Facilitators and Barriers to Nurses’ Participation in the National Health Insurance Scheme at a Teaching Hospital in Southeast Nigeria
TL;DR
To achieve universal health coverage in Nigeria, it is necessary to address workload problems, offer incentives, enhance drug supply, and engage nurses in decision making to achieve universal health coverage.
Abstract
Background: The National Health Insurance Scheme (NHIS) was established in Nigeria to improve healthcare access and reduce out of pocket expenditure. However, participation among healthcare professionals, particularly nurses, remains suboptimal. Understanding the facilitators and barriers affecting nurses’ involvement is critical for strengthening the scheme. Objective: To identify facilitators promoting participation and to assess individual and organizational barriers hindering participation among nurses at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka, Anambra State. Methods: A cross-sectional survey was used to conduct a descriptive survey on 184 registered nurses who were chosen through multistage sampling. The structured validated questionnaire was used to collect the data. The SPSS version 28 was used to analyze the descriptive statistics such as means, frequencies, and percentages. The scale was a 5 points Likert scale with the mean scores of 3.41 and above being regarded as agreement. Results: Most of the respondents were women (61%), with an age between 28 and 37 years (37%), and a Bachelor of Nursing Science degree (50%). The main facilitators were the realization of the benefits of NHIS to the healthcare system, better access to care by patients and the sense of being valued in the implementation of NHIS policies. The significant personal obstacles included lack of involvement in decision making, heavy work load, and lack of incentives. Organizational obstacles comprised of insufficient provision of medicines and equipment, bad grievance systems, and protracted enrolment processes. Conclusion: Although nurses recognize the advantages of NHIS, there are major personal and organizational obstacles that curtail their involvement. To achieve universal health coverage in Nigeria, it is necessary to address workload problems, offer incentives, enhance drug supply, and engage nurses in decision making.