Preferred approach to performance improvement among stakeholders in the health insurance industry in Southwest Region of Nigeria: Implications for Universal Health Coverage

Background: Population coverage of the National Health Insurance Scheme (NHIS) of Nigeria is low. This study aimed to assess the capacity gaps of personnel in the health insurance industry in southwest Nigeria as well determined the approach to improvement. Methods: This was a cross-sectional survey conducted in the health insurance industry in southwest Nigeria. Survey tool adapted was the World Health Organization adopted Hennessy-Hicks Training Needs Analysis Questionnaire with a set of 30 tasks which are important to the job performance of personnel in the health insurance industry. From the register made available by stakeholders, there were a total of 275 personnel in the industry in the zone. A total population of all available personnel in all the organizations were recruited into the study. Data analysis was done using the guideline provided in the Hennessy-Hicks Training Needs Analysis Questionnaire. Results: Only 32 (13.7%) reported having a training background in health-related degrees, 119 (50.9%) had work-related (actuarial science) training while 148 (63.3%) has had a form of on-the-job actuarial science and related training. The training course approach was generally preferred to organisational change in all items. Conclusion: This study showed that there were gaps in the capacity of personnel in the health insurance industry. Training course was the preferred approach to addressing these. While not neglecting organizational change, stakeholders in Nigeria and in similar settings are advised to pay more attention to personnel training to improve performance

Awareness and coverage of the national health insurance scheme among formal sector workers in Ilorin, Nigeria

A prepayment scheme for health through the National Health Insurance Scheme (NHIS) was commenced in Nigeria about ten years ago. Nigeria operates a federal system of government. Sub-national levels possess a high degree of autonomy in a number of sectors including health. It is important to assess the level of coverage of the scheme among the formal sector workers in Nigeria as a proxy to gauge the extent of coverage of the scheme and derive suitable lessons that could be used in its expansion. This is a cross-sectional; descriptive survey carried out among formal sector workers in Ilorin Kwara State; Nigeria. A stratified sampling technique was used to select study participants. A self-administered questionnaire was used to collect data from respondents. Data was analysed with the SPSS. Ethical approval to conduct the study was obtained from the Bowen University Teaching Hospital Research Ethics Committee. A total of 370 people participated in the study. Majority; (78.9%) of the respondents were aware of the NHIS; however only 13.5 % paid for health care services through the NHIS. Logistic regression analysis shows that respondents with post-secondary education (OR = 9.032; CI = 2.562 - 31.847; p = 0.001) and in federal civil service (OR = 2.679; CI = 1.036 - 6.929; p = 0.042) were over nine and three times more likely to be aware of the scheme than others. Coverage of the scheme among the respondents was unimpressive. A lot still need to be done to fast-track the expansion of the scheme among this sector of the population