An Evaluation of the National Health Insurance Scheme (NHIS) in Jos, a North-Central Nigerian City

Abstract

National health Insurance Scheme (NHIS) is a health care scheme established by the Federal Government of Nigeria in 2005 for better healthcare delivery to its populace. The objective of this study was to determine the proportion of Nigerian adults enrolled in the scheme, their satisfaction with the quality and availability of services within the scheme and the factors responsible for the dismal health indices in the country despite the scheme. Questionnaires were administered randomly to 200 adult respondents in Jos metropolis. The findings show that only 24% of adults were enrolled in the scheme. Notably, 82% of enrolled respondents were aware of NHIS and prefer it to the fee for service system. There was some level of dissatisfaction in the scheme (26% of enrollees). Sources of dissatisfaction included poor registration services, poor referral system, delays in receiving required services and unavailability or non coverage of some required services. It was statistically determined by the Chi Square tool of analysis that there was a direct relationship between the percentage of enrollees and the poor health indices of the populace. We strongly recommend modification of existing policies to enable enrollment of the self employed and unemployed as well as improved coverage and quality of services within the scheme.