Awareness, Acceptance, and Utilization of National Health Insurance Scheme Among Traders in Atakumosa Market, Ilesha Osun State
Chapter One
OBJECTIVE OF THE STUDY
The broad objective of this study is to determine the awareness acceptance and utilization of national health insurance scheme among traders.
OBJECTIVE OF STUDY
The specific objective of this study is to;
- Determine the level of awareness for national health insurance scheme among traders.
- Assess the level of acceptance of national health insurance scheme among traders
- To evaluate the utilization of national health insurance scheme among traders.
CHAPTER TWO
LITERATURE REVIEW
CONCEPT OF HEALTH
Some definition of good health emphasized self-actualization the fulfillment of the individual with normal body function and concept of well-being (Mahler, 2016). Datong (2015) emphasized that health does not only means the fitness of the body but also the soundness of mind and emotion which makes life worth living. WHO has given a comprehensive definition of health as a state physical, mental health and social well being and not merely the absence of disease or infirmity. Physically, the body functions to laid down standard within the range of normal development and functions of all the system. Mentally, the individual realizes his own ability could cope with normal stresses of life, work productive and fruitfully and able to make contribution to his own community. Social well being implies the individual ability to adjust with this social life at home, with people around him and at work place. Ademola(2017) defines health within the context of peace, security, shelter, education, food, stable ecosystem, sustainable resource and social justice and equity. Health is a fundamental human right of the individual, family, and community for this study.
EVOLUTION OF HEALTH INSURANCE
Andersen, (2015) the practice of pooling resources to ensure protection against the risks of ill-health grew mainly out of labour developments, in Mediaeval Europe, craftsmen formed societies. (“guilds”) which in turn created funds to help members in times of distress, due to sickness. Each member contributed to the fund on a regular basis.
The threat to the individual worker’s earnings because of illness was seen as a risk to be shared and from the late eighteenth and early nineteenth century’s groups of workers and small farmers in the same industry or location formed sickness funds as mutual benefit societies to serve this purpose. First cash benefits were provided, and then the guilds asked doctors to certify sickness. To ensure services for their members, some guilds then began to contract with providers on a regular basis, and later to develop their own medical services, particularly in countries with a low supply of doctors and hospital beds. New initiative came from employers: the schemes often becoming compulsory as employers in specific high-risk industries, such as mining made employment conditional upon regular contributions to a fund to cover health care. With these developments, the concept of contributions related to earnings rather than to individual risk became firmly established in some countries (ILO and Pan-American Health Organization). The term health insurance is basically used to describe that form of insurance which pays for almost all medical expenses. It is many times used much more broadly to include insurance covering long term nursing or disability care needs (Quaye, 2017). It is technically defined as a mechanism in which the risk of incurring health care costs are spread over a group of individuals or households (Arhin – Tenkorang, 2016). It may be provided through a private insurance company, agency or provider or from a government – sponsored social insurance program. It may also be on a group basis (e.g by a company to cover its employees) or bought by individual consumers.
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
This chapter aims at providing an overview of the research design, research settings, target population, sampling techniques, Method of data collection, Analysis, and Instrument for data collection, Validity, Reliability and Ethical consideration.
Research design
The research method adopted was descriptive design which was aimed at finding out the level of awareness, acceptance and utilization of National Health Insurance Scheme among traders in Atakumosa market, ilesha, Osun State.
Research setting
This study will be conducted among traders in Atakumosa market in Ilesha East Local Government Area, Osun State. It’s a local government in Osun State. Its headquarters are in lyemogun in the city of Ilesha. It has an area of 71km2 and population of 106,586 at the 2006 census. The postal code of the area is 233. ( National Population Commission of Nigeria).
Target population
The target population for this study were market women in Atakumosa market Ilesha, Osun state.
CHAPTER FOUR
PRESENTATION OF DATA AND ANALYSIS
This chapter deals with presentation of results collected. Three hundred and fifty (350) copies of questionnaires were administered, and three hundred and eleven were duly completed and returned giving a return rate of 88.9%. The responses were tallied and presented in frequency, tables and percentages according to research objectives.
CHAPTER FIVE
SUMMARY OF THE STUDY, CONCLUSIONS AND RECOMMENDATION
Summary of the Study
The main purpose of the study was to assess the awareness acceptance and utilization of national health insurance scheme among traders. The specific objectives were to Determine the level of awareness for national health insurance scheme among traders. Assess the level of acceptance of national health insurance scheme among traders, To evaluate the utilization of national health insurance scheme among traders. Three research questions were set. Relevant literatures were reviewed, including few related empirical studies and the theory of reasoned action and planned behaviour was used to anchor the study. A descriptive survey method was used for the study.
A total population of 350 respondents including all the traders in Atakumosa market, Ilesha. Osun state were sampled using the researcher self developed questionnaires. The instrument was validated by experts, after which 30 of the questionnaires were administered for a pilot study and subjected to split half reliability analysis. Data were analyzed using descriptive statistics such as frequencies, percentages, and inferential statistics such as chi-square. All analysis was done using statistical package for social sciences (SPSS) version 17.
The major findings of the study revealed that respondents have good knowledge of the principles of the scheme like majority of them did not know the percentage they contribute and that of the employers. It was also observed that majority of the respondents are registered with the scheme, but the number of the registered dependents did not tally based on the marital status of the respondents, this depicted lack of confidence in the programme. The respondents were not accessing benefit package as and when due. There are a lot of challenges identified especially out of pocket expenses and delay in issuances of cards. Based on the findings, conclusion was drawn and recommendations made.
Conclusion
Based on the study, the following conclusions were made;
- The number of traders registered with NHIS is impressive, although registration is mandatory.
- Some of the registered members of the scheme did not have identity cards that will enable them access healthcare services.
- Most of the biological dependents of the registered traders were not registered with the scheme.
- All the registered dependents of traders have identity cards that enable them access healthcare services.
- The respondents have knowledge on the benefit package accessible to the registered members of the scheme.
- The respondents indicated that in as much they have accessed healthcare services, but they were not able to access all their due benefit package.
- There are still a lot of challenges encountered by the beneficiaries which include out of pocket expenses, delay in issuance of identity cards and so on.
Recommendations
Based on the findings of this study, the following recommendations are made:
- Stakeholders participation/ input should be incorporated into decision making and oversight of the programme. This implies that the primary traders like the hospitals should have a say in the administration of the scheme because they have direct contact with the beneficiaries of the scheme.
- Transparent information should be made available to both the decision makers and the beneficiaries. This could be done through organizing seminars, workshops, in order to highlight all on the principles guiding the scheme.
- The primary traders should be allowed to have enough health maintenance Organizations (HMOs). This will boost competitions among them which will lead to enhancement in their roles.
- The beneficiaries of the scheme should be allowed to choose their individual Health Maintenance Organizations. This being based on efficiency of the HMOS will motivate the redundant ones to step up in their deliveries of their roles.
- Mandatory registration of staff into the scheme should be enforced, as their own contributions are collected at source whether they are registered or not.
- Supervision and regulation of the HMOs and the primary traders, as they should be accountable for their actions and performances. This is necessary in the disbursement of premium revenue for the provision of healthcare services for the beneficiaries.
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