, who were employed by all levels of government were allegeable to the participle. The sampling was taken in two-stage stratified sampling was used to select 370 respondents and using the systematic sampling the respondents were recruited into the study.

The data was analyzed with SPSS, this ethical approval of the study was obtained from Bowen University teaching hospital research ethics committee. The result concludes that majority of the respondents were are of the NHIS. Unfortunately, only 13.5 % of the respondents paid for health care services through NHIS. Furthermore, respondents with post-secondary education and in federal civil services were more likely to be aware of the NHIS program. This means that the program is available and promoted in the higher ranks or socioeconomic status have more access to this information.