Factors Determining Enrollee’s Choice of Private and Public Healthcare Providers of Community Based Health Insurance Scheme in Edu Lga Kwara State

Abstract

Purpose: Private sector is the major providers of Primary health care for the poor in many low- and middle-income countries. In the public healthcare providers, the health facilities are built by the government and the healthcare workers, draw their salaries from government treasuries. In the private providers, the health facilities are owned by individual or a group of people and the salaries of the workers are paid from the resources generated in the facilities. They are either for profit or non-profit making. Enrollees are given freehand to choose either of the providers, but the information available to them is not enough to make decision on which of the providers to choose. This study aimed at determining the enrollee’s choice of private and public healthcare providers of community-based health insurance scheme in Edu LGA Kwara state.
 Methodology: The design was descriptive cross-sectional study. Sample size of 400 was used in each of the provider. The respondents were recruited by systematic sampling method among private healthcare provider while multistage sampling method was adopted in public healthcare providers. Data was collected using semi structured questionnaire. Focus Group Discussion was also carried out. Data collected were analyzed using SPSS version 23.0. Results were tabulated and logistic regression was adopted to determine level of significance. Level of Significance was set at P<0.05
 Findings: Nine- point-five (9.5%) of the respondents of the private healthcare provider and 5.7% of the respondents of the public healthcare providers had good knowledge score of community based health insurance scheme. The difference in knowledge score was statistically significant as the p=0.035. Mode of premium collection had Odd ratio 2.99 (CI =1.934- 4.622), P<0.001; Trust of the system Odd ratio 2.987 (CI = 1.884-4.733); Quality of health care Odd ratio 2.673 (CI = 1.757-4.065) P<0.001; Proximity to health facility Odd ratio 2.225 (CI = 1.412-3.506) P=0.001. Mode of joining the scheme Odd ratio 0.400 (CI = 0.290-0.552) P<0.001 and cost of accessing care Odd ratio 0.577 (CI = 0.42-0.779) P<0.001.
 Recommendation: It was recommended that private health facilities should be maintained which will improve access to health care for the enrollees. The government should also improve the quality of health care in the public healthcare providers.