Evaluation of the Benefits, Quality of Services and Challenges to the Nigerian National Health Insurance Scheme among Enrollees in a Tertiary Teaching Hospital in Southeast Nigeria

Objective: Access to quality healthcare has been a prerogative of the middle and high socioeconomic class leading to the introduction of health insurance in developing countries to share the burden, reduce cost, and step up health care financing and coverage. This study assessed the benefits, quality of services and challenges of the National Health Insurance Scheme (NHIS).

Methods: The study was a cross-sectional descriptive survey of all eligible NHIS enrollees. The study was conducted between January 2014 and April 2016. Data was collected using self-administered structured questionnaire and analyzed for demographics, enrollees perceived benefits of NHIS, quality of services, challenges, and problems using descriptive statistics.

Results: Study showed that 91.1% of enrollees believed that the scheme is beneficial while 92.5% had confidence in the services and believed that it has reduced payment of their hospital bills. A total of 74.5% of the enrollees indicated positive response to quality and effective service under the scheme. The challenges borders on poor funding which does not allow for full coverage of all the essential medicines and entire family members for people with large families. Delay in collection of enrollees’ card was another major setback.

Conclusion: The National Health Insurance Scheme is beneficial to the enrollees and offers quality and effective services. However, poor funding limits its impact on the health benefits of the enrollees. The government needs to develop strategies to facilitate the operations of the scheme more efficient through improved funding and awareness campaign to improve coverage at all levels, boost the asset base, and improve services and efficiency.