KNOWLEDGE AND UTILISATION OF NATIONAL HEALTH INSURANCE SCHEME AMONG CIVIL SERVANTS IN PAAUTH ANYIGBA

KNOWLEDGE AND UTILISATION OF NATIONAL HEALTH INSURANCE SCHEME AMONG CIVIL SERVANTS IN PAAUTH ANYIGBA

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Background of the study

The National Health Insurance Scheme (NHIS) was established in Nigeria in 2005 with the aim of providing accessible, affordable, and qualitative healthcare services to all Nigerians, including civil servants. However, despite the implementation of the NHIS, there are concerns about the level of knowledge and utilization of the scheme among civil servants, particularly in institutions like the Federal Medical Centre, Anyigba (PAAUTH). Understanding the factors influencing the knowledge and utilization of the NHIS among civil servants in PAAUTH Anyigba is crucial for improving healthcare delivery and achieving universal health coverage in Nigeria.

Knowledge of the NHIS among civil servants in PAAUTH Anyigba is a critical factor that influences their utilization of the scheme. Several studies have highlighted the varying levels of knowledge among different demographic groups and geographical locations in Nigeria. For instance, a study by Sule et al. (2017) found that only 45% of civil servants in a tertiary institution in Nigeria had adequate knowledge of the NHIS. Similarly, another study by Aregbeshola and Khan (2016) reported that knowledge of the NHIS among civil servants in Osun State, Nigeria, was low, with only 37.5% of respondents having adequate knowledge of the scheme.

Utilization of the NHIS among civil servants in PAAUTH Anyigba is influenced by various factors, including knowledge of the scheme, socioeconomic status, and accessibility of healthcare facilities. Several studies conducted in Nigeria have identified several barriers to the utilization of the NHIS among civil servants. For example, a study by Onwujekwe et al. (2018) found that out-of-pocket payments for healthcare services, lack of awareness about the benefits of the NHIS, and long waiting times at healthcare facilities were significant barriers to utilization among civil servants in Enugu State, Nigeria. Similarly, Adekanmbi et al. (2019) reported that low-income earners and those with low levels of education were less likely to utilize the NHIS in Nigeria.

Several factors influence the knowledge and utilization of the NHIS among civil servants in PAAUTH Anyigba. These factors can be categorized into individual, institutional, and policy-level factors. Individual factors include demographic characteristics such as age, gender, education, income, and occupation, which have been found to influence both knowledge and utilization of the NHIS (Odeyemi and Nixon, 2013; Sule et al., 2017). Institutional factors such as the availability and quality of healthcare services within PAAUTH Anyigba, as well as the attitudes of healthcare providers towards NHIS beneficiaries, also play a significant role in determining utilization rates (Aregbeshola and Khan, 2016). At the policy level, factors such as the comprehensiveness of NHIS benefit packages, the efficiency of NHIS administration, and government commitment to funding the scheme can impact both knowledge and utilization (Onwujekwe et al., 2018).

1.2 Statement of the problem

Access to healthcare services is a fundamental right for every individual, yet in many parts of the world, including Nigeria, the ability to access quality healthcare remains a challenge for a significant portion of the population. In Nigeria, the National Health Insurance Scheme (NHIS) was established to address this issue by providing a framework for universal health coverage. However, the effectiveness of the NHIS in reaching its intended beneficiaries, particularly civil servants, remains a subject of concern. This study aims to investigate the knowledge and utilization of the National Health Insurance Scheme among civil servants in PAAUTH Anyigba.

Several studies have highlighted gaps in the understanding of the NHIS among various demographic groups in Nigeria. For instance, a study by Adewole et al. (2018) found that only 35% of respondents in a survey conducted in Southwest Nigeria had adequate knowledge of the NHIS. Similarly, in a study conducted in Ebonyi State, Southeast Nigeria, by Ewelum et al. (2016), it was revealed that only 40.5% of respondents had good knowledge of the NHIS. These findings suggest a need for further investigation into the level of awareness and understanding of the NHIS among civil servants in PAAUTH Anyigba.

Despite the existence of the NHIS, utilization rates remain low in many parts of Nigeria. A study by Osungbade et al. (2017) conducted in Osun State, Southwest Nigeria, revealed that only 22.7% of respondents had utilized the NHIS at least once. Similarly, a study by Yusuf et al. (2019) in Kwara State, Northcentral Nigeria, found that only 17.9% of respondents had ever enrolled in the NHIS. These findings suggest that there may be barriers preventing civil servants in PAAUTH Anyigba from accessing and utilizing the NHIS, warranting further investigation.

Several factors have been identified as barriers to NHIS utilization in Nigeria. A study by Onwujekwe et al. (2018) identified factors such as high out-of-pocket expenses, inadequate coverage of health services, and poor quality of care as major challenges to NHIS utilization. Additionally, administrative issues such as long waiting times and bureaucratic procedures have been cited as deterrents to enrollment in the NHIS (Adewole et al., 2018). These challenges may also be contributing to low utilization rates among civil servants in PAAUTH Anyigba, highlighting the need for further investigation into the specific barriers faced by this population.

1.3 Objective of the study

1. Assess the level of awareness civil servants in PAAUTH anyigba has about the national health insurance scheme.

2. Identify the level of knowledge civil servants in PAAUTH anyigba has about the national health insurance scheme.

3. Examine the level of utilization of the national health insurance scheme among civil servants in PAAUTH anyigba.

1.4 Research Questions

1. What is the level of awareness civil servants in PAAUTH anyigba have about the national health insurance scheme?

2. What is the level of knowledge civil servants in PAAUTH anyigba have about the national health insurance scheme?

3. What is the level of utilization of the national health insurance scheme among civil servants in PAAUTH anyigba?

1.5 Research hypotheses

Null Hypothesis (H0): The level of knowledge and utilisation of national health insurance scheme among civil servants in PAAUTH anyigba is low.

Alternative Hypothesis (H1): The level of knowledge and utilisation of national health insurance scheme among civil servants in PAAUTH anyigba is high.

1.6 Significance of the study

1. Policy Enhancement and Implementation

Understanding the level of knowledge and the patterns of utilization of the National Health Insurance Scheme (NHIS) among civil servants in PAAUTH Anyigba can directly inform policymakers about the effectiveness of current health policy outreach and education efforts. This study could reveal critical gaps in awareness or misconceptions about the NHIS, providing a solid evidence base for refining communication strategies and policy design. Improved knowledge and utilization of health services directly correlate with better health outcomes, which is a primary goal of public health policy. Therefore, the findings could lead to more targeted and effective interventions that increase enrollment rates, enhance the scheme's coverage, and optimize resource allocation within the NHIS.

 

2. Enhancing Healthcare Access and Equity

The study could have significant implications for improving healthcare access and equity among civil servants. By examining the factors influencing the knowledge and utilization of the NHIS, the research could uncover socioeconomic, demographic, or institutional barriers that prevent certain groups from benefiting from the scheme. Addressing these barriers can lead to more equitable health services, ensuring that all civil servants, regardless of their position, income level, or educational background, have equal access to healthcare. This can help mitigate health disparities within the workforce, promoting a healthier, more productive community of public servants in Anyigba.

 

3. Foundation for Future Research

The findings from this study can provide a valuable foundation for further research in health insurance schemes and their impact on different segments of the population. By establishing a detailed baseline of how well civil servants understand and use the NHIS, future research can explore longitudinal trends, compare with other sectors or regions, and evaluate the impact of specific changes or interventions within the scheme. Additionally, this research could serve as a model for similar studies in other regions or sectors, expanding the understanding of health insurance dynamics in various contexts. This can contribute to a broader academic dialogue about how to best implement and manage national health insurance schemes in diverse settings, enhancing the overall body of knowledge in public health and administration.

1.7 Scope of the study

This study focuses to assess the level of awareness civil servants in PAAUTH anyigba has about the national health insurance scheme, identify the level of knowledge civil servants in PAAUTH anyigba has about the national health insurance scheme, and examine the level of utilization of the national health insurance scheme among civil servants in PAAUTH anyigba. Hence civil servants in PAAUTH anyigba in Kogi State shall serve as enrolled participants for this study.

1.8 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. The significant constraint are:

Time: The researcher encountered time constraint as the researcher had to carry out this research along side other academic activities such as attending lectures and other educational activities required of her.

Finance: The researcher incurred more financial expenses in carrying out this study such as typesetting, printing, sourcing for relevant materials, literature, or information and in the data collection process.

Availability of Materials: The researcher encountered challenges in sourcing for literature in this study. The scarcity of literature on the subject due to the nature of the discourse was a limitation to this study.

1.9 Definition of terms

1. Knowledge

In the context of this study, "knowledge" refers to the awareness and understanding that civil servants in PAAUTH, Anyigba have about the National Health Insurance Scheme (NHIS). This includes familiarity with the benefits, eligibility criteria, enrollment process, covered services, and claim procedures of the NHIS.

2. Utilization

"Utilization" in this research denotes the extent to which the civil servants in PAAUTH, Anyigba engage with or use the NHIS. This includes actions such as enrolling in the scheme, making regular premium payments, using medical services covered by the insurance, and submitting claims for medical expenses.

3. National Health Insurance Scheme (NHIS)

The NHIS is a government initiative aimed at providing accessible and affordable health insurance to citizens. For this study, it specifically refers to the framework and operations of the NHIS as implemented in Nigeria, designed to ensure that every participant receives sufficient medical care, protects families from the financial hardship of huge medical bills, and provides equitable distribution of health care costs among different income groups.

4. Civil Servants

In the context of this research, "civil servants" refers to individuals employed by government agencies or departments. Specifically, it concerns those working under PAAUTH in Anyigba, Kogi State. It encompasses all grades and cadres of employees.

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