EFFIONG COMPARISON OF KNOWLEDGE, ATTITUDE AND UTILIZATION OF THE NATIONAL HEALTH INSURANCE BY WORKERS IN THE TEACHING AND GENERAL HOSPITALS IN CALABAR

EFFIONG COMPARISON OF KNOWLEDGE, ATTITUDE AND UTILIZATION OF THE NATIONAL HEALTH INSURANCE BY WORKERS IN THE TEACHING AND GENERAL HOSPITALS IN CALABAR

Abstract

Introduction: In Nigeria, inequity and poor accessibility to quality health care have been a persistent problem. Many people may not have the money to pay for services when in need. The National Health Insurance Scheme is about a client paying a certain percentage of his salary as
premium to the scheme to enable him or her access affordable care easily when in need. This study compared the knowledge, attitude and utilization of NHIS among health care workers at the General and Teaching Hospitals Calabar.
Methodology: A comparative survey to determine and compare the level of knowledge, attitude, utilization and factors that influence the utilization of the national health insurance among the health care workers in the General and Teaching hospitals in Calabar was conducted between September and November 2010 .
A systematic random sampling method was used to select 503 health care workers. Data was collected from 251 persons from the General hospital and 252 from the Teaching hospital Calabar using a self administered questionnaires. In-depth interviews were conducted with four directors of Health Maintenance Organization (HMOs), Chief medical director (CMD) and Medical superintendent. A checklist of policy positions was also used to further enrich the data from HMO and NHIS desk officers . Quantitative data analysis was done using Epi-info version 3.5.1 statistical soft ware, while qualitative analysis involved themes with FGD and In-depth interviews.
Result: Almost all respondents (99%) from General Hospital and about 90% of respondents from UCTH were aware of the existence of the NHIS. Over three quarters (79%) of the respondents from UCTH had a good knowledge of the NHIS while only 63% of respondents
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from the GHC had good knowledge. The mean knowledge score of respondents from UCTH was 58.2 as compared to 53.7 of that of GHC. The mean score for attitude of respondents from GHC was 74.5 while the mean score for attitude of respondents towards the NHIS for UCTH was 81.7. More than 70% or two thirds of respondents from UCTH agreed with the objectives while only 55% of the respondents from GHC agreed with the objectives of NHIS. The respondents from the teaching hospital had better attitude towards the scheme than respondents from the general hospital. Out of those registered with NHIS 60% of the respondents from GHC had collected their NHIS identification cards while about 72% of the respondents from UCTH had collected their NHIS identification cards.
There was higher level of utilization of the scheme among respondents from Teaching hospital (49. 1%,) as compared to the level of utilization of the scheme from General hospital Calabar (42.2%). More than half of the respondents from both hospitals, 72% from GHC and 82% from UCTH purchased drugs out of pocket. Access to care was less in UCTH though the difference is not statistically significant.
Conclusion: The respondents from the Teaching hospital were knowledgeable, had better attitude towards the scheme and had higher level of utilization of the national health insurance scheme than respondents from the general hospital Calabar. However the study also revealed inadequacy of drugs and delayed issuance of registration cards are militating against the success of the scheme.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

EFFIONG COMPARISON OF KNOWLEDGE, ATTITUDE AND UTILIZATION OF THE NATIONAL HEALTH INSURANCE BY WORKERS IN THE TEACHING AND GENERAL HOSPITALS IN CALABAR

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