Funding is a critical determinant for both quantity and quality of health care
services. In Nigeria, government subvention has remained the major mechanism
of health care financing. In 1997, a national health insurance scheme (NHIS) was
launched with a view to relieving the current excessive pressure on government
finances for public services, and enhance the even distribution of health senfices 0
all over the country. This study was aimed at an assessment of the knowledge and
attitude of Nigerian doctors towards the NHIS.
The study population consisted of all doctors practicing within the South-East
geo-political zone of the country which is made up of Enugu, Ebonyi, Anambra,
Imo and Abia states. Eighty two percent of the doctors were males compared to
17.7% females while 33.5% had post graduate qualifications. Doctors with postgraduate
qualifications had a higher level of awareness on the NHIS (85.7%)
compared to those with a basic medical degree (64.8%) [ X* = 9.05; df = 1; p <
0.051. More male doctors were also found to be aware of the NHIS (72.3%)
compared to the female doctors (60.6%). The institutions where the doctors were
&ctising; did not influence their level of awareness on the scheme. The main
sources of information on the NHIS among the doctors were newspapers (58.5%),
Radio/TV(51.6%) and colleagues/friends (55.9%): Only 17.6% of the doctors knew
that providers will be paid either by capitation or the fee-for-service mechanism.
More male doctors (1 8.1 %) correctly identified the provider payment mechanism
compared to females (1 2.1 %). Knowledge of provider payment mechanism was
positively influenced by the level of qualification of the doctors. More doctors in
private practice (15.5%) knew of the provider payment mechanism compared to
those in public institutions (12.0%). 93.5% of the doctors were willing to participate
in the scheme, while only 5.3% were satisfied with the level of information
available to health care providers.
This study demonstrated a very low level of knowledge among doctors of the
modalities for the operation of the NHIS. The implications of this finding on the ,,.
8uccess of the scheme is discussed.