A Comparative Assessment of the Knowledge, Enrolment and Factors Affecting the Utilization of National Health Insurance Scheme among Women Attending Antenatal Care in a Secondary and Tertiary Health Facility in Benin City, Nigeria

Abstract

Background: Health insurance is a risk-pooling prepayment of healthcare cost and this study assessed the knowledge, enrolment and factors affecting the utilization of the National Health Insurance Scheme by women attending Antenatal Care in Benin City, Nigeria. Methodology: A comparative cross-sectional study conducted among 604 pregnant women attending antenatal care in Central Hospital Benin and University of Benin Teaching Hospital in Benin City, Nigeria. Respondents were selected through a multistage sampling technique and data collected using self-administered semi-structured questionnaires, analyzed using IBM SPSS version 22.0 with level of significance set at p < 0.05. Results: Thirty one (9.8%) respondents attending antenatal care in the secondary healthcare center were enrolled in the National Health Insurance Scheme compared to 21 (15.8%) respondents in the tertiary healthcare center. For 191 (66.8%) respondents in secondary health center, poor knowledge was responsible for non-enrolment in the Scheme compared to 67(59.8%) in the tertiary health center (p = 0.191). While inadequate funds was the hindrance to enrolment into health insurance, the absence of drugs/equipment was the major challenge to the utilization of health insurance services (p = 0.869). Conclusion: Although awareness of National Health Insurance Scheme among the respondents was high, knowledge was poor. Enrolment into the scheme was almost two times higher among respondents in tertiary healthcare facility compared to the secondary healthcare facility. The absence of drugs, cost of registration and poor quality of services were major barriers to utilization of the National Health Insurance Scheme services.