Effectiveness of the Kano State Health Contributory Scheme in Improving Healthcare Accessibility among Polytechnic Staff in Kano State, Nigeria
Abstract
Contributory health insurance schemes have been widely adopted across Nigerian states to address healthcare financing gaps, yet evidence on their institutional-level effectiveness remains limited. This study assessed the effectiveness of the Kano State Health Contributory Scheme (KSHCS) in improving healthcare accessibility among staff of Kano State Polytechnic. A descriptive survey design was adopted, and structured questionnaires were administered to 200 respondents comprising polytechnic staff, healthcare providers, and scheme administrators, selected through stratified random sampling. Data were analyzed using descriptive statistics, and chi-square goodness-of-fit tests were used to assess whether observed response patterns differed significantly from a chance (equal) distribution. Findings show that 52% of respondents were actively enrolled and utilizing the scheme, with over two-thirds reporting at least some reduction in out-of-pocket healthcare expenditure; however, these patterns did not differ significantly from an even distribution (p > .05), indicating substantial variability in beneficiary experience rather than a uniform effect. Two patterns were statistically robust: administrative dissatisfaction was significantly more prevalent than chance would predict (χ² (3) = 10.08, p = .018), as was the unevenness in the ranking of implementation challenges, led by an inadequate number of accredited facilities (χ² (4) = 10.40, p = .034). Respondents nonetheless overwhelmingly supported the continuation of the scheme and recommended digitization, expanded facility coverage, staff training, and stronger awareness campaigns. The study concludes that the KSHCS has made measurable but uneven progress toward improving healthcare accessibility for public institution staff, with administrative weaknesses and facility shortages standing out as statistically significant, targetable constraints. Findings offer practical guidance for policymakers and scheme administrators seeking to strengthen contributory health insurance implementation in Nigeria’s public sector.