NATIONAL HEALTH INSURANCE SCHEME: A MEANS TO EFFECTIVE STROKE PREVENTION AMONG HYPERTENSIVES IN SUBSAHARAN AFRICA

Abstract

<h2>ABSTRACT</h2><h3>Background and Aims</h3> Uncontrolled hypertension is a leading cause of stroke in Sub-Saharan Africa. Factors affecting blood pressure control include low income, sedentary lifestyle and unhealthy diet. We sought to determine the role of National Health Insurance Scheme (NHIS) in achieving good blood control among hypertensives in Ghana and Nigeria and thus prevention of stroke and other cardiovascular complications of uncontrolled hypertension. <h3>Methods</h3> A hospital-based descriptive cross-sectional study of 206 adult hypertensives systematically selected from 4 hospitals in Ghana (Adabraka and Maproby Polyclinics) and Nigeria (Ekiti State University Teaching Hospital, Ado-Ekiti and Federal Teaching Hospital, Ido-Ekiti). Patients were interviewed and physically examined and information entered into a questionnaire and analysed using SPSS 21. Informed consent was obtained from respondents and ethical approval obtained from all the four institutions. <h3>Results</h3> Respondents were mostly middle aged 113 (54.8%) with a mean age of 57±14; females 134 (65.5%); married 132 (64.1%) and NHIS enrollees 108 (52.4%). Majority of respondents had poor BP control 122 (59.2%). There was a significantly better blood pressure control among respondents from Ghana (OR 5.526; CI 3.006 to 10.161) and those on NHIS (OR 3.516; CI 1.946 to 6.352). <h3>Conclusions</h3> Out of pocket spending is a major cause of poor Blood Pressure control with predisposition to stroke. Universal Health Coverage through enrolment of all citizens under the NHIS scheme would provide standard healthcare to citizens irrespective of their income levels and help in blood pressure control and in turn prevent stroke in these patients.