Evaluating the Impact of National Health Insurance Scheme on Health Care Consumers in Calabar Metropolis, Southern Nigeria

Abstract

This study was aimed at evaluating the impact of National Health Insurance Scheme (NHIS) on health care consumers in Calabar metropolis, southern Nigeria. A pre-tested, 43 itemed questionnaires were designed and administered to 200 respondents using the household survey and patient exit survey methods. The result of this study showed that respondents were predominantly males (58.0%), Christians (94.5%), married (56.0%), civil servants (39.5%), had tertiary level of education (60.5%) and aged 30-34 years (27.5%). A reasonable proportion of the respondents 89.0% were aware of the scheme but enrolment into the scheme was only 37%. Inadequate information on the scheme, deficient delivery of health care services and lack of trust on scheme management were significant barriers to enrolment into the scheme. The scheme has a positive impact on health seeking behavior, utilization of maternal health services and reducing out-of-pocket expenditure for health services. About 72% of the respondents expressed their satisfaction with the performance of the scheme, whereas those who were dissatisfied with the scheme’s performance suggested it should be reformed. Wider coverage and increase awareness about the scheme will enhance equitable access to health care.