Attitude And Utilization Of National Health Insurance Scheme Among Nurses In Federal University Teaching Hospital Owerri

Abstract

This study assessed the attitudes and utilization of the National Health Insurance Scheme (NHIS) among nurses at Federal University Teaching Hospital, Owerri (FUTHO), and identified factors influencing their attitudes and utilization of the scheme. A descriptive cross-sectional survey design was adopted for the study. The target population comprised 130 registered nurses working at FUTHO, while data were analyzed from 100 completed questionnaires using descriptive statistics, including frequencies, percentages, means, and grand mean scores. Findings revealed that nurses generally exhibited a negative attitude towards the NHIS, with a grand mean score of 2.43, which was below the decision criterion of 2.50. Most respondents expressed nonchalant feelings towards the scheme and questioned its continuity. Despite the negative attitude observed, the level of utilization was relatively high, with 75% of respondents reporting that they utilized the NHIS, while 25% did not. Among the users, 53% reported always utilizing the scheme, 25% seldom utilized it, 15% rarely utilized it, and 7% never utilized it. Furthermore, the majority of respondents (80%) had been registered with the scheme for one to five years. The study also identified several factors affecting attitudes and utilization of NHIS among nurses. These included gender, location and distance to NHIS facilities, accessibility to healthcare services, poor reception, expensive drugs, and environmental conditions, with an overall grand mean score of 2.92 indicating significant influence. However, long queues and insufficient funds were not perceived as major influencing factors. The study concludes that although nurses at FUTHO generally hold negative attitudes toward the NHIS, the scheme enjoys substantial utilization among them. Factors related to accessibility, service delivery, and healthcare facility characteristics significantly influence both attitudes and utilization. The study recommends strengthening awareness campaigns, improving service delivery, enhancing accessibility to NHIS-accredited facilities, and addressing identified barriers to improve nurses’ perceptions and sustained utilization of the scheme.