Strategies to Improve Demand for Services in the Social Health Insurance Programme: Nigerian Enrollee Perspective

Abstract

Globally, the World Health Organization has championed the introduction of various forms of health insurance as a means of improving the utilization of quality healthcare service which is targeted at achieving universal health coverage. Unfortunately, the operations of the Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the demand for healthcare services as a result of moral hazard and this is evidenced by the non-achievement of set-out objective of the programme in Nigeria. Design/Methodology: The study adopted a qualitative approach which comprised of 3 focus group discussions (N=24). Key informants were purposely selected for the focus group discussion from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The focus group participants relayed their experiences in the programme which includes poor identification system, choice of only one provider except on emergency, benefit package not being comprehensive which has enabled moral hazard and suggested ways to improve it. Conclusions: Most of the enrollees do not show diligence in areas of demand for services and these were shown to emanate principally from economic issues around the enrollees desire to utilize the premium paid thereby leading to moral abuse. Therefore, certain measures need to be put in place so as to curtail observed market failures in the SHIP programme.