Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement

African Journal of Primary Health Care & Family Medicine

 
 
Field Value
 
Title Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement
 
Creator Nwanaji-Enwerem, Onyemaechi Bain, Paul Marks, Zoe Nwanaji-Enwerem, Pamaji Staton, Catherine A. Olufadeji, Ayobami Nwanaji-Enwerem, Jamaji C.
 
Subject primary health care; general practice; health systems; national health insurance Nigeria; health insurance; patient satisfaction; systematic review; NHIS; SDG 2030
Description Background: To improve healthcare access and mitigate healthcare costs for its population, Nigeria established a National Health Insurance Scheme (NHIS) in 1999. The NHIS remains Nigeria’s leading vehicle for achieving universal health coverage; nonetheless, questions remain regarding its quality and effectiveness. Studies on patient satisfaction have served as a useful strategy to further understand the patient experience and the efficacy of health systems.Aim: To synthesise current knowledge on patient satisfaction with the NHIS.Methods: The authors performed a systematic review of primary literature from 1999 to 2020 reporting on NHIS patient satisfaction in eight databases (including PubMed, Embase, and Africa-wide Information).Results: This search returned 764 unique records of which 21 met criteria for full data extraction. The 21 qualifying studies representing 11 of the 36 Nigerian states, were published from 2011 to 2020, and found moderate overall satisfaction with the NHIS (64%). Further, when disaggregated into specific domains, NHIS enrolees were most satisfied with provider attitudes (77%) and healthcare environments (70%), but less satisfied with laboratories (62%), billings (62%), pharmaceutical services (56%), wait times (55%), and referrals (51%). Importantly, time trends indicate satisfaction with the NHIS is increasing – although to differing degrees depending on the domain.Conclusion: The beneficiaries of the NHIS are moderately satisfied with the scheme. They consider it an improvement from being uninsured, but believe that the scheme can be considerably improved. The authors present two main recommendations: (1) shorter wait times may increase patient satisfaction and can be a central focus in improving the overall scheme, and (2) more research is needed across all 36 states to comprehensively understand patient satisfaction towards NHIS in anticipation of potential scheme expansion.
 
Publisher AOSIS
 
Contributor
Date 2022-01-13
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — systematic review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/phcfm.v14i1.3003
 
Source African Journal of Primary Health Care & Family Medicine; Vol 14, No 1 (2022); 10 pages 2071-2936 2071-2928
 
Language eng
 
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The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://phcfm.org/index.php/phcfm/article/view/3003/5201 https://phcfm.org/index.php/phcfm/article/view/3003/5202 https://phcfm.org/index.php/phcfm/article/view/3003/5203 https://phcfm.org/index.php/phcfm/article/view/3003/5204
 
Coverage Africa; Nigeria 1999-2020 —
Rights Copyright (c) 2022 Onyemaechi Nwanaji-Enwerem, Paul Bain, Zoe Marks, Pamaji Nwanaji-Enwerem, Catherine A. Staton, Ayobami Olufadeji, Jamaji C. Nwanaji-Enwerem https://creativecommons.org/licenses/by/4.0
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