Aim: To assess enrolees’ perception and experiences on the National Health Insurance Scheme,
launched in Nigeria, in 2005 and made mandatory for all Federal civil servants.
Study Design: This descriptive cross-sectional study conducted between August and September
2013 focused on civil servant enrolees of three tertiary health institutions in Lagos, South-West
Nigeria.
Methodology: Three tertiary health institutions were purposively selected. Systematic sampling
was employed in selecting 150 enrolees. Quantitative data were collected from each consenting
selected enrolee using semi-structured questionnaire which probed into demographic
characteristics, knowledge, expectations, services accessed, experiences, perceptions and,
suggestions for improvement.
Results: A total of 143 enrolees (males 43.7%; females 56.3%) completed the questionnaire.
Majority (97.2%) had knowledge of the scheme: easy access to affordable healthcare (40.7%),
subsidized health care services (22.2%) and pooling of resources (11.1%). Subsidized treatment,
quality healthcare provision and free treatment were the most mentioned expectations. Treatment
and general care were the most accessed services (55.7%). One in every five enrolees (22.9%)
never accessed the services and, 18% had no knowledge of complaints channels. More than half
(59.8%) were dissatisfied with services accessed for reasons ranging from drug unavailability
(27.8%) to poor quality of service (12.6%) and out-of-pocket payment on drugs and tests (11.4%).
Majority (57%) however claimed reduction in out-of-pocket expenses. Major suggestions proffered
by enrolees (53.1%) for improving the scheme covered regular monitoring, continuous availability of
genuine drugs, sensitisation, prompt response to enrolees’ complaints and continuous review of the
policy.
Conclusions: Regular monitoring of the scheme’s operations is expected to contribute greatly to
improvement of the scheme which should minimise out-of-pocket health expenses. Continuous
enlightenment is desirable with emphasis on ensuring enrolees’ satisfaction for sustainability to
secure the universal health coverage target in the country.