Knowledge, Acceptability, Enrollment, and willingness to support health insurance Program among traders in an Urban Community in Abia State
Prince Ezenwa Onyemachi1, Nneka Chioma Okoronkwo2* and Chukwuemeka Ngozi Onyearugha2
1Consultant Community Physician/Senior Lecturer, Department of Community Medicine, Abia State University Teaching Hospital, Aba, Abia State, Nigeria
2Consultant Paediatrician/Reader, Department of Paediatrics, Abia State University Teaching Hospital, Aba, Abia State, Nigeria
*Corresponding Author: Nneka Chioma Okoronkwo, Consultant Paediatrician/Reader, Department of Paediatrics, Abia State University Teaching Hospital, Aba, Abia State, Nigeria.
Received: September 02, 2021; Published: September 24, 2021
Background: The desire to provide equitable access to healthcare delivery in Nigeria led the Federal Government of Nigeria to introduce National Health Insurance Scheme (NHIS). For this program to succeed, there must be adequate knowledge, acceptability, enrollment, and willingness to support national health insurance program among the masses.
Objectives: To assess the knowledge and acceptability of health insurance among traders in Umuahia, Abia State, Nigeria. To assess their level of enrollment and suggested voluntary monetary contribution to a community-based health insurance program.
Methods: This study took place in Umuahia, the capital city of Abia State, Nigeria. A pre-tested interviewer-administered questionnaire was used to collect information on socio-demographic data and knowledge of health insurance from a group of traders selected by simple random sampling at an urban market. Following collection of data on baseline knowledge of health insurance, the Universal health coverage and Community-based health insurance schemes were explained to respondents and responses were obtained. Results were analyzed using SPSS Version 24.
Results: A total of 564 traders were interviewed out of which 39% were aware of national health insurance scheme. Amongst these group that are aware of the program, 68% knew about National Health Insurance scheme, while 27% were aware of only community-based health insurance. Only 5.3% of the traders were enrolled in a health insurance scheme. Following education and public enlightenment on universal health coverage and community-based health insurance, over 80% of respondents believed health insurance was beneficial to achieving universal health coverage. Overall, 83.5% of respondents would be willing to support a community-based health insurance scheme if introduced in their communities. The mean amount suggested by respondents as monthly contribution to a community health insurance was nine hundred and twenty naira (N920.00)
Conclusion: Awareness of health insurance, especially community health insurance is low. However, acceptability is high. It is imperative that greater awareness be created in communities to enhance enrollment. Government subsidies will also be necessary to ensure sustainability.
Keywords: Knowledge; Acceptability; Health Insurance; Traders; Umuahia
- Otuyemi OD. “Orthodontics in Nigeria: Journey so far and Challenges ahead”. Journal of Orthodontics1 (2001): 90-92.
- Sanusi RA and Awe AT. “An Assessment of Awareness Level of National Health Insurance Scheme (NHIS) among Healthcare Consumers in Oyo State, Nigeria”. The Medwell Journals2 (2009): 143-148.
- Shaw RP and Griffin C. “Financing Healthcare in Sub-Saharan Africa through user fees and insurance”. Washington, DC: World Bank (1995): 14-21.
- Ononokpono E. NHIS and the Challenges of Healthcare (2008).
- Kutzin J. “Health Insurance for the Formal Sector in Africa”. WHO Geneva (1997).
- Ibiwoye A and Adeleke AA. “The Impact of Health Insurance on Healthcare provision in Developing Countries”. Ghana Journal of Development Studies 21 (2007): 49-58.
- Ubong Ukpong. Poor Coverage by NHIS worries Senate. Daily Sun Newspaper (2009).
- Onuekwusi N and Okpala CO. “Awareness and Perception of the National Health Insurance Scheme (NHIS) Among Nigeria Healthcare Professions”. Journal of College of Medicine2 (1998): 97-99.
- Abia state Ministry of Local Government and Chieftaincy Affairs annual report. Ogurube Layout Umuahia (2012).
- Abia State Ministry of Commerce and Industry Annual report, Ogurube Layout Umuahia (2018).
- Yeboah-Mensah MA. The socio-economic factors that affect utilisation of health care services by the exempt groups under the National Health Insurance Scheme in Ghana. Doctoral dissertation (2021).
- Ghana National Health Insurance Authority 2012 Annual Report. Accra Ghana: Ministry of Health (2013).
- Sarpong N., et al. “National health insurance coverage and socio-economic status in a rural district of Ghana”. Tropical Medicine and International Health 15 (2010): 191-197.
- Manje L. “Client Satisfaction with Health Insurance in Uganda” (2007).
- Angwenyi V., et al. “Health providers’ perceptions of clinical trials: lessons from Ghana, Kenya and Burkina Faso”. PloS One 10 (2015): e0124554.
- Liheluka EA., et al. “Community perceptions on the secondary health benefits established by malaria vaccine trials (RTS, S phase 2 and phase 3) at the Korogwe site in Northeastern Tanzania”. Malaria Journal 12 (2013): 157.
- Tinto H., et al. “The impact of clinical research activities on communities in rural Africa: the development of the clinical research unit of Nanoro (CRUN) in Burkina Faso”. Malaria Journal 13 (2014): 113.
- Akazili J., et al. “Is Ghana’s pro-poor health insurance scheme really for the poor? Evidence from Northern Ghana”. BMC Health Service Research 14 (2014): 637.
- Onwujekwe O., et al. “Constraints to universal coverage: inequities in health service use and expenditures for different health conditions and providers”. International Journal for Equity in Health 10 (2011): 50.
- Mtei G., et al. “Who pays and who benefits from health care? An assessment of equity in health care financing and benefit distribution in Tanzania”. Health Policy Plan 27 (2012): i23-34.
- Onwujekwe O., et al. “Willingness to pay for community-based health insurance in Nigeria: Do economic status and place of residence matter?” Health Policy Plan 25 (2010): 155-161.
- Babatunde O and Akande T. “Willingness to Pay for Community Health Insurance and its Determinants among Household Heads in Rural Communities in North-Central Nigeria”. Irssh Com 2 (2012): 133-142.
- World Health Organisation. Fiscal space, public finance management and health financing (2014).
- Federal Ministry of Health. National Health Account (2016).
- Social health protection. World Heal Organ (2007).
- Xu K., et al. “Chapter 42: Understanding household catastrophic health expenditures: A multi-country analysis”. Lancet 362 (2003): 111-7: 565-572.
- McIntyre D., et al. “Explaining the incidence of catastrophic expenditures on health care: Comparative evidence from Asia”. Bulletin of the World Health Organization 86 (2008): 871-876.
- Onwujekwe O and Velenyi E. “Feasibility of Voluntary Health Insurance in Nigeria”. Washingt DC: World Bank (2006).