Users’ Satisfaction with Services Provided Under National Health Insurance Scheme in South Western Nigeria

Aims: National Health Insurance Scheme became operational in Nigeria over eight years ago; yet, population coverage is below 20% and healthcare services are provided ineffectively and inefficiently. Satisfaction surveys might be part of useful interventions required to increase universal healthcare coverage and improve optimal access and success of the scheme.
Study Design: A cross-sectional, exploratory study.
Place and Duration of Study: Federal Secretariat, Ibadan, Nigeria. 4 weeks of the month of July, 2011.
Methodology: 380 eligible federal staff completed a self-administered modified SERVQUAL questionnaire, which assessed satisfaction domains of healthcare provider services (competence), staff attitude and waiting time. Clients’ experiences were related to a health facility visit in the last three months preceding the survey and assessed on a 5-point Likert scale of “very poor = 1”, “poor = 2”, “good = 3”, “very good = 4” and “excellent = 5”. Associations between dependent and independent variables were subjected to Chi-square test and logistic regression at P-value of 0.05.
Results: 201 (52.8%) male and 179 (47.2%) female participated in the study. Their mean age was 42.5±8.0 years. Most frequently health conditions for which services were sought were malaria (52.9%), medical check-up (5.8%) and dental problem (2.9%). 55.6% of participants were satisfied with drug services, 56.2% with healthcare provider services, 77.8% with waiting time and 51.7% with staff attitude. Education and type of health facility were predictors of satisfaction with healthcare provider services. Length of years of enrolment was a predictor of satisfaction with waiting time while length of years and grade level attained in service were predictors of satisfaction with staff attitude.
Conclusion: Periodic documentation of experiences of enrollees in relation to satisfaction domains of social insurance is useful as it could help identify and prioritise appropriate interventions required to improve its effectiveness and efficiency.