Establishment of Health Insurance Scheme for Informal Sector Populace in Ogun State Of Nigeria: A Mixed Methodology Approach
DOI:
https://doi.org/10.14738/jbemi.95.13105Keywords:
health insurance, awareness, knowledge, satisfaction, universal health coverage, willingness to payAbstract
This study evaluated the perception of informal sector populace towards the proposed state health insurance (SHI) scheme and identified factors associated with willingness to join and pay for it; using mixed methodology. The mean age of the respondents was 39.67 with standard deviation of 13.94. Out-of-pocket payment for health care services accounted for 89.5% of healthcare financing. The level of awareness of the state health insurance schemes was 23.1%. The mean satisfaction score with health care system was 2.85 (± 0.51) out of 5 while the mean knowledge score on health insurance concept was 0.32 (± 0.31) out of 1. The average weight of concerns about the scheme management was 2.96 (± 0.47) out of 5. Willingness to join the scheme (which measured the demand for state health insurance scheme) was 65.3% whereas willingness to pay one thousand naira (N1000) per month per individual was 47.1% while willingness to pay four thousand naira (N4000) per month per family was 18.2%. However, preference for family package of health insurance was 73.3%. The maximum amount willing to pay was N1541.45 and N736.99 per month for a family and individual package respectively. Health insurance coverage among respondents was 7.4%. The study included six logistic regression models that identified predictors of satisfaction with present health care system, knowledge of health insurance concept, implementation concerns, willingness to join SHI, willingness to pay N1000 and N4000 respectively.
References
Arhin-Tenkorang, Dyna (2001) “Health Insurance for the Informal Sector in Africa: Design Features, Risk Protection, and Resource Mobilization”, HNP discussion paper series;. World Bank, Washington, DC. © World Bank. https://openknowledge.worldbank.org/handle/10986/13643 License: CC BY 3.0 IGO
Acharya, Arnab; Vellakkal, Sukumar; Taylor, Fiona; Masset, Edoardo; Satija, Ambika; Burke, Margaret; and Ebrahim, Shah (2013) “The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review”, The World Bank Research Observer, 28(2): 236-266
Hsiao, William and Shaw, Paul (2007) “Social Health Insurance for Developing Nations”, WBI Development Studies, Washington, DC: World Bank. © World Bank. https://openknowledge.worldbank.org/handle/10986/6860 License: CC BY 3.0 IGO
WHO (2010) “The world health report - Health systems financing: the path to universal coverage”, Geneva, Switzerland: World Bank
Acharya, Arnab; Vellakkal, Sukumar; Kalita, Soumik; Taylor, Fiona; Satija, Ambika; Burke, Margaret; Masset, Edoardo; Tharyan, Prathap and Ebrahim, Shah (no date) “Do Social health insurance schemes in developing country settings improve health outcomes and reduce the impoverishing effect of healthcare payments for the poorest people?”, Cochrane Database of Systematic Reviews
Ojerinde, Dayo (2021) “Ogun to implement health insurance in informal sector”, Punch, accessed at https://punchng.com/ogun-to-implement-health-insurance-in-informalsector/ on 9 June 2022
Sowole, James (2022) “Ogun Launches Health Insurance Scheme for Informal Sector”, This Day, accessed at https://www.thisdaylive.com/index.php/2022/02/04/ogun-launcheshealth-insurance-scheme-for-informal-sector/, on 9 June 2022
Ayinla, Rasaq (2014) “Amosun launches community-based health insurance scheme”, Business Day, accessed at https://businessday.ng/science/article/amosun-launchescommunity-based-health-insurance-scheme/, on 9 June 2022
Adeneye, AK; Musa, AZ; Afocha, EE; Adewale, B; Ezeugwu, SMC; Yisau, J; Raheem, TY; Akande, DO; Akinremi, AO; Runsewe, OA and Mafe, MA (2021) “Perception of community-based health insurance scheme in Ogun State, Nigeria”, Global Journal of Infectious Diseases and Clinical Research, 7(1): 001-012. DOI: https://doi.org/10.17352/2455-5363.000039
Raheem, TY; Adewale, B; Adeneye, AK; Musa, AZ; Ezeugwu, SMC; Yisau, J; Afocha, E; Sulyman, MA; Adewoyin, OO; Olayemi, M; Ayeni, OC; Akinremi, AO; Runsewe, K; Mafe, MA and Ujah, IAO (2019) “State of Health Facilities in Communities Designated for Community-Based Health Insurance Scheme in Nigeria: A Case Study of Kwara and Ogun States”, International Journal of Tropical Disease & Health, 36(1): 1-10
Djahini-Afawoubo, Dosse and Atake, Esso-Hanam (2018) “Extension of mandatory health insurance to informal sector workers in Togo”, Health Economics Review, 8(22): 1-13, https://doi.org/10.1186/s13561-018-0208-4 331
Adewole, David; Akanbi, Saidat; Osungbade, Kayode and Bello, Segun (2017) Expanding health insurance scheme in the informal sector in Nigeria: awareness as a potential demand-side tool, Pan Afr Med J, 27(52): 1-11, doi: 10.11604/pamj.2017.27.52.11092
Bascom, William (1952) “The Esusu: A Credit Institution of the Yoruba”, The Journal of the Royal Anthropological Institute of Great Britain and Ireland, 82(1): 63-69
Dror, David and Firth, Lucy (2014) “The Demand for (Micro) Health Insurance in the Informal Sector”, The Geneva Papers, 39: 693–711
Deng, Yingli; Wang , Cynthia; Aime, Federico; Wang, Long; Sivanathan, Niro and Kim, Yun (2020) “Culture and Patterns of Reciprocity: The Role of Exchange Type, Regulatory Focus, and Emotions”, Personality and Social Psychology Bulletin, 1–22 DOI: 10.1177/0146167220913694 journals.sagepub.com/home/pspb
Kim, Steffie; Huang-Isherwood, Ke; Zheng, Weiwei and Williams, Dmitri (2022) “The art of being together: How group play can increase reciprocity, social capital, and social status in a multiplayer online game”, Computers in Human Behavior, 133: 1-11
Tahlyan, Divyakant; Stathopoulos, Amanda and Maness, Michael (2022) “Disentangling social capital – Understanding the effect of bonding and bridging on urban activity participation”, Transportation Research Interdisciplinary Perspectives, 15: 1-15
Ahn, Suhwoo; Lee, Chul-joo and Ko, Yena (2022) “Network social capital and health information acquisition”, Patient Education and Counseling, xxx (xxxx) xxx, pg 1-11
Peterson, Lauren; Comfort, Alison; Hatt, Laurel; van Bastelaer, Thierry (2018) “Extending health insurance coverage to the informal sector: Lessons from a private micro health insurance scheme in Lagos, Nigeria”, Int J Health Plann Mgmt., 33: 662–676, https://doi.org/10.1002/hpm.2519
2Gidey, Meles; Gebretekle, Gebremedhin; Hogan, Mary-Ellen and Fenta, Teferi (2019) “Willingness to pay for social health insurance and its determinants among public servants in Mekelle City, Northern Ethiopia: a mixed methods study”, BMC; 17:2; https://doi.org/10.1186/s12962-019-0171-x
Dartanto, Teguh; Pramono, Wahyu; Lumbanraja, Alvin; Siregar, Chairina; Bintara, Hamdan; Sholihah, Nia (2020) “Enrolment of informal sector workers in the National Health Insurance System in Indonesia: A qualitative study”, Heliyon, 6: e05316, pp 1-12
Doetinchem, Ole; Carrin, Guy and Evans, David (2010) “Thinking of introducing social health insurance? Ten questions” World Health Report, Background Paper, No 26
Eberhardt, Wiebke; de Bruin, Wändi and Strough, JoNell (2019) “Age differences in financial decision making: The benefits of more experience and less negative emotions”, J Behav Dec Making, 32: 79–93.
Worthy, Darrell; Gorlick, Marissa; Pacheco, Jennifer; Schnyer, David and Maddox, Todd (2011) “With Age Comes Wisdom: Decision-Making in Younger and Older Adults”, Psychol Sci., 22(11): 1375–1380. doi:10.1177/0956797611420301
de Bruin, Wändi (2016) “How ageing affects the way we make decisions”, The Conversation, 17 June, accessed at https://theconversation.com/how-ageing-affects-theway-we-make-decisions- 332 58607#:~:text=How%20ageing%20affects%20the%20way%20we%20make%C2%A0de cisions, 9 July 2022
Oyedeji, Olanrewaju (2022) “Nigerian Health Insurance Schemes you can Benefit From”, Dataphyte, 5 February, accessed at https://www.dataphyte.com/latestreports/health/nigerian-health-insurance-schemes-you-can-benefit-from/, on 9 July,
Yusuf, Kabir (2022) “Nigeria’s minimum wage grossly inadequate, can’t meet basic nutritional needs of an adult – Report”, Premium Times, 21 January, accessed at https://www.premiumtimesng.com/news/headlines/507087-nigerias-minimum-wagegrossly-inadequate-cant-meet-basic-nutritional-needs-of-an-adult-report.html, on 13August 2022
Abdulkadri, Abdullahi; Cunningham-Myrie, Colette and Forrester, Terrence (2009) “Economic burden of diabetes and hypertension in Caricom States”. Social and Economic Studies, 58 (3/4): 175-197
Okoronkwo, Ijeoma; Ekpemiro, Jessie; Okwor, Edna; Okpala, Pat and Adeyemo, Florence (2015) “Economic burden and catastrophic cost among people living with type2 diabetes mellitus attending a tertiary health institution in south-east zone, Nigeria”, BMC Res Notes, 8:527, DOI 10.1186/s13104-015-1489-x
Yunusa, U; Irinoye, O; Suberu, A; Garba, AM; Timothy, G; Dalhatu, A and Ahmed, S (2014) “Trends and Challenges of Public Health Care Financing System in Nigeria: The Way Forward”, IOSR Journal of Economics and Finance (IOSR-JEF), 4(3): 28-34
OECD (2017) “Sources of health care financing”, in Health at a Glance 2017: OECD Indicators, OECD Publishing, Paris, DOI: https://doi.org/10.1787/health_glance-2017-47-en
Onwujekwe, Obinna; Mbachu, Chinyere; Ezenwaka, Uche; Arize, Ifeyinwa and Ezumah, Nkoli (2020) “Characteristics and Effects of Multiple and Mixed Funding Flows to Public Healthcare Facilities on Financing Outcomes: A Case Study From Nigeria”, Frontiers in Public Health, 7:403, doi: 10.3389/fpubh.2019.00403, pp 1-13
Uzochukwu, BSC; Ughasoro, MD; Etiaba, E; Okwuosa, C; Envuladu, E and Onwujekwe, OE (2015) “Health care financing in Nigeria: Implications for achieving universal health coverage”, Nigerian Journal of Clinical Practice, 18(4): 437-444
Preker, Alexander and Langenbrunner, John (2005) “Spending Wisely - Buying Health Services for the Poor”, The International Bank for Reconstruction and Development / The World Bank, pp 1-413
Bump, Jesse; Sparkes, Susan; Tatar, Mehtap and Çelik, Yusuf (2014) “Turkey on the way of universal health coverage through the health transformation program (2003–13)”, Editors: Aran, Meltem and Rokx, Claudia, The International Bank for Reconstruction and Development / The World Bank Group, Discussion Paper
Ujunwa, FA; Onwujekwe, O and Chinawa, JM (2014) “Health services utilization and costs of the insured and uninsured under the formal sector social health insurance scheme in Enugu metropolis South East Nigeria”, Nigerian Journal of Clinical Practice, 17(3): 331-335 URL: http://dx.doi.org/10.14738/jbemi.95.13105 333
Sakunphanit, Thaworn (2015) “Universal Health Care Coverage Through Pluralistic Approaches: Experience from Thailand”, International Labour Organisation Subregional Office for East Asia, pp 1-27
Abodunrin, Olugbemiga; Bamidele, James; Olugbenga-Bello, Adenike and Parakoyi, Dauda (2010) “Preferred Choice of Health Facilities for Healthcare among Adult Residents in Ilorin Metropolis, Kwara State, Nigeria”, International Journal of Health Research, 3(2): 79-86
Connell, Thomas (2012) “National health insurance in Asia and Africa: Advancing equitable Social Health Protection to achieve universal health coverage”, UNICEF
Ejughemre, Ufuoma; Agada-Amade, YA; Oyibo, PG and Ugwu, IC (2015) “Healthcare financing in Nigeria: A systematicreview assessing the evidence of the impact ofhealth insurance on primary health care delivery”, Journal of Hospital Administration, 4(1): 1-8
HIAA (no date) “An Employer’s Guide to Long-Term Care Insurance”, Health Insurance Association of America, pp 1-8
Onoka, Chima; Onwujekwe, Obinna; Uzochukwu, Benjamin and Ezumah, Nkoli (2012) “Why are states not adopting the formal sector programme of the NHIS and what strategies can encourage adoption?”, Policy Brief
Kutzin, Joseph (no date) “Health Insurance for the Formal Sector in Africa: Yes, But...”, Sustainable Health Care Financing in Southern Africa
Onoka, Chima; Onwujekwe, Obinna; Uzochukwu, Benjamin and Ezumah, Nkoli (2013) “Promoting universal financial protection: constraints and enabling factors in scaling-up coverage with social health insurance in Nigeria”, Health Research Policy and Systems, 11:20 http://www.health-policy-systems.com/content/11/1/20, doi:10.1186/1478-4505-11-20, pp 1-10
Onwujekwe, Obinna; Ezumah, Nkoli; Mbachu, Chinyere; Obi, Felix; Ichoku, Hyacinth; Uzochukwu, Benjamin and Wang, Hong (2019) “Exploring effectiveness of different health financing mechanisms in Nigeria; whatneeds to change and how can it happen?”, BMC Health Services Research, 19:661, https://doi.org/10.1186/s12913-019-4512-4, pp 1-13
Akwaowo, Christie; Umoh, Idongesit; Motilewa, Olugbemi; Akpan, Bassey; Umoh, Edidiong; Frank, Edidiong; Nna, Emmanuel; Okeke, Uchenna and Onwujekwe, Obinna (2021) “Willingness to Pay for a Contributory Social Health Insurance Scheme: A Survey of Rural Residents in Akwa Ibom State, Nigeria”, Front. Public Health, 9: 654362, https://doi.org/10.3389/fpubh.2021.654362, pp 1-9
47Osaro, Benjamin; Jaja, Ishmael and Uzosike, Tondor (2021) “Awareness and Willingness to Participate in Community Health Insurance Scheme among Household Heads in Rivers State Nigeria”, Global Journal of Medical Research: K Interdisciplinary, 21(1): 1-12
48Elegbede, O; Durowade, K; Sanni, T; Ipinnimo, T and Alabi, A (2022) “Assessment of Willingness to pay for Community-Based Health Insurance among Artisans in a selected Community of Ekiti State, Southwest Nigeria”, Ibom Medical Journal, 15(2): 148 - 158
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Amos Oluwasayo Akinremi, Marcellina Oluwatomi Coker, Afolabi Oladimeji Dosunmu, Adedapo Olugbenga Adeniregun, Adebayo Amos Oluwole, Abiodun Richard Amusa, Folarin Opeyemi Edun, Atinuke Yetunde Sennuga, Obed Gaibwedsa

This work is licensed under a Creative Commons Attribution 4.0 International License.