Assessment of patients' satisfaction with healthcare services provided under the Nigeria national health insurance authority.

Abstract

Background: The Nigeria National Health Insurance Authority (NHIA) is the official Social Health Insurance Agency of the Federal Government established to provide quality healthcare services to Nigerians at affordable cost, sufficient to address catastrophic health expenditures. One key indicator of quality healthcare services is patient satisfaction. This National Survey aimed to assess enrollees' satisfaction with healthcare services under this organization.

Methodology: This was a cross-sectional, observational study conducted among enrollees of NHIA in four Nigerian cities (Aba, Kano, Lagos, and Onitsha) from three randomly selected geopolitical zones of the federation. A sample size of 1,043 was proportionately allocated to the study states based on the number of enrollees in the state (Aba 204; Kano 250; Lagos 359 and Onitsha 230). Data were collected as exit interviews with adapted validated interviewer-administered questionnaires. Quantitative data were analyzed using a statistical package for social science (SPSS v. 21). Logistic regression was done to determine predictors of satisfaction with services. A p-value of <0.05 was considered statistically significant.

Results: A total of 1043 respondents were interviewed, with 451 from private healthcare facilities and 592 from public facilities. There were 599 (57.49) dependents and 444 (42.62) principal enrollees. The majority, 608 (58.3%) were females. The mean age of respondents was 38.83 years and 679 (65.1%) had tertiary education. Overall, 928 (89%) of the respondents were satisfied with NHIA healthcare services with the following predictors: marital status, time spent in the hospital, and services received from healthcare providers.

Conclusion: Most of the study participants were satisfied with the services provided by the Authority. However, there are identified limitations and administrative challenges at the facility levels that need attention to further enhance quality services and overall patients' satisfaction.