An Assessment of Enrollees’ Knowledge and Satisfaction with Delta State Contributory Health Scheme: A Cross- Sectional Survey of Civil Servants in Delta State, Nigeria https://doi.org/10.60787/NMJ-64-5-330

Main Article Content

Emmanuel Nonyelum Onyebadi
Ibobo Mike Enemuwe
Nyemike Simeon Awunor
Patrick Oyibo

Keywords

Knowledge, Satisfaction, Contributory health scheme, Delta State, Nigeria

Abstract

Background: Delta State Contributory Health Scheme (DSCHS) was established to provide quality and affordable healthcare services to all Deltans, irrespective of socioeconomic status and geographical location. This study assessed the knowledge and satisfaction of formal sector enrollees with the Delta State Contributory Health scheme.


Methodology: This was a cross-sectional descriptive study involving 400 public/civil servants enrolled in DSCHS using a multistage sampling technique. Data was collected using an interviewer-administered structured questionnaire and was analyzed using IBM SPSS version 25.0 software.


Results: The study revealed that 207 (51.7%) of the respondents were males, while 193 (48.3%) were females. Two hundred and five (51.2%) of the respondents were within the age group of 43 – 52 years, and 353 (88.2%) of the respondents had tertiary education. Overall, 296 (74.0%) of the respondents had good knowledge, and 104 (26.0%) had poor knowledge of DSCHS; while 138 (52.1%) of the respondents were unsatisfied with DSCHS and 127 (47.9%) were satisfied with the scheme. Age (X2 = 19.67; P<0.001), gender (X2 = 8.53; P=0.004), education (X2 = 20.52; P<0.001), marital status (X2 = 14.13; P=0.001), religion (X2 = 13.12; P=0.001) and years of working experience (X2 = 39.66; P<0.001) was significantly associated with knowledge of DSCHS. The factors significantly associated with satisfaction with DSCHS were ethnicity (X2 = 14.39; P=0.013) and years of working experience (X2 = 11.23; P=0.024).


Conclusion: The majority of the study participants had good knowledge regarding DSCHS but were unsatisfied with the level of services provided by the scheme. It is therefore recommended that Delta State Contributory Health Commission should review its benefits package and urgently scale up services to improve enrollees' satisfaction with the scheme.

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References

1. Asante A, Price J, Hayen A, Jan S, and Wiseman V. Equity in Health Care Financing in Low- and Middle-Income Countries: A Systematic Review of Evidence from Studies Using Benefit and Financing Incidence Analyses. PLoS One, 2016; 11 (4): e0152866.

2. Chisholm D, Docrat S, and Abdulmalik J. Mental Health Financing Challenges, Opportunities and Strategies in Low- and Middle-Income Countries: Findings from the Emerald Project. BJPsych Open, 2019; 5 (5): 68

3. Lagarde M and Palmer N. The Impact of Health Financing Strategies on Access in Low and Middle Income Countries: Protocol. Cochrane Database of Systematic Reviews; 2018; (4): CD006092.

4. Jimmy AI, Boateng KA, Twum P, Larbie D, Bangura A, Conteh MH, and Agyei-Baffour P. Population Characteristics and their Implications on the Benefit Basket of National Social Health Insurance Scheme in Sierra Leone: A Prospective View. Adv Public Health; 2021; 1-10

5. Carapinha JL, Ross-Degnan D, Desta AT and Wagner AK. Health Insurance Systems in Five Sub-Saharan African Countries: Medicine Benefits and Data for Decision Making. Health Policy Amst Neth; 2011; 99(3): 193-202.

6. Okiche EL, Okiche CY, Isife CT, Obi-Ochiabutor CC, and Ogbuabor CA. Health Care Payment Practice, Perception and Awareness of National Health Insurance Scheme by Market Women in Enugu Metropolis South-East Nigeria. PAMJ; 2015; 40: 127.

7. Delta State Contributory Health Scheme, operational guidelines. 2015. [cited 02 February, 2023]. Available at: https://dschc.org.ng/DSCHS-Operational-Guidelines.pdf

8. Delta State Contributory Health Commission (DSCHC) Law, 2015. [cited 02 February, 2023]. Available at: https://www.dschc.org.ng/DSCHC_LAW.pdf

9. Delta State Contributory Health Commission (DSCHC). [cited 02 February 2023] Available at: https://www.dschc.org.ng/index.html

10. Ononokpo E. Overview of National Health Insurance Scheme: A paper presented at the 3rd Junior Staff Workshop; Abuja. 2010.

11. Delta state government. [cited 02 February, 2023]. Available at: https://www.deltastate.gov.ng/

12. Delta state government MDAS. [cited 02 February, 2023]. Available at: https://www.deltastate.gov.ng/mdas/

13. Cochran WG. Sampling Techniques. John Wiley & Sons, Hoboken. 2007.

14. Yusuf HO, Kanma-Okafor OJ, Ladi-Akinyemi TW, Eze UT, Egwuonwu CC, and Osibogun AO. Health Insurance Knowledge, Attitude and the Uptake of Community-Based Health Insurance Scheme among Residents of a Suburb in Lagos, Nigeria. West African journal of medicine, 2019; 36(2): 103–111.

15. Mohammed SI, Busayo AE, Dambam SM, Ndagi JS, and Shu’aibu LA. Factors Determining Enrollee’s Choice of Private and Public Healthcare Providers of Community-Based Health Insurance Scheme in Edu Lga Kwara State. European Journal of Health Sciences, 2022; 7(6): 34–44.

16. Kongmany C, Bounfeng P, Bouaphat P, Vanpahnom S, Jo D, and Essink DR. Factors affecting knowledge of National Health Insurance Policy among out-patients in Lao PDR: an exit interview study. Global Health Action, 2020; 13(sup2).

17. Aderibigbe AS, Aganaba D, Osagbemi GK, and Aderibigbe A. Knowledge, Practice and Willingness to Participate in Community Health Insurance Scheme among Households in Nigerian Capital City. Sudan Journal of Medical Sciences, 2017; 12(1): 9 – 18.

18. Suleiman YS, Mukhtar M, Nasir L, and Yahaya RJ. Knowledge of Community-Based Health Insurance among Residence of Katsina state, Nigeria: A comparative cross-sectional study. Texila International Journal of Academic Research. 2022; Available at: https://doi.org/10.21522/TIJAR.2014.SE.22.01.Art006.

19. Abiola AO, Ladi-Akinyemi TW, Oyeleye OA, Oyeleke GK, Olowoselu OI, Abdulkareem, AT. Knowledge and Utilization of the National Health Insurance Scheme among adult patients attending a tertiary health facility in Lagos State, South-Western Nigeria. Afr J Prm Health Care Fam Med. 2019; 11(1): a2018.

20. Abdulraheem SI. Experience and Satisfaction with State-Based Health Insurance Scheme (SBHIS) among Enrolees’ Attending Accredited Health Care Facilities in Kano State, North West Nigeria. Texila International Journal of Public Health, 2020; 8(3): 191–203.

21. Haile M, Hassen SL, and Temesgen MM. Client Satisfaction on Community-Based Health Insurance Scheme and Associated Factors at Boru Meda Hospital, Northeast Ethiopia: Institutional Based Cross-sectional Study. BMC Health Service Research; 2021; 21: 1287.

22. Ogben C and Ilesanmi OS. Community-based health insurance scheme: Preferences of rural dwellers of the federal capital territory Abuja, Nigeria. Journal of Public Health in Africa, 2018; 9(1): 54–59.

23. Ajeigbe AK, Ayinbuomwan E, Adesina OM, Adedeji TA and Makinde RA. National Health Insurance Scheme: An Assessment of Service Quality and Clients' Dissatisfaction. Ethiop J Health Sci; 2020; 30 (5): 795-802.

24. Okafor UG. Assessment of Knowledge Attitude Perception and Practice of Health Insurance Scheme among Community Pharmacies in Lagos State. Texila International Journal of Public Health, 2016; 4(4): 308–317.