National Health Insurance Scheme and Universal Health Coverage among Formal Sector Employees in Ilorin, Nigeria: Has Any Progress Been Made?

Abstract

Aims: Nigeria implemented a prepayment scheme for health over a decade ago with the aim of achieving universal health coverage. Though the formal sector employees in the federal civil service are the focus, universal health coverage has not been achieved among them. This study aimed to assess the awareness and annual coverage rate of the scheme among employees in the formal sector in Ilorin, Nigeria. Study Design: A cross-sectional survey. Place and Duration of Study: Ilorin, Kwara state Nigeria. July and August, 2015. Methodology: Study was carried out among 507 formal sector employees in Ilorin metropolis. The respondents were chosen using stratified random sampling in 2 stages among employees in the federal, state and local government establishments. Data was collected with the aid of a semi-structured, interviewer-administered questionnaire. Analysis was carried out using SPSS statistical package version 17. Chi-square test was used to establish associations while logistic regression analysis was used for estimation of predictors of awareness about the coverage and enrolments in the scheme. Level of statistical significance was set at p value of <0.05. Results: Awareness about the scheme was higher than it was in a previous study (85.4% vs 78.9%). Population coverage was better than it was in the previous study (89.8% vs 63.3%). Predictors of awareness of the scheme include working in federal (OR = 7.75, CI = 1.749-10.152, P = 0.001) and state governments establishments (OR = 2.544, CI = 1.212-5.340, P = 0.014). Conclusion: The present annual population coverage rate of the scheme is too slow. There is a need for stakeholders to address this finding as a challenge and strategize modalities for enrolling those who are currently not under the scheme.