Fortune Benjamin Effiong, Roseline Dzekem Dine, Ibrahim Adebayo Hassan, Dimeji Abdulsobur Olawuyi, Idongesit Kokoabasi Isong, David Ayobami Adewole
{"title":"尼日利亚国家支持的健康保险计划的覆盖率和入学预测因素:一项多地点定量研究。","authors":"Fortune Benjamin Effiong, Roseline Dzekem Dine, Ibrahim Adebayo Hassan, Dimeji Abdulsobur Olawuyi, Idongesit Kokoabasi Isong, David Ayobami Adewole","doi":"10.1186/s12889-025-23329-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>In efforts to advance universal healthcare coverage (UHC) in Nigeria, the federal government empowered sub-national entities such as states to develop and implement their respective state-supported health insurance schemes (SSHIS). This study assessed the coverage and predictors of enrollment in the SSHIS in six Nigerian states.</p><p><strong>Methods: </strong>This study used a quantitative cross-sectional design. Respondents were recruited across six Nigerian states with operational SSHIS, corresponding to the country's six geopolitical zones. These include the Cross River, Enugu, Oyo, Kwara, Sokoto, and Taraba states, representing the South-South, South-East, South-West, North-Central, North-West, and North-East zones respectively. Data were collected from community members in congregate settings such as markets, churches/mosques, schools, bus stations/parks, and healthcare facilities. Descriptive, bivariate, and multivariate analyses were conducted using SPSS version 25.</p><p><strong>Results: </strong>The number of study respondents was 3732. The greater majority of the respondents were self-employed 1855 (49.7%) and were living with an average monthly income of < 10,000 naira 1175 (31.5%). Coverage of the state health insurance was highest in the North-Central Kwara State 326 (37.3%), but lowest in the South-Eastern Enugu State 6 (1%). Among beneficiaries, overall satisfaction with the scheme was highest in Oyo State 73 (77.7%), but lowest in Cross River State 16 (32.7%). After adjusting for confounders, several covariates were identified as decreasing the odds of enrolling into the schemes; however, lack of awareness about the scheme was most significant across all the six states.</p><p><strong>Conclusion: </strong>Low coverage due to poor awareness, financial barriers, and enrollee dissatisfaction currently affect the SSHIS in Nigeria. To improve enrollment and sustainability, nationwide educational campaigns and consolidation of health insurance schemes are recommended.</p>","PeriodicalId":9039,"journal":{"name":"BMC Public Health","volume":"25 1","pages":"2125"},"PeriodicalIF":3.6000,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143090/pdf/","citationCount":"0","resultStr":"{\"title\":\"Coverage and predictors of enrollment in the state-supported health insurance schemes in Nigeria: a quantitative multi-site study.\",\"authors\":\"Fortune Benjamin Effiong, Roseline Dzekem Dine, Ibrahim Adebayo Hassan, Dimeji Abdulsobur Olawuyi, Idongesit Kokoabasi Isong, David Ayobami Adewole\",\"doi\":\"10.1186/s12889-025-23329-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>In efforts to advance universal healthcare coverage (UHC) in Nigeria, the federal government empowered sub-national entities such as states to develop and implement their respective state-supported health insurance schemes (SSHIS). This study assessed the coverage and predictors of enrollment in the SSHIS in six Nigerian states.</p><p><strong>Methods: </strong>This study used a quantitative cross-sectional design. Respondents were recruited across six Nigerian states with operational SSHIS, corresponding to the country's six geopolitical zones. These include the Cross River, Enugu, Oyo, Kwara, Sokoto, and Taraba states, representing the South-South, South-East, South-West, North-Central, North-West, and North-East zones respectively. Data were collected from community members in congregate settings such as markets, churches/mosques, schools, bus stations/parks, and healthcare facilities. Descriptive, bivariate, and multivariate analyses were conducted using SPSS version 25.</p><p><strong>Results: </strong>The number of study respondents was 3732. The greater majority of the respondents were self-employed 1855 (49.7%) and were living with an average monthly income of < 10,000 naira 1175 (31.5%). Coverage of the state health insurance was highest in the North-Central Kwara State 326 (37.3%), but lowest in the South-Eastern Enugu State 6 (1%). Among beneficiaries, overall satisfaction with the scheme was highest in Oyo State 73 (77.7%), but lowest in Cross River State 16 (32.7%). After adjusting for confounders, several covariates were identified as decreasing the odds of enrolling into the schemes; however, lack of awareness about the scheme was most significant across all the six states.</p><p><strong>Conclusion: </strong>Low coverage due to poor awareness, financial barriers, and enrollee dissatisfaction currently affect the SSHIS in Nigeria. To improve enrollment and sustainability, nationwide educational campaigns and consolidation of health insurance schemes are recommended.</p>\",\"PeriodicalId\":9039,\"journal\":{\"name\":\"BMC Public Health\",\"volume\":\"25 1\",\"pages\":\"2125\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-06-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143090/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Public Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12889-025-23329-4\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Public Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12889-025-23329-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Coverage and predictors of enrollment in the state-supported health insurance schemes in Nigeria: a quantitative multi-site study.
Background: In efforts to advance universal healthcare coverage (UHC) in Nigeria, the federal government empowered sub-national entities such as states to develop and implement their respective state-supported health insurance schemes (SSHIS). This study assessed the coverage and predictors of enrollment in the SSHIS in six Nigerian states.
Methods: This study used a quantitative cross-sectional design. Respondents were recruited across six Nigerian states with operational SSHIS, corresponding to the country's six geopolitical zones. These include the Cross River, Enugu, Oyo, Kwara, Sokoto, and Taraba states, representing the South-South, South-East, South-West, North-Central, North-West, and North-East zones respectively. Data were collected from community members in congregate settings such as markets, churches/mosques, schools, bus stations/parks, and healthcare facilities. Descriptive, bivariate, and multivariate analyses were conducted using SPSS version 25.
Results: The number of study respondents was 3732. The greater majority of the respondents were self-employed 1855 (49.7%) and were living with an average monthly income of < 10,000 naira 1175 (31.5%). Coverage of the state health insurance was highest in the North-Central Kwara State 326 (37.3%), but lowest in the South-Eastern Enugu State 6 (1%). Among beneficiaries, overall satisfaction with the scheme was highest in Oyo State 73 (77.7%), but lowest in Cross River State 16 (32.7%). After adjusting for confounders, several covariates were identified as decreasing the odds of enrolling into the schemes; however, lack of awareness about the scheme was most significant across all the six states.
Conclusion: Low coverage due to poor awareness, financial barriers, and enrollee dissatisfaction currently affect the SSHIS in Nigeria. To improve enrollment and sustainability, nationwide educational campaigns and consolidation of health insurance schemes are recommended.
期刊介绍:
BMC Public Health is an open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health. The journal has a special focus on the social determinants of health, the environmental, behavioral, and occupational correlates of health and disease, and the impact of health policies, practices and interventions on the community.