Akinyemi O O, Owopetu O F, Agbejule I O
Department of Health Policy and Management, College of Medicine, University of Ibadan.
Department of Total Quality Management, University College Hospital, Ibadan.
Ann Ib Postgrad Med. 2021 Jun;19(1):49-55.
The National Health Insurance Scheme is a social health insurance programme designed by the Federal Government of Nigeria to complement sources of financing the health sector and to improve access to health care for the majority of Nigerians. Presently, the enrolment level on the Scheme is majorly among those in the formal sector and user experiences have been different. This study seeks to determine the perception and participation of Civil Servants regarding the National Health Insurance Scheme in Ibadan.
A descriptive cross-sectional study was conducted among 273 civil servants working at the Federal Secretariat, Ikolaba, between October and November 2015. An interviewer-administered questionnaire was used to collect information on socio-demographic characteristics, awareness, and membership of the NHIS, perception of NHIS, and health-seeking behaviour. Participation was defined as the number of civil servants registered or enrolled under the scheme, in other words, members of the scheme. Information on perceptions was sought using a 3-point Likert scale. Descriptive statistics and chi-square tests were used for data analysis at a 5% level of significance.
About 60.1% of the respondents were males. The average age was 39.7±9.1 years, with 85.0% of the respondents being married. The majority (65.2%) of the respondents were mid-level cadre workers, 17.62% were working as senior-level workers and the remaining 17.6% were low cadre workers. The majority (88.9%) completed tertiary education, while just 11.1% completed basic education. The mean household size was 2.5±0.6. Awareness of the National Health Insurance Scheme was very high (95.2%) with 83.5% enrolled under the scheme. About (50%) of the respondents joined the scheme because it is cheap and affordable. There was a significant association between awareness, level of education, knowledge of NHIS, and registration into the scheme by respondents. The majority of the respondents (87.3%) claimed that NHIS is a better means of settling healthcare costs than Out-of-pocket-payment. The majority of the respondents thought that health insurance is a viable programme.
The perception of health insurance among civil servants was varied while participation was high. Relevant intervention should be introduced to remove bottlenecks to accessing and operating the scheme.
国家健康保险计划是尼日利亚联邦政府设计的一项社会健康保险计划，旨在补充卫生部门的融资来源，并改善大多数尼日利亚人获得医疗保健的机会。目前，该计划的参保水平主要集中在正规部门，用户体验也各不相同。本研究旨在确定伊巴丹公务员对国家健康保险计划的认知和参与情况。
2015年10月至11月期间，对在伊科拉巴联邦秘书处工作的273名公务员进行了一项描述性横断面研究。采用访谈式问卷调查收集社会人口学特征、对国家健康保险计划的知晓情况和参保情况、对该计划的认知以及就医行为等信息。参与度定义为在该计划下注册或参保的公务员人数，即该计划的成员。使用3点李克特量表来获取关于认知的信息。描述性统计和卡方检验用于在5%的显著性水平上进行数据分析。
约60.1%的受访者为男性。平均年龄为39.7±9.1岁，85.0%的受访者已婚。大多数（65.2%）受访者为中层干部，17.62%为高层干部，其余17.6%为低层干部。大多数（88.9%）完成了高等教育，而只有11.1%完成了基础教育。平均家庭规模为2.5±0.6。对国家健康保险计划的知晓率非常高（95.2%），83.5%的人参保。约50%的受访者加入该计划是因为其费用低廉且负担得起。受访者的知晓情况、教育水平、对国家健康保险计划的了解程度与参保情况之间存在显著关联。大多数受访者（87.3%）声称，与自费支付相比，国家健康保险计划是支付医疗费用的更好方式。大多数受访者认为健康保险是一个可行的计划。
公务员对健康保险的认知各不相同，但参与度较高。应引入相关干预措施，消除参与该计划和运作该计划的瓶颈。
