Enrollees’ knowledge, satisfaction, and barriers to uptake of National Health Insurance Scheme in north-central Nigeria

Abstract

Background: Enrollees’ knowledge, behavior, and perception of health insurance substantially influence a decision about the uptake of sustainability of the program. This study assessed enrollees’ knowledge, satisfaction, and barriers to the National Health Insurance Scheme (NHIS) uptake in Benue State, Nigeria. Materials and Methods: The study was a descriptive survey conducted among hospital clients enrolled in the formal sector program of the health insurance scheme in Makurdi, Benue State, Nigeria. A structured questionnaire was used to collect respondents’ demographic information and data related to the knowledge, satisfaction, and barriers to the uptake of NHIS in Nigeria. IBM-SPSS version 25.0 was used to analyze the data. Results: The study comprised 53.2% males, and 46.8% were females. The majority (82.9%) of the enrollees were aware of the objectives of the NHIS, but only 33.4% were aware of their benefits as enrollees and only 56.0% were satisfied with NHIS services. Factors that significantly influenced enrollees’ satisfaction include sex, age, education level, income, and knowledge of enrollees’ entitlements (P < 0.05), but the family size and knowledge of the objectives of the NHIS were not significantly associated with the level of satisfaction (P > 0.05). The most common barriers to the uptake of the NHIS include cultural and religious norms (67.4%) and poor social infrastructures (60.6%). Conclusion: This study revealed that the enrollees had poor knowledge of their entitlements for enrolling in the NHIS and a low level of satisfaction. There is a need for more awareness interventions across Nigeria to sensitize citizens of the scheme’s importance, objectives, and benefits.