National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure?
Background The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if househo...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Kerman University of Medical Sciences
2014-05-01
|
| Series: | International Journal of Health Policy and Management |
| Subjects: | |
| Online Access: | http://www.ijhpm.com/pdf_2837_a1c2a72b48a82940a19afb06e2e8f6f6.html |
| _version_ | 1818176661377515520 |
|---|---|
| author | Olayinka Stephen Ilesanmi Akindele Olupelumi Adebiyi Akinola Ayoola Fatiregun |
| author_facet | Olayinka Stephen Ilesanmi Akindele Olupelumi Adebiyi Akinola Ayoola Fatiregun |
| author_sort | Olayinka Stephen Ilesanmi |
| collection | DOAJ |
| description | Background
The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE.
Methods
The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done.
Results
The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000–680,000 naira (46.7–4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1–118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3–16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant
Conclusion
Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE. |
| first_indexed | 2024-12-11T20:19:44Z |
| format | Article |
| id | doaj.art-52f8504a3f9b482c93619cc66639008b |
| institution | Directory Open Access Journal |
| issn | 2322-5939 2322-5939 |
| language | English |
| last_indexed | 2024-12-11T20:19:44Z |
| publishDate | 2014-05-01 |
| publisher | Kerman University of Medical Sciences |
| record_format | Article |
| series | International Journal of Health Policy and Management |
| spelling | doaj.art-52f8504a3f9b482c93619cc66639008b2022-12-22T00:52:06ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392322-59392014-05-012417518010.15171/ijhpm.2014.39National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure?Olayinka Stephen Ilesanmi0Akindele Olupelumi Adebiyi1Akinola Ayoola Fatiregun2Department of Community Health, Federal Medical Centre, Owo, Ondo State, NigeriaDepartment of Community Health, Federal Medical Centre, Owo, Ondo State, Nigeria; Department of Preventive Medicine and Primary Care, College of Medicine, University of Ibadan, Ibadan, Oyo State, NigeriaDepartment of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Oyo State, NigeriaBackground The major objective of the National Health Insurance Scheme (NHIS) in Nigeria is to protect families from the financial hardship of large medical bills. Catastrophic Health Expenditure (CHE) is rampart in Nigeria despite the take-off of the NHIS. This study aimed to determine if households enrolled in the NHIS were protected from having CHE. Methods The study took place among 714 households in urban communities of Oyo State. CHE was measured using a threshold of 40% of monthly non-food expenditure. Descriptive statistics were done, Principal Component Analysis was used to divide households into wealth quintiles. Chi-square test and binary logistic regression were done. Results The mean age of household respondent was 33.5 years. The median household income was 43,500 naira (290 US dollars) and the range was 7,000–680,000 naira (46.7–4,533 US dollars) in 2012. The overall median household healthcare cost was 890 naira (5.9 US dollars) and the range was 10-17,700 naira (0.1–118 US dollars) in 2012. In all, 67 (9.4%) households were enrolled in NHIS scheme. Healthcare services was utilized by 637 (82.9%) and CHE occurred in 42 (6.6%) households. CHE occurred in 14 (10.9%) of the households in the lowest quintile compared to 3 (2.5%) in the highest wealth quintile (P= 0.004). The odds of CHE among households in lowest wealth quintile is about 5 times. They had Crude OR (CI): 4.7 (1.3–16.8), P= 0.022. Non enrolled households were two times likely to have CHE, though not significant Conclusion Households in the lowest wealth quintiles were at higher risk of CHE. Universal coverage of health insurance in Nigeria should be fast-tracked to give the expected financial risk protection and decreased incidence of CHE.http://www.ijhpm.com/pdf_2837_a1c2a72b48a82940a19afb06e2e8f6f6.htmlNational Health Insurance Scheme (NHIS)Catastrophic Health Expenditure (CHE)HouseholdsWealth QuintilesCostHealthcare Utilization |
| spellingShingle | Olayinka Stephen Ilesanmi Akindele Olupelumi Adebiyi Akinola Ayoola Fatiregun National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure? International Journal of Health Policy and Management National Health Insurance Scheme (NHIS) Catastrophic Health Expenditure (CHE) Households Wealth Quintiles Cost Healthcare Utilization |
| title | National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure? |
| title_full | National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure? |
| title_fullStr | National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure? |
| title_full_unstemmed | National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure? |
| title_short | National Health Insurance Scheme: How Protected Are Households in Oyo State, Nigeria from Catastrophic Health Expenditure? |
| title_sort | national health insurance scheme how protected are households in oyo state nigeria from catastrophic health expenditure |
| topic | National Health Insurance Scheme (NHIS) Catastrophic Health Expenditure (CHE) Households Wealth Quintiles Cost Healthcare Utilization |
| url | http://www.ijhpm.com/pdf_2837_a1c2a72b48a82940a19afb06e2e8f6f6.html |
| work_keys_str_mv | AT olayinkastephenilesanmi nationalhealthinsuranceschemehowprotectedarehouseholdsinoyostatenigeriafromcatastrophichealthexpenditure AT akindeleolupelumiadebiyi nationalhealthinsuranceschemehowprotectedarehouseholdsinoyostatenigeriafromcatastrophichealthexpenditure AT akinolaayoolafatiregun nationalhealthinsuranceschemehowprotectedarehouseholdsinoyostatenigeriafromcatastrophichealthexpenditure |