Patients Experiences in Accessing National Health Insurance Services in Nigeria

Objective: Since the National Health Insurance Scheme (NHIS) commenced operations in 2005, the coverage has remained low. This has been attributed to poor service delivery, and numerous challenges experienced by citizens in accessing care at the provider level. This study identifies challenges faced by enrollees and their levels of satisfaction with the NHIS in Nigeria. Methods: This prospective qualitative study was conducted using enrollees of the NHIS. To elicit information from enrollees on topical issues which relate to service accessibility and satisfaction, Focused Group Discussions and interviews were employed. Data were analyzed using NVivo Qualitative Data Analysis Software Version 11 and presented in the perspective of Health Management Organizations (HMOs) and healthcare providers' levels. Results: Availability of prescribed drugs and poor referral system were major challenges encountered by enrollees in the process of accessing health services. Some of these challenges were occasioned by the non-remittance of funds to service providers at the due time. Hence, satisfaction among enrollees was also found to be low. Conclusion: The NHIS in Nigeria needs to strengthen its regulatory role by ensuring that HMOs comply fully with the operational guidelines and that HMOs in turn intensify their oversight and quality assurance responsibilities for healthcare providers.